In my 28 year career, I have noticed one of the biggest causes of relapse for people in recovery is the abuse of prescription medications. This is even the case for recovering people with decades of abstinence. It is critical that addicts and alcoholics be extremely careful when and if they are being prescribed addictive and mood-altering medications because they can easily trigger a regression back to old addictive patterns. My philosophy is that we need to do more to teach the recovering person what to do “when they have to take medications, not if they have to take medications” because sooner or later most all of us are going to have some medical procedure where medications will be prescribed. And remember, pain is just as much a threat to one’s recovery as pain medication, so we have got to help people get through these difficult situations and maintain their recovery. This article offers some concrete information and suggestions that can help to avoid a relapse.
Many addicts and alcoholics have relapsed following a “legitimate reason” to take prescription medications. Some medications are harmless and do not necessarily pose a threat to one’s recovery, anti-depressants for example, are less likely to trigger cravings. However once the recovering person takes an addictive, mood-altering medication such as pain medications, sleeping pills, anxiety medications, and/or muscle relaxants, there is great risk that the addictive disease will “wake-up”. And once awake the disease will often demand more of the drug and a return to old addict behavior, like lying and manipulating to stay high.
Often times the recovering person is not aware or prepared for the risk. He or she may not know to ask for non-narcotic pain medications. The addict may defer to the prescribing physician’s expertise, assuming that the doctor knows what to do, but many doctors have very little training in how to deal with addiction. They may inadvertently prescribe medication that can start the disease process in motion. It is extremely important to know what medications you are taking and what the abuse potential is and whether the drug is addictive and mood altering. Just because a doctor prescribed it doesn’t mean it’s okay. It is the responsibility of the recovering person to protect their recovery. Ask questions, look the drug up online, get feedback and be accountable before you start taking medication.
Even some over the counter medications contain substances can be dangerous for the recovering person. Many cough syrups and mouthwashes contain a very high alcohol content, and some antihistamines contain stimulants. So read the labels very carefully before you start taking something.
The most commonly abused prescription medications:
Physicians are very quick to prescribe pain, sleep and anxiety medications and recovering people need to be extra cautious. Even in addiction treatment we are seeing the enormous lobbying of pharmaceutical companies advocating for medication-assisted recovery as the first line of defense.
Some managed care policies are actually blocking attempts to place opiate addicts in their late teens into residential treatment, mandating that these young people be seen instead by buprenorphine-prescribing physicians in private practice. Hospitals have very strong policies regarding pain and are eager to prescribe pain medications to assure that patients have little or no discomfort. This makes their jobs easier but puts the patient at enormous risk for dependence.
So here are some suggestions that may help a recovering person avoid a relapse:
Before you take medications:
When you have to take medications:
Once the need for the medication is done:
In summary; the key to avoiding relapse here is to advocate for your own recovery, be honest and open about your thoughts, feelings, urges and behaviors… and most of all stay accountable. The biggest danger is going underground and not letting the key people in your support system know what’s going on. I have seen many addicts relapse and some even die, because they were unwilling or unable to reach out and ask for help when they were struggling.