Medications Recovering Addicts Should Avoid After Rehab

Recovery is an ongoing process, fraught with constant challenges. Whether you’re dealing with everyday stress or are around friends who use drugs or drink alcohol, it can be all too easy to slip and slide backward.

One of these challenges includes avoiding medications that may interfere with your recovery. Even if your doctor prescribes you a medication for a legitimate reason, it can make you relapse, depending on its chemical makeup. You did the hard work, went through detox and got healthy. Now it’s time to stay that way, and this means knowing what medications to avoid during recovery.

Detox is Good

First, detox was the foundation of your addiction recovery and was absolutely necessary. When detoxing, you got rid of the poisons in your body, which allowed it to heal. No doubt, your detox experience was long and demanding. Nevertheless, it helped you gain some insight into how your body works and how different chemicals can affect it. It would be unfortunate for you to relapse because you take a medication that gets you craving drugs again.

The problem, however, is that today when you’re looking to relieve pain, fall asleep or treat a cold, it’s too easy to reach into the medicine cabinet for that bottle of pills, or even drive to the drugstore and purchase over-the-counter medications.

As a recovering addict, you can’t afford to do that — at least without knowing if they’re safe for you to take. You have to stop and determine if those couple of pills will threaten your recovery. If so, perhaps you might be better off toughening up and going on with your day with that headache or stuffy nose.

When You Have Conditions that Require Medication

When you’re recovering from a chemical dependency, your treatment goal is to stay healthy and avoid relapse. When your physician knows about your substance abuse history, they must have a nonjudgmental and open attitude about the consequences of taking certain medications.

Your physician should be providing nonpharmacologic treatments to you — and all patients with chemical dependencies, while avoiding prescribing medications that can be addictive when medication is necessary. The good news is that since up to 25 percent of primary care practice patients are seen because of a chemical dependency, it is a chronic and common disease that most physicians have experience with.

The prescription drugs recovered addicts should avoid are the ones that impair judgment or have sedative effects.  If you’re suffering from a psychiatric illness, you should be treated aggressively, since it can increase your risk of relapsing if left untreated. If you’re depressed, your doctor may prescribe selective serotonin reuptake. Trazodone is an effective medication for treating insomnia.

As an overview, you should try nonpharmacologic treatments first, and if they can’t be avoided, you should take non-addictive medications.  If you are suffering from severe pain, it’s not wise to leave it untreated. Many of the OTC medications are not effective enough for severe pain, and uncontrolled pain can cause you to relapse. If your doctor has exhausted all nonpharmacologic and non-addictive options and you require a long-acting opiate, you should use them under strict supervision.

Understanding Cross-Addiction

Cross-addiction occurs when one who has struggled with addiction exposes the hypothalamus or mesolimbic system to new chemicals or drugs. This can result in a return to the original drug of dependency.

Take for example a recovered alcoholic who is not supposed to have alcohol in any form. They visit their doctor for pain and don’t tell him about their history of alcohol abuse. With good intentions, their physician prescribes them with a narcotic medication that’s great for pain management. Unfortunately, there is a high probability that it will lead the recovered alcoholic back to alcohol. This is just another reason as to why it’s so important that you know which medications to avoid during recovery.

Medications Recovered Addicts Should Avoid

Unfortunately, being a recovered addict means you’ll l have to avoid certain medications. This can be tricky, especially if you legitimately need them. You have to read all medication labels carefully since some could contain secondary ingredients with addictive properties.

It’s also a good idea to know some common medications (prescriptions, OTCs or Herbal) that you should avoid. This guide will help.

Rx (Prescription) Drugs

Remember, letting your doctor know about your addiction and recovery is important so he can mark it in your charts. This will ensure there are no mistakes made when he prescribes medications to you. If you’re ever unsure if you should take a certain medication or not, simply consult with your addictionologist, psychiatrist or treatment facility professional.

Most mood stabilizers and antidepressants are fine when recommended by a physician. They’re even encouraged in some cases since they can help keep your mood stable in your recovery.

Certain prescription drugs to avoid during recovery include pain, stimulants, sedatives, muscle relaxers, and antidiarrheals.

Pain Medication

In many cases, medication taken because of pain can often lead to abuse. Narcotics and psychoactive medications are strong pain relievers derived from opium. These types of drugs are not acceptable for you or your loved one with an addiction to take. Even when used appropriately, psychotropic and opioid medications pose a high risk of relapse. However, at the same time, there is a high risk of relapse associated with inadequate pain management.

These drugs are used often in pain management to interrupt the central nervous system’s pain messages. When it comes to healing properly, reducing pain down to levels that are manageable is an important component. Nevertheless, since opium and opiates are very addictive, it becomes a problem when you are recovering from an addiction.

Managing pain for the five to 17 percent of the population in the U.S. that have a substance abuse disorder causes unique challenges for primary care doctors. If you’re one of these people, when you walk into your doctor’s office complaining of pain, chances are you’ll walk out without having received adequate pain management.  Therefore, physicians face the challenges of distinguishing between whether you’re actually in need of pain relief or if you’re looking for medications to get the euphoric effects they offer.

Examples of some types of pain medication and muscle relaxers you are encouraged to avoid include:

• Soma
• Darvocet
• Darvon
• Hydrocodone
• Fentanyl
• Demerol
• Oxycodone
• Opium
• Percocet
• Ultram
• Morphine Sulfate
• Codeine
• Hydromorphone
• Fioricet
• Fiorinal

Overdose and addiction are serious challenges, but when you are in recovery, they can be life-threatening. Taking any kind of narcotic painkiller is not a good idea when you are recovering from an addiction.

This is especially true if you were addicted to opiates. Even when prescribed by your doctor, taking another opiate is dangerous. During recovery, you are re-training your mind and body addiction. So, if you take any, even in small amounts, you’ll jeopardize your recovery.

Allergies/Colds

You should avoid prescription antihistamines like Zyrtec since they are mood altering and sedating. Similarly, you should also avoid Allegra D, Claritin D and other antihistamines with decongestants. If you have rhinitis from a cold or allergies, Atrovent nasal solution is an effective option.

Examples of allergy/cold medications to avoid include:

• Ambenyl
• Ah-Chew D
• Endal HD
• Efidac
• Hycomine
• Hycodan
• Temaril
• Pyrilamine Maleate
• Periactin
• Phenergan (w/codeine)
• Propagest
• Tussionex
• Teldrin
• Polaramine
• Nucofed
• PBZ

Dextromethorphan should be avoided since it’s a weak narcotic agonist. If you need to treat a cough, water, expectorants or Tessalon Perles are recommended. If your cough requires a stronger medication, then you would want to use the Dextromethorphan over Hydrocodone or Codeine.

Anti-Diarrheals / Gastrointestinal Upsets

Examples of Gastrointestinal (anti-diarrheals) to avoid include:

• Motofen (atropine/difenoxin)
• Lomotil (atropine/diphenoxylate)

Diphenoxylate belongs in the opioid drug class. To discourage recreational abuse, the drug is formulated with atropine. It doesn’t cause any effects at recommended doses, but when taken at larger doses, it causes unpleasant symptoms. Higher doses could also lead to psychological and physical dependence with continued use.

Examples of OTC medicines for gastrointestinal upsets you should avoid during recovery include Imodium AD Liquid.

While Imodium AD is safe to use, it contains a small amount of alcohol. Motofen and Lomotil (although prescriptions) contain narcotics. These are all things you need to be aware of.

Because they affect the central nervous system, you should use caution when taking Compazine or Phenergan.

Sedatives

Examples of sedative-hypnotics to avoid include:

• Noctec (chloral hydrate)
• Ambien (zolpidem)
• Placidyl (ethchlorvynol)
• Doriden (glutethimide)
• Sonata (zaleplon)
• Sopor (methaqualone)
• Soma Compound (carisoprodol/aspirin)
• Librax (chlordiazepoxide/clidinium)
• Soma (carisoprodol)
• Miltown (meprobamate)
• Midrin (acetaminophen/dichloralphenazone)

These medications act on your central nervous system, which can lead to abuse and drug dependency. If you stop them suddenly, you can experience withdrawal symptoms as well.

Stimulants

Examples of some stimulants you should avoid during recovery include:

• Meridia (sibutramine)
• Metadate (methylphenidate)
• Adderall (amphetamine/dextroamphetamine)
• Cylert (pemoline)
• Concerta (methylphenidate)
• Adipex-P (phentermine)
• Preludin (phenmetrazine)
• Ritalin (methylphenidate)
• Methylin (methylphenidate)
• Tenuate (diethylpropion)
• Dexedrine (dextroamphetamine)
• Fastin (phentermine)
• Focalin (dexmethylphenidate)

You risk both a psychological and physical addiction taking stimulants. They also impair your sight and hearing, learning and memory, problem-solving ability and speed of information processing.

Weight Loss

Orlistat (Xenical) is preferred over stimulant weight loss medications such as ephedra, sibutramine (Meridia) or phentermine (Fastin) or Ma Haung.

OTC Drugs

Minor illnesses like allergies, colds, cough, respiratory and stomach flu are not dangerous by themselves, but when you’re recovering from a substance abuse disorder (or you have a loved one who is), they can cause problems.

It’s important you know what OTC medicines to avoid during recovery. There is a variety of over-the-counter (OTC) medications that overlap and duplicate one another in effect, which can cause a lot of confusion.

In fact, many relapses have occurred because of misinformation regarding OTC medications. Many of the OTC medications have chemical ingredients that mimic the effects of addictive drugs and your brain might not be able to distinguish between them. This can set off some intense cravings.

Even though OTC medications are safe for the general population, they can be harmful and potentially fatal when you’re in recovery. People in recovery (PIRs) tend to be ultra-sensitive to mood-altering drugs, particularly when they are first beginning their recovery. When you have a drug dependency, you react differently than the general population to medications, whether you’re in recovery or active addiction.

Therefore, medications like Benadryl (which is an OTC antihistamine) might be fine for the general population, but not for you. Benadryl and other OTC antihistamines can alter your mood and make it tempting to abuse it. If you require an antihistamine, you should use Allegra, Claritin or another type of non-sedating antihistamine.

You should avoid over-the-counter decongestants like pseudoephedrine or phenylpropanolamine (PPA), particularly if you have a history of abusing stimulants. These also alter your mood and are structurally similar to amphetamines. You quickly build up a tolerance to the effects of pseudoephedrine too. Allegra-D and Claritin-D contain pseudoephedrine, for example, and therefore should be avoided if you are recovering from a drug addiction.

Examples of OTC medicines you should avoid during recovery include:

• Allergy Medications
• Actifed
• Allegra-D
• Benadryl Allergy Relief
• Afrin Nasal Spray
• Cough & Cold Medications
• Alka-Seltzer Plus Cold & Cough
• Benadryl
• Bayer Children’s Cough Syrup
• Chloraseptic Total (throat lozenges)
• Claritin-D
• Sudafed
• Dimetapp
• Chloraseptic Sore Throat Max
• Comtrex
• Sucrets DM Cough Formula
• Benylin Cough
• Ambelyn-D
• Chlor-Trimeton
• Amberlyn Cheracol Plus
• Cheracol D
• NyQuil
• Tylenol Cold
• Delsym
• DayQuil

Many of the OTC cold, cough or pain relief medications contain alcohol, which can trigger cravings or even a relapse. You should check all OTC medications, even mouthwashes. In many cases, several name brands offer both safe and unsafe options for PIRs, such as Vicks, Chloraseptic, Tylenol, and Allegra.

Just remember, these medications themselves are harmless when taken as directed, but this is not the case for you if you’re in recovery. You should also note that some formulations of these medications may change over time, and what may have been a medication to avoid may now be safe to take.

Most laxatives are safe to use for recovered addicts, but stimulant laxatives should be avoided if possible.

Manufacturers change the ingredients in their various formulations, so it is important for you to look at the label closely. When looking at these types of medications, if you need help finding an alternative that is safe for you to use, you can ask the pharmacist.

Herbal Supplements

Besides prescription drugs and over-the-counter medications, another category that you need to be aware of is herbal supplements. Now, vitamins are perfectly fine and are even recommended when you’re living a healthy lifestyle.

Moreover, there are various herbal supplements that are safe as well, but you have to take extreme caution when using them. Some herbal supplements are not safe. These include certain sleep or mood supplements, like Kava, for instance.

Appetite suppressants and weight loss products are a no go as well since they often work like a stimulant. Milk thistle is fine and is supposed to help repair your liver. You don’t want to touch Red Bull (an energy drink) since it also has a stimulant-type effect and loads of caffeine. Some of these energy drinks also contain small amounts of alcohol, so they should be on your avoidance list.

Examples of herbal supplements that you should avoid include:

• John’s Wort
• Kava Kava
• Valerian Root
• Ma Huang

Alcohol

Consuming alcohol reduces your social inhibitions and produces a sense of well-being and pleasure. However, it is also a stimulant and a depressant. It affects the reward pathways of your brain and even interacts with GABA, dopamine, opioid, serotonin, and NMDA neurotransmitter systems. You should even avoid non-alcohol types of beer since they often contain small amounts of alcohol. Even smelling a non-alcoholic beer can trigger a relapse for some alcoholics.

As mentioned earlier, many cold and cough preparations have alcohol in them. Certain soft-gels, topical products, and capsules should also be avoided because they contain ethyl alcohol.

Examples of alcohol-related products you should avoid include:

• Cheracol-D Cough Syrup
• Diphenhydramine Elixir Kay Ciel Liquid
• Dilaudid Cough Syrup
• Phenergan VC Syrup
• Feosol
• Imodium A-D
• Dramamine Liquid
• Dihistine DH Elixir Tussend Syrup
• Tylenol Extra Strength Liquid
• Benylin Cough Syrup Guiatuss AC Syrup
• Vicks Formula 44M
• Tylenol with Codeine Elixir
• Geritol Tonic Liquid
• Elixir Vicks 44 D
• Kaon Liquid
• Vicks 44 E
• Nucofed Expectorant Syrup
• Hycotuss Expectorant Syrup
• Excedrin PM Liquid

Some nasal sprays that you would use for allergic rhinitis, as well as other types of sinus/nasal congestion, have alcohol in them. These types of sprays should be avoided if you’re recovering from an addiction. This is especially true of Nasonex, Flonase, and Antabuse nasal sprays. Many of the mouthwashes have alcohol too, so be sure you check all the labels before you buy.

These are the common medications that you want to stay away from as a recovering substance abuser.  While the list may seem long, it’s intended to bring to your attention some medications and ingredients that could put you at risk for a relapse.

And, above all, if you and your physician, with full knowledge of your history, feel that any of the above medications should be used, then they can be prescribed. However, they must be used with extreme caution and close supervision. In addition, if used, they should only be on a short-term basis. A well-trained physician who understands addiction should be able to provide you with acceptable alternatives and the safest treatment plan.

Medications that are Considered Acceptable for Recovering Addicts

Below is a table of the medications you can use safely for some common conditions. There may be others, and it is best to always speak with your physician about any medication you are thinking of taking.

Medications That Are Fine for Recovering Addicts

Pain/Muscle	Herbals	Sedatives/Sleep Aids	Allergies	Cough/Cold	Anti-Diarrheals & Vomiting
Acetaminophen (Tylenol) Aleve Anacin Ascriptin Aspirin BC Powders Bufferin Dolobid Excedrin Goody’s Powder Ibuprofen (Advil, Motrin) Midol and Midol ib Nuprin Pamprin Vanquish Baclofen (muscle relaxer) NSAIDs Anaprox Celebrex Feldene Lodine Mobic Motrin Naprosyn (naproxen) Relafen Vioxx	Echinacea (immune booster) Gingko Biloba (antioxidant) Melatonin (sleep aid)	Abilify Buspar (buspirone hcl) Desyrel (trazodone) Elavil Geodon Paxil Risperdal Rozerem Seroquel Sinequan (doxepin) Thorazine Trilafon	Allegra (fexofenadine) Clarinex (desloratadine) Claritin, Alavert (loratadine) Zyrtec (cetirizine)	Mucinex (guaifenesin) Tessalon Perles (benzonatate)	Beano Citrucel Dulcolax Gas-X Strips, Chewable Tabs or Gel Caps Imodium Kaopectate Simethicone Bonine Emecheck Emetrol Nausetrol Norzine Octamide Pepto-Bismol Reglan Thorazine Tigan Trilafon Zofran

It is important to point out that manufacturer formulations and ingredients change, so what was once on the acceptable list for a recovering addict, may not always be.

Has Your Treatment Failed if You Relapse?

Because of the chronic nature of substance abuse, relapsing is possible. The good news is there are medications, such as Naltrexone, Subutex, Campral, and others that you can take that will help you manage cravings. Your doctor can direct you to some pharmacologic interventions too. You might have to get some blood work done before you start using any of these medications. You’ll need to use them under counseling medical supervision as part of your ongoing recovery.

Your Successful Recovery is Up to You

Ultimately, successful recovery is up to you. Your goal of recovery should be to live a healthy and clean life. Even if you have friends who take medications a few times a week and seem to live a normal, healthy life, doesn’t mean you can do the same.

Non-addicts don’t have the same chemistry as you do. It doesn’t matter if your substance abuse created this chemistry or if you were born with it, you need to realize you possess it. This doesn’t mean you have to live in pain or with allergies. It just means you have to make wise decisions about the medications you take for these conditions.

It is absolutely possible to live a clean life and reach your goals of happiness. But, you do have to work hard and stay away from anything that will cause you to relapse, and that includes refraining from certain medications. Your body is still learning how to function off your substance of choice and you are healing from emotional challenges as well.

So, before you reach for those pills, even if they are natural remedies, make sure you read the labels and ask about their ingredients. If for some reason, you absolutely have to take a specific medication that could threaten your recovery, you and your doctor can work out a plan on how you’ll take the medication and you’ll be watched carefully by your addiction specialist and your medical doctor.

For additional details on medications that are to be avoided and those that are safe to take for people with a substance abuse condition or are in recovery, the American Academy of Family Physicians has a reference guide to help avoid a relapse into addiction.

If you are in recovery for an addiction and have additional questions about medications, contact us here at JourneyPure At The River.

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