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Drugs to Avoid During Recovery

People in recovery must be cautious when taking both over-the-counter (OTC) or prescription medications. Many OTC medications contain alcohol or other ingredients that could endanger their sobriety by triggering a relapse. Physicians who are not familiar with addiction may prescribe medicines that are not safe for people with a substance use disorder. Be vigilant in protecting your sobriety. Before you take any medication, read the ingredients, ask questions, and use caution. When in doubt, contact your psychiatrist or addictionologist for guidance.

Make sure your physicians are aware that you are a person who has struggled with addiction. Ensure that the chart at your physicians’ offices are marked accordingly so no one can make a mistake in prescribing medications.

As always, never take a medication given to you by someone else without knowing what it is. An unknowing friend or family member can inadvertently cause a setback for a person in recovery. Always follow a doctor’s advice before taking any medication.

Pain Medication and Recovery

Pain medication can be tricky for people in recovery. Most OTC pain relievers are acceptable, such as ibuprofen (Advil, Motrin), naproxen (Aleve), acetaminophen (Tylenol). These medications are very effective for many aches and pains. There are times when people in recovery must have stronger pain medications, such as narcotics, after surgery or for a severe injury. Here are a few guiding principles for pain medications and recovery:

If narcotic medications are necessary and taken only as prescribed by a doctor, this is not considered a relapse. That said, so it is recommended that the recovered person prepare themselves before surgery. Extra recovery support can be critical during this time.
If you must take narcotics, be accountable and transparent with your support system. Tell your sponsor, therapists, recovery friends, and loved ones that you have been prescribed a course of narcotic medication for a set period of time.
When possible, do not handle your own pain medications. Someone close to the person, such as a spouse, sponsor, or trusted recovery friend, should keep the medication and give it only as directed during recuperation.
Discard any leftover pain medications as soon as possible. When in doubt, discard them at your local pharmacy.

While you do not need to suffer from severe pain just because you are a person in recovery, you must be very cautious with pain medications, even those prescribed by a doctor.

CLASS A DRUGS – Absolutely Avoid

The following drugs are considered dangerous to people in recovery and should be avoided.

ANTITUSSIVES/EXPECTORANTS

Any cough medications containing narcotics such as codeine or hydrocodone should be avoided. These medications bind to opiate receptors in the central nervous system, altering the perception of and response to pain and produce generalized central nervous system depression and may alter mood or cause sedation.

  • Ambenyl (codeine/bromodiphenhydramine)
  • Duratuss HD (hydrocodone/dextromethorphan)
  • Guiatuss (codeine/pseudoephedrine/guaifenesin)
  • Hycodan Syrup (hydrocodone/homatropine)
  • Hycodan Tablets (hydrocodone/homatropine)
  • Hycomine (hydrocodone/chlorpheniramine/phenylephrine/acetaminophen/caffeine)
  • Hycotuss (hydrocodone/guaifenesin)
  • Hydromet (hydrocodone/homatropine)
  • Mytussin (codeine/pseudoephedrine/guaifenesin)
  • Nucofed (codeine/pseudoephedrine/guaifenesin)
  • Phenergan with Codeine (codeine/promethazine)
  • Robitussin AC (codeine/guaifenesin)
  • Tussionex PennKinetic (hydrocodone/chlorpheniramine)
  • Vicodin Tuss (hydrocodone/guaifenesin)

BARBITURATES

These medications can produce central nervous system depression ranging from mild (sedation) to hypnotic (sleep induction). As the dose is increased, coma and death can occur. These medications can also lead to an unusual excitatory response in some people.

  • Amytal (amobarbital)
  • Barbita (phenobarbital)
  • Butisol (butabarbital)
  • Donnatal (phenobarbital/atropine/hyoscyamine/scopolamine)
  • Esgic (acetaminophen/butalbital/caffeine)
  • Fioricet (butalbital/acetaminophen/caffeine)
  • Fiorinal (butalbital/aspirin/ caffeine)
  • Nembutal (pentobarbital)
  • Seconal (secobarbital)

BENZODIAZEPINES

The following prescription drugs medications are mood-altering and/or can cause central nervous system depression resulting in sedation, dizziness, confusion or ataxia, which may impair physical and mental capabilities. Abrupt discontinuation or a large decrease in dose can lead to withdrawal, seizures, coma or death. They are frequently misused.

  • Ativan (lorazepam)
  • Centrax (prazepam)
  • Dalmane (flurazepam)
  • Doral (quazepam)
  • Halcion (triazolam)
  • Klonopin (clonazepam)
  • Librium (chlordiazepoxide)
  • Restoril (temazepam)
  • Serax (oxazepam)
  • Tranxene (chlorazepate)
  • Valium (diazepam)
  • Versed (midazolam)
  • Xanax (alprazolam)

HALLUCINOGENS

The category of drugs includes both synthetic and naturally occurring drugs. It is best known for cannabis, most commonly known as marijuana or weed. Using these substances can possibly lead to memory disturbances, psychosis and vivid hallucinations. Marinol is the psychoactive substance in marijuana and may cause withdrawal symptoms if stopped suddenly.

  • 2-CB (dimethoxy-bromophenethylamine)
  • 5-MeO-DMT (foxy methoxy)
  • Cannabis (grass, green marijuana, pot, weed)
  • DMT (dimethyltryptamine)
  • Ketamine (special K)
  • Kratum (Mitragyna speciosa-ketum, kratom or kratum, Thai)
  • LSD (acid, blotter, paper, sunshine, window pane)
  • Marinol (dronabinol)
  • Mescaline (peyote)
  • PCP (angel dust, phencyclidine)
  • Psilocybin (magic mushroom, ‘shrooms)
  • MDMA (E, eckies, ecstasy, love drug, X, XTC)
  • STP (DOM)

INHALANTS

Inhalants are central nervous system depressants. Use of inhalants can cause sedation and loss of inhibitions possibly lead-ing to liver, kidney, nerve, heart, brain, throat, nasal and lung damage up to and including coma and death. Inhalants are the most commonly consumed recreational drugs and their presence is growing stronger. The reason is the wide availability of aerosol sprays and the incredible high a person achieves from using an aerosol inhalant even once.

    • Aerosols (hair sprays, deodorants)
    • Airplane Glue Paint (butane, propane, toluene)
    • Amyl Nitrate (poppers)
    • Butyl Nitrate (room deodorizer)
    • Gases (ether, chloroform, nitrous oxide, butane lighters, propane tanks, whipped cream dispensers)
    • Nail Polish Remover (acetone)
    • Solvents (paint thinner, gasoline, glue, correction fluid, felt tip marker)
    • Varnish (xylene, toluene)

OPIOIDS

Most of the drugs in this category have gained recent notoriety because they have a high potential for substance use disorder and drug dependency. Opioids bind to opiate receptors in the central nervous system causing inhibition of ascending pain pathways and altering the perception of and response to pain. Generalized central nervous system depression is also produced. Tolerance or drug dependence may result from extended use.

  • Buprenorphine binds to receptors in the brain leading to a suppression of withdrawal and cravings but also feeling of euphoria.
  • Actiq (fentanyl oral transmucosal)
  • Buprenex (buprenorphine)
  • Combunox (oxycodone/ibuprofen)
  • Darvocet (propoxyphene napsylate/acetaminophen)
  • Darvon (propoxyphene hydrochloride)
  • Demerol (meperidine)
  • Dilaudid (hydromorphone)
  • Dolophine (methadone)
  • Duragesic (fentanyl transdermal)
  • Endocet (oxycodone/acetaminophen)
  • Heroin (down, H, horse, smack)
  • Kadian (morphine sulfate)
  • Lorcet (hydrocodone/acetaminophen)
  • Methadose (methadone)
  • MS Contin (morphine sulfate)
  • Norco (hydrocodone/acetaminophen)
  • Nubain (nalbuphine HCl)
  • OxyContin (oxycodone)
  • OxyIR (oxycodone)
  • Percocet (oxycodone/acetaminophen)
  • Percodan (oxycodone/aspirin)
  • Roxanol (morphine sulfate)
  • Roxicet (oxycodone/acetaminophen)
  • Roxicodone (oxycodone)
  • Soma Compound with Codeine (codeine/carisoprodol/aspirin)
  • Stadol (butorphanol)
  • Suboxone (buprenorphine/naloxone)
  • Subutex (buprenorphine)
  • Talacen (pentazocine/acetaminophen)
  • Talwin (pentazocine lactate)
  • Tylenol #2, #3 or #4 (codeine/acetaminophen)
  • Ultram (tramadol) (a non-opioid analgesic)
  • Vicodin (hydrocodone/acetaminophen)

GASTROINTESTINAL (ANTI-DIARRHEALS)

Diphenoxylate is a member of the opioid class of drugs. Atropine is added to discourage abuse for recreational purposes. At recommended doses, the atropine causes no effects but in larger doses, unpleasant symptoms are experienced. These medications should not be used because high doses may cause physical and psychological dependence with prolonged use.

    • Lomotil (atropine/diphenoxylate)
    • Motofen (atropine/difenoxin)
    • OTHER CENTRAL NERVOUS SYSTEM DEPRESSANTS
    • GHB (G, gamma-hydroxybutyrate, everclear)

This class of drugs depresses the central nervous system possibly leading to confusion, psychosis, paranoia, hallucinations, agitation, depression, seizures, respiratory depression, decreases in level of consciousness, coma and death.

OTHER SEDATIVE-HYPNOTICS

These drugs act on the central nervous system and have the potential for drug dependency and abuse. Withdrawal symptoms can be seen if stopped suddenly.

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

STIMULANTS

Stimulants cause physical and psychological addiction, impair memory and learning, hearing and seeing, speed of information processing, and problem-solving ability.

  • Adderall (amphetamine/dextroamphetamine)
  • Adipex-P (phentermine)
  • Cocaine (blow, coke, crack, rock, snow, white)
  • Concerta (methylphenidate)
  • Cylert (pemoline)
  • Dexedrine (dextroamphetamine)
  • Fastin (phentermine)
  • Focalin (dexmethylphenidate)
  • Meridia (sibutramine)
  • Metadate (methylphenidate)
  • Methamphetamine (crank, crystal meth, glass, ice, speed)
  • Methylin (methylphenidate)
  • Preludin (phenmetrazine)
  • Ritalin (methylphenidate)
  • Tenuate (diethylpropion)
  • Sonata (zaleplon)