Each person’s recovery process is different. If you have an ongoing health problem, such as diabetes, high blood pressure, or chronic pain, have an open discussion with your doctor about the medication you can safely take during recovery. When possible, discuss this before you leave residential treatment and make medication management a part of your continuing care plan.
It is important to note that some medicines, even when prescribed by a doctor, may increase your risk of relapse. That’s why your physician or addictionologist may want you to try other forms of treatment. Alternative forms of treatment for pain may include:
- Physical therapy or massage therapy
- Applying ice or heat to the area that hurts
- Relaxation techniques and meditation
- Biofeedback or neurofeedback techniques
Your doctor may suggest non-narcotic pain medicines to help relieve pain if other methods don’t work. However, if your doctor prescribes a medication with a potential for abuse, make sure you discuss the risk of relapse. Through open communication and transparency, you and your doctor can work together to find the safest treatment.
Considerations for People in Recovery
Many types of medicine include alcohol or ingredients that could trigger a relapse. These include prescriptions and over-the-counter drugs. Never take any medication without your doctor’s approval, and make sure your doctor knows that you have a history of substance use disorders. Don’t accept medicine from other people.
Other tips for safely taking medicines include:
- Read the list of ingredients
- Read and follow dosage and instructions
- Choose products that are alcohol-free
- Avoid herbal supplements and weight-loss products
- Ask a trusted friend or family member to manage and dispense your medication
In addition to various prescription and OTC medications, be mindful of what you put in your body and avoid other products that could cause a relapse. Examples include mouthwash, caffeine, and energy drinks.
CLASS B DRUGS With Addiction Medicine Specialist/Doctor Approval Only
The following drugs are considered safe only with approval by an addiction medicine specialist or doctor.
Although the medications listed in this Addiction Treatments section are specifically intended to be taken for prevention
of relapse to dependence upon one or more drugs, none of them are habit-forming or addictive themselves and should therefore be considered safe for recovering people to take. However, their proper use in the context of a recovery program requires monitoring by a health care professional, and it is for this reason that we place them in Class B.
- Antabuse (disulfiram)
- Campral (acamprosate)
- Catapres (clonidine)
- Chantix (varenicline)
- Revia (naltrexone)
- Symmetrel (amantadine)
- Zyban (bupropion)
- Naltrexone may precipitate intense withdrawal symptoms in patients addicted to opiates. Clonidine acts via autoreceptors in the locus coeruleus to suppress adrenergic hyperactivity there that is involved in the expression of the opioid withdrawal syndrome.
- Disulfiram is dangerous if taken with alcohol. Amantadine can cause decreased mental alertness or altered coordination.
- Chantix and Zyban are medications to help with nicotine (cigarettes, cigars, chewing tobacco, snuff) addiction.
COUGH AND COLD PREPARATIONS
- Antihistamines (Sedating)
- Atarax (hydroxyzine hydrochloride)
- Benadryl (diphenhydramine) OTC
- Chlor-Trimeton (chlorpheniramine) OTC
- Dimetane (brompheniramine) OTC
- Efidac (chlorpheniramine) OTC
- Periactin (cyproheptadine)
- Polarmine (dexchlorpheniramine)
- Tavist (clemastine) OTC
- Teldrin (chlorpheniramine) OTC
- Vistaril (hydroxyzine pamoate)
- Benylin Cough (dextromethorphan) OTC
- Nyquil (dextromethorphan/alcohol) OTC
- Comtrex (dextromethorphan) OTC
- Phenergan DM (promethazine/dextromethorphan) Contac (dextromethorphan) OTC
- Robitussin DM (dextromethorphan/guaifenesin) Delsym (dextromethorphan) OTC
- Vicks Formula 44D (dextromethorphan) OTC Mucinex DM (dextromethorphan/guaifenesin) OTC
Any preparation containing dextromethorphan should be used with caution because dextromethorphan acts on opioid receptors in the brain. Respiratory depression and perceptual distortions can also be seen in those people taking large doses.
Decongestants (Many Are Combination Products)
Decongestants should be used with caution because they are stimulating and precipitate in a craving which leads to relapse.
- Actifed (pseudoephedrine/triprolidine) OTC
- AH-chew D (phenylephrine) OTC
- Alavert D (loratadine/pseudoephedrine) OTC
- Allegra D (fexofenadine/pseudoephedrine)
- Benzedrex Nasal Inhaler (propylhexamine) OTC
- Bromfed (phenylephrine/brompheniramine)
- Bromfed DM (pseudoephedrine/brompheniramine/dextromethorphan)
- Cardec DM (pseudoephedrine/carbinoxamine/dextromethorphan)
- Clarinex D (desloratadine/pseudoephedrine)
- Claritin D (loratadine/pseudoephedrine) OTC
- Deconamine SR (pseudoephedrine/chlorpheniramine) OTC
- Dimetapp (pseudoephedrine/brompheniramine) OTC
- Duratuss (pseudoephedrine/guaifenesin)
- Entex LA (phenylephrine/guaifenesin)
- Entex PSE (pseudoephedrine/guaifenesin)
- Humibid DM (pseudoephedrine/ dextromethorphan/potassium guaiacolsulfonate)
- Mucinex D (pseudoephedrine/guaifenesin) OTC
- Nalex-A (phenylephrine) OTC
- Novafed (pseudoephedrine) OTC
- Profen (pseudoephedrine) OTC
- Prolex-D (phenylephrine) OTC
- R-Tannate Pediatric (phenylephrine/chlorpheniramine/pyrilamine)
- Rondec (phenylephrine/chlorpheniramine)
- Rynatan-S (phenylephrine/chlorpheniramine/pyrilamine) Semprex-D (pseudoephedrine/acrivastine)
- Sinutuss DM (phenylephrine) OTC
- Sudafed (pseudoephedrine) OTC
- Tussafed-EX (phenylephrine) OTC
- Zyrtec D (cetirizine/pseudoephedrine)
All OTC nasal sprays should be used for a short period of time. If used for a long period of time symptoms may worsen. Use for a maximum of 5 days. Intranasal corticosteroids (non-OTC) may cause a reduction in growth velocity in pediatric patients.
- Afrin (oxymetazoline) OTC
- Astelin (azelastine)
- Dristan (oxymetazoline) OTC
- Flonase (fluticasone)
- Nasacort AQ or HFA (triamcinolone)
- Nasonex (mometasone)
- Neo-synephrine (phenylephrine) OTC
- Nostrilla (oxymetazoline) OTC
- Rhinocort Aqua (budesonide)
- Vicks Nasal Inhaler (desoxyephedrine) OTC
- Vicks Sinex (phenylephrine) OTC
- 4-Way Nasal Spray (phenylephrine) OTC
Muscle relaxants are frequently prescribed to patients for sports injuries, post-surgery recuperation; and should be monitored because central nervous system depression (sedation, dizziness), which may impair physical or mental abilities.
- Flexeril (cyclobenzaprine)
- Parafon Forte (chlorzoxazone)
- Robaxin (methocarbamol)
- Skelaxin (metaxalone)
- Zanaflex (tizanidine)
- NEUROPATHIC PAIN
- Lyrica (pregabalin)
Lyrica has gained consumer prominence due to advertising and availability to a burgeoning audience
of users. Neuropathic pain killers act in the central nervous system and produces euphoria in certain individuals.
Sleep aids act in the central nervous system and can alter judgement and cause sedation.
- Excedrin PM (diphenhydramine) OTC
- Nytol (diphenhydramine) OTC
- Sleep-eze (diphenhydramine) OTC
- Sominex (diphenhydramine) OTC
- Tylenol PM (diphenhydramine/acetaminophen) OTC
- Unisom (diphenhydramine) OTC
- Primatene Mist (epinephrine) OTC
- Decadron (dexamethasone)
- Deltasone (prednisone)
- Medrol (methylprednisolone)
- Asthma/COPD/Pulmonary (Inhaled Corticosteroids/Long-Acting Beta 2 Agonists)
- Advair Diskus (fluticasone/salmeterol)
- Azmacort (traimcinolone)
- Flovent (fluticasone)
- Pulmicort (budesonide)
- Serevent Diskus (salmeterol)
- QVAR (beclomethasone)
Continued use of laxatives can lead to dependency for colon function. They are also misused by people with eating disorders or disordered eating. Use for only a short period of time.
- Ex-Lax (senna) OTC
- Dulcolax (bisacodyl) OTC
- Senokot (senna) OTC
These medications affect the central nervous system and can cause sedation.
- Compazine (prochlorperazine)
- Phenergan (promethazine)
- Tigan (trimethobenzamide)
- Zofran (ondansetron)
These medications affect the central nervous system and can cause dizziness, drowsiness or blurred vision.
- Antivert (meclizine)
- Transderm Scop (scopolamine)
- Dramamine (dimenhydrinate) OTC