Medication (Symptom Reduction)
Recovering drug or alcohol dependent persons often complain of mood and
anxiety problems. The origin of these problems is not clear in many
cases. People's mood and anxiety problems may have preceded their drug
or alcohol dependence (and may have been a partial cause of the drug or
alcohol dependence). Mood and anxiety problems may also have been
caused by drugs or alcohol. In either case, the continuing presence of
mood and anxiety problems is a considerable stressor to the recovering
person. Left untreated, such symptoms can provoke the recovering person
to return to substance abuse. For these reasons, a physician may
prescribe medication to reduce symptoms of depression, anxiety, and
other concerns. Anti-depressant, anti-anxiety and even anti-psychotic
medications may be used for these purposes.
Some drug and alcohol dependent persons are known to have a
mental health diagnosis that preceded their substance dependence (and
cannot be accounted for by the effects of the drug), or that remains a
significant problem for them despite sustained recovery from
substances. Such persons are known as "dual diagnosis" patients. Dually
diagnosed patients may require psychiatric medication to treat their
A general warning about medication treatment for anxiety is
appropriate. Some of the most effective anti-anxiety drugs are also
themselves highly addicting. Drug and alcohol dependent people aren't
stupid - they tend to abuse those drugs that help them to feel better
(at least in the short run). For example, anxious addicts often
gravitate towards alcohol abuse, as alcohol has anti-anxiety
properties. Some physicians will treat their recovering patients'
underlying anxiety with benzodaizapines (a class of medicines that
includes Valium, Ativan, Klonopin and Xanax) which are themselves
addicting! This sort of 'treatment' can result in the trading in of one
sort of addiction for another, if both the patient and the physican are
not careful. Not all physicians are thoughtful about this problem!
There are several anti-anxiety medications that are non-addicting.
Consult with your doctor to find out if one of these medications is
most appropriate for you.
Medication (Relapse Reduction)
Detoxified drug and alcohol dependent people are at significant
risk for relapsing back to using their drugs of choice, particularly in
the early hours, days, weeks and months of their recovery. There are
several medications that physicians can prescribe for their recovering
patients which can help to minimize their chances of relapsing.
Administration of Antabuse (generic: Disulfiram) blocks alcohol
from being metabolized (detoxified) by the liver, resulting in an
extremely unpleasant reaction when alcohol is consumed. Patients who
drink while taking disulfiram will turn purple, become severely ill for
30 to 60 minutes (or longer) and often vomit. Patients on disulfiram
may also have this same response to alcohol ingested in mouthwash, wine
sauces or vinegars, or even to inhaled alcohol vapors from aftershave
lotions. Giving alcoholic patients Antabuse can provide them with a
strong motivation to not relapse.
Naltrexone is a drug that blocks the action of heroin, codine,
morphine and other opioid compounds. Naltrexone binds with but does not
activate opioid endorphin receptors, thus reducing or blocking entirely
the effects of opioid consumption. In essence, an opioid addict can
take opioids (heroin, codine, etc.) while on Naltrexone, but it won't
get them all that high. Being on Naltrexone then, can help discourage
an opioid dependent person from relapsing. Naltrexone is also
administered to alcoholics as a way to help them remain sober. The
exact way in which Naltrexone compounds are able to help prevent
relapse to alcohol is not well known. Unlike Disulfiram, consumption of
alcohol while on Naltrexone does not produce sickness; rather it seems
to make the alcoholic less interested in the effects of alcohol.
A new alternative to Naltrexone has become available in the last few
years. Like Naltrexone, Suboxone is a partial agonist for opioid
receptors, meaning that it fills up many of the the receptor spaces on
nerons where opioid drugs would normally bind to produce their effect.