Cross Addictions and Safe Medications

For example, you may realize that you are an alcoholic, and cannot have any form of alcohol, but if you go see your doctor for insomnia, pain, anxiety, etc., he may give you perfectly good medications, and be a well-meaning doctor, but some of those medicines will lead you right back to alcohol. In an effort to try and help you when you leave here, we have compiled a list of acceptable safe medications and have tried to include classes or individual drugs that we consider dangerous in the addicted patient. We have broken this down by diagnoses that are most commonly used in a primary care setting. It is in no way complete, meaning not every drug is listed. The FDA approved list of drugs numbers in the thousands. So, in an effort to keep the list manageable, we have listed the disease or diagnosis with a list of safe or acceptable medications. In some cases we have included drugs that we know lead to increased risk of relapse. We have listed the chemical to avoid up front for easy review when discussing medications with your doctor or seeking over the counter medications.

Safe drugs for allergies include Allegra, Claritin and Zyrtec. The ones without the decongestants (those without the -D) are preferred. Some of the over-the-counter drugs have addiction potential as well, so please check with your pharmacist or doctor before buying over-the-counter allergy, cough, or cold medications. Remember that chronic use of Afrin or similar agents leads to a physical addiction and you get rebound nasal congestion when you try and stop. For coughs we recommend Tessalon Perles, a cough suppressant, or Guaifenesin syrups or tablets as an expectorant. Cough drops or throat lozenges are also helpful.

There are no safe diet pills in addiction that are rapidly effective. All of the stimulant classes of drugs to “speed up your metabolism” are potentially dangerous and may not be effective either. There are a couple of non-stimulant type drugs for weight control: Meridia and Xenical. Meridia works on serotonin and Xenical blocks fat absorption. Neither in our experience have been as successful as exercise and reduced portions of food.

The whole benzodiazepine class of drugs are potentially addicting. Those are medications like Xanax, Ativan, Valium, Klonopin, etc. There are safe alternatives to anxiety treatment such as Buspar, the SSRIs like Prozac, Paxil, Zoloft, Lexapro and Celexa, and other anti-depressants like Effexor or Cymbalta. Antidepressants as a general class are acceptable medications, BUT remember that early in recovery most people are depressed and just sobriety alone may be the only “drug” you need. Anxiety can be treated through other avenues besides drugs such as meditation and exercise.

This class of drugs is relatively CONTRAINDICATED in drug dependent patients. We prefer to use drugs that are non-stimulants to control these diseases, like Strattera or Wellbutrin. If one must have stimulants to control ADD/ADHD, it is safest to use the long-acting or slow release forms, but even these can lead to relapse.

In dental procedures they can use local anesthesia to numb the mouth. It is best not to use Nitrous Oxide (laughing gas) or any relaxing agents before or during procedures UNLESS absolutely indicated. An NSAID, such as Toradol 10 mg, taken an hour before dental work will frequently keep pain under control. It is very important to let your dentist know that you have the disease of addiction, so that they do not give you prescriptions for narcotics.

For diarrhea, Kaopectate and Imodium are acceptable. Lomotil is contraindicated. For stomach cramps, Bentyl or Levsin are safe. For nausea, Tigan and Vistaril are preferred. Phenergan is potentially dangerous.