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Recovery and Medication that has the Potential for Abuse

The prescription of medication that may be abused is a contentious issue in substance use treatment. There are three general ways to describe these types of medication. Medication that is non-narcotic but still has abuse potential, narcotic medication for detox or short term treatment like surgery, and narcotic medication for long term use (Medication-Assisted Treatment).

Non-Narcotic Medication with Abuse Potential

Much medication is prescribed for short-term use at an inpatient treatment level-of-care to assist with the transition to abstinence and post-acute withdrawal symptoms. These medications may be called “comfort meds” in the industry. Some of these are relatively harmless, but others have a high abuse potential. We urge caution is using these medications, allowing many professionals and family to be involved in the decision-making process. In addiction, the choice areas of the brain are compromised. So, while you may believe your intentions are good, that does not mean that this is the case. We have seen far too many clients spiral out of control on these types of medications and return to active substance use. Please don't make these decisions alone.

Narcotic Medication for Short Term Purposes (Detox, Surgery, Hospitalization)

We are fully in support of using medications for detox purposes.  While it may be beneficial for individuals to feel the full force of withdrawal to solidify their decision to avoid substance use going forward, this is not always realistic.  Furthermore, in some situations, detoxification without medication can be dangerous, such as in benzodiazepine or alcohol detox.  This issue is relatively simple and should be discussed with a medical professional.

Medication for surgery, while in the hospital, or for an injury, is a much grayer area. Are those with substance use disorders able to take pain medication ever again?  The answer is yes, as many have accomplished this, but it is something that should not be done lightly and should not be done alone. This requires a thoughtful discussion with a team of competent professionals.  Questions that should be discussed are as follows.  Do you really need the pain medication? What alternatives have/can be tried?  Have you tried to cope with non-narcotic pain medication first?  During this candid discussion, if it is agreed upon that there are no alternatives, a plan will need to be developed to take this medication in a time-limited fashion exactly as prescribed under the supervision of supports and medical professionals.

As a general rule, it is important to let your medical team know that you are unable to take pain medication due to a diagnosed substance use disorder.  This means you even need to tell your dentist.  All medical professionals will hold this information as confidential as any other information, and they will not judge you for it.  It will also help them to provide you with the safest and best possible care.  Additionally, in the event that you wake up in the hospital after a car accident, it may be documented somewhere in medical records, so hospital staff will have taken this into consideration.  If not, it is imperative that you inform hospital staff immediately, and let your family and sober supports know as soon as you can contact them.

Narcotic Medication for Medication Assisted Treatment

This is a much grayer area than the previous one.  Medication-Assisted Treatment (MAT) such as naltrexone and vivitrol are helpful medications, though they are contentious issues within the substance use treatment community.  We are in support of this medication if utilized with counseling and a robust recovery plan.  This medication cannot be your solution.  The ultimate goal with this medication is to get a recovery program in place so that the medication is no longer required.  The same goes for medication containing buprenorphine, such as suboxone and subutex.  These medications are typically used for detox, but some may use this for treatment of addiction in the very beginning.  This is a very contentious issue as well.  It is best to make this decision with trained medical staff, but again, this medication should be taken as a part of a comprehensive program which includes counseling and social sober support.  Again, this medication should be viewed as having an end date, and not be a lifelong solution to substance use.

Independent Recovery

At Independent Recovery, we are here to support you with all of the issues that we have discussed.  Medication is a challenging issue for those with substance use disorders, no matter what stage of recovery they are at.  We wish to support you in your journey and are more than happy to talk about utilizing MAT as a comprehensive part of your recovery program.  Or, perhaps you are in long-term recovery and undergoing surgery and just wish to seek counseling while you are on medication.  We can help in this capacity as well.  If you have any additional questions, head on over to our Get Started page and let us know medication is a concern that you would like to discuss.  We will be in touch shortly!