Medications and Drugs to Avoid in Recovery

A person who has EVER been addicted to alcohol or other drugs has a lifetime higher risk of becoming addicted to other addicting drugs or medications--even if the drugs are used for legitimate medical and/or psychiatric reasons. Because of the risk of relapse and cross-addiction, anyone with a history of addiction or drug problems should not use any alcohol, street drugs, or potentially addicting prescribed medications. Any use of alcohol, street drugs, or medications listed below can precipitate or increase the likelihood of relapse to addiction.

If your physician believes that there is a compelling medical reason to prescribe an addicting medication (except in the case of an acute emergency or while you are hospitalized), ask your physician to consult an addiction medicine specialist or an addiction psychiatrist before prescribing for you. Prescribing addicting medications is a high-risk medical procedure for a person with a history of addiction, alcoholism, drug problems, or substance abuse. Exposure to any addicting drugs can precipitate relapse to addiction and problems. If you or your physician need to consult an addiction specialist, the American Society of Addiction Medicine (www.asam.org or 301-656-3920) and the American Academy of Addiction Psychiatry (www.aaap.org or 401-524-3076) can assist you with finding a specialist in your area.

To safeguard your continuing recovery, do NOT use the following drugs. [For a more detailed list, click here or here and download the pamphlet "Medications and the Recovering Person."]

• Alcohol in any form:
• Alcoholic beverages of any kind:
• Beer, malt liquor, wine, wine coolers, liquor, mixed drinks, etc.
• Liquid medications containing alcohol:
• Over the counter liquid medications (e.g., Nyquil and many others)
• Prescribed liquid medications containing alcohol
• Sedative-Hypnotic Drugs:
• All Benzodiazepines: Ativan, Klonopin, Librium, Xanax, Halcion, Valium, Restoril, Serax, and others
• Hypnotics: Sonata, Ambien, Lunesta, and others
• Carisoprodol (Soma)
• All Barbiturates: Phenobarbital, Seconal, etc.
• Other sedatives:
• Equanil, Miltown, Noludar, Chloral hydrate, etc.
• GHB, GBL, Rohypnol, etc.
• Opioid Drugs:
• Morphine (MS-Contin and others)
• Propoxyphene (Darvon, Darvocet, and others)
• Codeine (Tylenol #3, and others); Dihydrocodeine
• Hydrocodone (Lortab, Vicodin, and others)
• Oxycodone (Percodan, Percocet, Oxycontin, and others)
• Hydromorphone (Dilaudid and others)
• Meperidine (Demerol and others)
• Pentazocine (Talwin NX)
• Fentanyl (Duragesic, Actiq, and others)
• Methadone [NOTE: Methadone may be legally prescribed for addiction ONLY in a Federally-approved methadone clinic.]
• Buprenorphine (Subutex, Suboxone, Buprenex), butorphanol (Stadol), and others [NOTE: A physician with a special Federal waiver may prescribe Suboxone or Subutex for the treatment of addiction.]
  
• Tramadol (Ultram)
• Heroin in any form (injectable, smoked, snorted, etc.)
• Stimulant Drugs:
• Methylphenidate
• Ritalin, Concerta, and others
• Amphetamines:
• Amphetamine and/or Dextroamphetamine (Adderall, Dexedrine, etc.)
• Methamphetamine
• MDMA (Ecstasy)
• Others
• Cocaine in any form:
• Smokable cocaine (crack, freebase cocaine)
• Powder cocaine
• Marijuana (Cannabis) in any form, including Dronabinol (Marinol)
  
• Hallucinogens and Dissociative Drugs:
• PCP, LSD, ketamine, and others
• Inhalants
• Gasoline, glue, solvents, other volatile chemicals

Letter to Referring Physicians

To Whom It May Concern:


RE: PATIENT NAME


PATIENT NAME was under my care at PLACE from ADMISSION DATE to DISCHARGE DATE for the treatment of DIAGNOSES. Because of the risk of relapse and cross-addiction, I recommend that this patient should not use any alcohol, street drugs, or potentially addicting prescribed medications. Any use of alcohol, street drugs, or the following medications can precipitate or increase the likelihood of relapse to addiction. A person who has ever been addicted to alcohol or other drugs has a lifetime risk of becoming addicted to other addicting drugs or medications--even if used for legitimate medical and/or psychiatric indications.

Therefore, I recommend that you safeguard your patient’s recovery and safety by NOT prescribing the following categories of medications on an outpatient basis:

Any Alcohol-Containing Liquid Medications or OTC preparations (e.g., Nyquil and many others)

Sedative-Hypnotic Medications

• All Benzodiazepines: Ativan, Klonopin, Librium, Xanax, Halcion, Valium, and others
• Hypnotics: Sonata, Ambien, Lunesta, and others
• Carisoprodol (Soma)
• All Barbiturates: Phenobarbital, Seconal, etc.
• Other sedatives: Equanil, Miltown, Noludar, Chloral hydrate, etc.

Opioid Medications

• Morphine (MS-Contin and others)
• Propoxyphene (Darvon, Darvocet, and others)
• Codeine (Tylenol #3, and others); Dihydrocodeine
• Hydrocodone (Lortab, Vicodin, and others)
• Oxycodone (Percodan, Percocet, Oxycontin, and others)
• Hydromorphone (Dilaudid and others)
• Meperidine (Demerol and others)
• Pentazocine (Talwin NX)
• Fentanyl (Duragesic, Actiq, and others)
• Methadone
• Buprenorphine injectable (Buprenex), butorphanol (Stadol), and others
• Tramadol (Ultram)

Stimulant Medications

• Methylphenidate (Ritalin, Concerta, and others)
• Amphetamines (Adderall and others)

Cannabinoids

• Dronabinol (Marinol)

If you believe there is a compelling medical reason to prescribe one of these medications to this patient, please consult an addiction medicine specialist or an addiction psychiatrist before you do so. Prescribing or administering any of these medications to a person with a history of addiction or substance abuse is a high-risk procedure, can precipitate relapse to addiction, and should be undertaken with extreme caution and only after consultation with an addiction specialist.

If you need to consult an addiction specialist, the American Society of Addiction Medicine (www.asam.org or 301-656-3920) and the American Academy of Addiction Psychiatrists (www.aaap.org or 401-524-3076) can assist you with finding a specialist in your area.

If you have questions, please do not hesitate to call me at MY PHONE NUMBER.

Sincerely,
PHYSICIAN'S NAME

What's my role in ASAM?

I am the current President of the American Society of Addiction Medicine, serving in that role from April 2005 through April 2007.

The ASAM President-Elect, Michael M. Miller, M.D., will take office at the ASAM Medical-Scientific Conference in April 2007 in Miami, FL.

Other officers are: Lawrence W. Brown, Sr., M.D. (Past President), A. Kennison Roy, M.D. (Secretary), and Donald Kurth, M.D. (Treasurer).

For additional information about ASAM Board members and staff, please refer to the ASAM website.

What is ASAM?

The mission of the American Society of Addiction Medicine is to:

increase access to and improve the quality of addiction treatment; to educate physicians (including medical and osteopathic students), other health care providers and the public; to support research and prevention; to promote the appropriate role of the physician in the care of patients with addiction; and to establish addiction medicine as a primary specialty recognized by professional organizations, governments, physicians, purchasers and consumers of health care services, and the general public.

Welcome to my blog!

My professional interests include addiction medicine, addiction psychiatry, psychiatry, women's issues, recovery, medical treatment of addiction, etc. etc.

For more information, see my Medem website.