Medication Guide for People in Recovery
Using this guide
Many medications, both over-the-counter (OTC) and prescription (Rx), have mood-altering effects. Not only do these medications have addiction potential of their own, but they may also lead to relapse.
This guide lists some common medications to avoid, and others that are safer to use. However, it is not meant to replace the advice of a physician, pharmacist, or other health care professional. If you have any questions regarding medication use during your recovery, please contact your physician and/or pharmacist.
Moreover, this guide is not exhaustive. With so many medications on the market, it is impossible to list them all. Instead, you’ll simply find a few common examples in various medication categories. Again, if you have questions about a specific medication not listed in this guide, contact your physician and your recovery team.
Most medications are listed here by generic name—that is, by its active ingredient—with an example of its brand name in parentheses: for example, acetaminophen (Tylenol). Some medications are sold under many brand names. Check the label for the active ingredients: any brand-name medication package should also include its generic name.
Symbols used in this guide:
Rx = prescription only
OTC = over-the-counter
Be up-front with your physician and/or pharmacist about your addiction. If they are aware of it, they can prescribe or recommend more suitable medications.
Important: read all labels. Many OTC medications contain one or more ingredients that you should not be taking. Check both the active and inactive ingredients, as many contain alcohol as an inactive ingredient. If a medication that you should not be taking is deemed medically necessary by your health care professional, notify your sponsor as well as your recovery team. Make a plan for use as well as a plan to discontinue use.
Cold, allergy, and asthma medications
Avoid the ingredient pseudoephedrine, which has stimulant-like properties and is contained in most OTC cold and sinus preparations.
Avoid these and other pseudoephedrine-containing OTC medications:
- Tylenol Cold & Sinus DayQuil
- Alavert D-12
- Advil Cold & Sinus
Other cold/allergy/asthma OTC medications to avoid:
- diphenhydramine (Benadryl)
- chlorpheniramine (Chlor-Trimeton)
- clemastine (Tavist)
- brompheniramine (Dimetapp Elixir)
- ephedrine (Bronkaid, Primatene)
- dextromethorphan (Robitussin DM, or any cough syrup with “DM”)
- nighttime preparations, since most contain alcohol (for example, NyQuil)
Safe medications for cold, sinus, and allergy symptoms:
- loratadine (Claritin, Alavert). Beware: Claritin-D and Alavert D-12 contain pseudoephedrine. Make sure you are using the pseudoephedrine-free medication.
- saline nasal spray (Ocean)
- Vicks VapoRub, Vicks steam
- guaifenesin (Mucinex, Vicks 44E)
- benzonatate (Tessalon Perles—Rx)
- acetaminophen (Tylenol)
- NasalCrom nasal spray
- cough drops (such as Halls)
- sore throat lozenges
- salt-water gargle
- Breathe Right nasal strips
The first thing you need to say at any visit to an emergency room or to a physician prescribing you pain medication is that you are recovering from an addiction. The physician and you will then create a plan to resolve your pain and maintain your sobriety.
Avoid all opioids:
Opioids are the most powerful known pain relievers. Naturally occurring opium derivatives include morphine and codeine. Partially synthetic derivatives of morphine include heroin, oxycodone, and oxymorphone. Synthetic opioid com- pounds include fentanyl, alfentanil, levorphanol, meperidine, methadone, and propoxyphene.
Avoid these and other opioid Rx pain medications:
- fentanyl (Duragesic patch)
- codeine (Tylenol #3)
- oxycodone (Percodan, Percocet, OxyContin)
- hydrocodone (Vicodin, Vicoprofen, Lortab)
- hydromorphone (Dilaudid)
- propoxyphene (Darvon, Darvocet)
For pain relief some physicians prescribe other medications, such as anti- depressants, that are also mood altering and addictive. Check this guide or talk to your doctor before adding them to your treatment plan. Avoid using all benzodiazepines (listed under “Psychiatric medications” below).
Be careful with dental procedures. Tell your dentist you’d like to avoid nitrous oxide or “laughing gas.” Injectable medications such as lidocaine or Novocaine are better because they provide the numbing pain relief without the mind-altering effect.
Safe pain medications:
Unless your doctor has told you to avoid these medications, they are generally safe (not addictive or mood-altering) to use for pain:
- aspirin (Bayer)—OTC
- ibuprofen (Motrin, Advil)—OTC
- acetaminophen (Tylenol)—OTC
- naproxen (Naprosyn, Aleve)—OTC celecoxib (Celebrex)—Rx
- ketorolac (Toradol)—Rx
- methotrexate (Rheumatrex)—Rx
- infliximab (Remicade)—Rx
- and many more
Most medications that are used for anxiety, depression, and other neurological disorders are mood-altering. Some of these are safe and nonaddictive and some are not. If you are diagnosed with a neurological disorder, work with your doctor to pick the safest one that will handle your symptoms. If you are already on a medication, talk to your doctor before discontinuing its use. Some of these medications have severe withdrawal effects that require tapering down the dose.
Avoid all benzodiazepines:
- diazepam (Valium)
- oxazepam (Serax)
- alprazolam (Xanax)
- midazolam (Versed)
- lorazepam (Ativan)
- clonazepam (Klonopin)
Some acceptable prescription psychiatric medications:
- fluoxetine (Prozac)—Rx
- sertraline (Zoloft)—Rx
- paroxetine (Paxil)—Rx
- citalopram (Celexa)—Rx
- escitalopram (Lexapro)—Rx
- bupropion (Wellbutrin)
- venlafaxine (Effexor)
- amitriptyline (Elavil)
- imipramine (Tofranil)
- nortriptyline (Aventyl, Pamelor)
- clomipramine (Anafranil)
- buspirone (BuSpar)
Anticonvulsant and antipsychotic prescription medications to avoid:
Medications like the following should be avoided:
- clozapine (Clozaril)
- olanzapine (Zyprexa)
- phenytoin (Dilantin)
- risperidone (Risperdal)
- phenobarbital (Luminal)
Most medications used for attention-deficit/hyperactivity disorder (ADHD/ADD) have a stimulant property. You should try to avoid:
- methylphenidate (Ritalin)—Rx
- dextroamphetamine (Adderal)—Rx
A safe medication for ADHD is:
- atomoxetine (Strattera)—Rx
The majority of diet medications have stimulant properties; many contain actual amphetamines, which are extremely addictive. Therefore, it is highly recommended that you avoid all of these types of medications.
Some specific examples of diet pills that should be avoided are
- sibutramine (Meridia)—Rx
- phentermine (Adipex)—Rx
- dextroamphetamine (Dexedrine)—Rx
Acceptable heartburn/upset stomach medications:
- ranitidine (Zantac)
- antacids such as Tums, Maalox, Mylanta, Rolaids; famotidine (Pepcid)
Acceptable diarrhea medications:
- loperamide (Imodium A-D)
Acceptable constipation medications:
These medications should all be avoided if you have an eating disorder. If you do not, the following medications can be taken:
- docusate sodium (Colace)
- Metamucil powder
- senna (Senokot)
Many OTC mouthwashes contain from 9 to 21 percent alcohol. Avoid any alcohol- containing brands, such as
Some mouthwash brands that are okay to use:
- Act Kids
It is best to avoid all sleep medications since they have depressant-like properties. The best treatment for insomnia is to find ways to relax: meditate, listen to music, or take a hot bath before bed. Try to find something that works for you. If you still have difficulty falling or staying asleep, discuss this with your physician and recovery team.
Sleep medications to avoid:
- diphenhydramine (Unisom, Sominex)—OTC
- zolpidem (Ambien)—Rx
- zaleplon (Sonata)—Rx
Motion sickness agents:
Most of these cause mood-altering effects and should be avoided. A few examples of motion sickness medications to avoid:
- meclizine (Bonine—OTC, Antivert—Rx)
- dimenhydrinate (Dramamine)—OTC
- scopolamine patch (Transderm Scop)—Rx