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truecomedian's avatar

For those in Recovery meaning (a twelve step program) is taking prescribed medications a violation of sobriety?

Asked by truecomedian (3912 points ) July 27th, 2010

Some medications may be narcotics, if these are prescribed and taken as prescribed is this ok? I know some old timers look down on this, and believe that taking any pills is not “being sober”. I am wondering what people here on Fluther think.

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19 Answers

gemiwing's avatar

The Big Book says it’s between your doctor and you- not between you and AA. As long as you are honest and your doctor knows of your personal issue with addictive substances, then it’s your business alone.

I personally defer to the doctor, and offer support if the person is frightened or needs my help. Beyond that- it’s not my call. Live and Let Live.

lillycoyote's avatar

I don’t really know, I think @gemiwing seems to know more. I would just think that it is something that you need to keep and eye on and a circumstance where you should have very good communication with your doctor. If you need medication for pain then you need it, but if you are worried that it might have detrimental effect on maintaining your sobriety then that is all the more reason to have a good relationship with your doctor and good communiction. You have to take some responsibility yourself, to weigh the opinions of say, your sponsor or other members of your recovery community and the hopefully, knowledgeable and medically based opinions of your doctor.

wundayatta's avatar

Personally, I think it’s ok, but then I’m not in a 12-step program that involves substances. Still, we all have to deal with tricky things. If you’re a love addict, you have to navigate between healthy and unhealthy relationships. It can be very hard to know which is which, and yet abstinence is addictive behavior. So saying no to all relationships is just as bad as saying yes and yes and yes to the wrong relationships.

I would think you are in a similar situation. There is healthy and unhealthy use of narcotics. You have to figure out which is which. Abstinence may not necessarily be a true sign of sobriety. There are times when you need these meds.

You have to watch yourself very carefully. You must have triggers to watch for—so you know when you are getting sucked into the habit again. Watch for them, and keep tabs on it carefully. Let your sponsor know and keep in close contact while you are in this situation. If you don’t have a sponsor, then use the other people in your group to help you watch yourself. If you find yourself getting into trouble, then let your doctor know right away. Hopefully there are alternatives. Or maybe get to the alternatives right from the beginning.

Only you know how much you think you can handle, but if your health is involved, I think you have to consider using the meds and being careful, so you can distinguish healthy from unhealthy use.

Robot's avatar

I wouldn’t think so. Unless you were addicted to pain pills or something and had them prescribed to you, however thatd be foolish of the doctor.their’s alternatives, different types of pills and those which are not addicting

Buttonstc's avatar

Any type of mind altering substances have a potential for abuse. The key word here is potential.

The difference between taking necessary medication for pain and addiction lies with the issue of WHY you are taking it at any one particular time.

It’s not merely how much or how often but why you take it. The amounts and frequency of taking this type of medication CAN be a tipoff that you’re headed for a problem if you find yourself exceeding what your Dr. has written for.

Generally speaking, if you are not exceeding his directions you’ll be ok for short term use. I assume that’s what you’re referring to here.

Any pain killers taken long term cause your body to become physically dependent upon them and that’s dangerous for your sobriety.

The only one who can prevent these meds from sliding you back into addiction is you. The primary way to do that is rigorous self honesty. If you find yourself taking the pills more for the euphoric effect rather than strictly to relieve physical pain, that’s the first warning sign.

The moment that you start taking them in order to cope with any part of the rest of your life, mentally or emotionally (apart from whatever physical condition for which the have been prescribed) that’s the beginning of the downhill slide back into addiction.

That’s what you need to be on the alert for. If you had a rough day or someone cut you off in traffic or you lose your job, thats not the time to take an extra dose That’s what I meant by rigorous self honesty. No one else in the program, your sponsor or even your Dr. can determine that for you since they aren’t mind readers.

It’s not necessarily how much you take, it’s WHY you are taking it. You are the only one who can determine that.

This is the primary reason why old timers in the program advise against it. They realize fully how easy it is to pull the wool over your own eyes.

And it’s totally unrealistic to think that you, as a recovering person, could take narcotics for long term chronic pain since your physical body will develop a dependence completely apart from the mind altering aspects and you will then be physically addicted.

So if this is a time limited acute pain situation and you watch it like a hawk and stay honest with yourself, you can consider it. Long term and chronic, you need to look for alternate solutions.

Just remember to continually stay focused on the WHY of EACH AND EVERY dose you take. As your physical pain begins to decrease, so should your frequency and amount of doses. You are the only one who can police yourself on this.

Proceed with extreme caution.

BTW. Someone mentioned that it shouldn’t be a problem if your addiction in the was not to pain pills but something else.

That sounds kind of nice but is unfortunately not accurate. This is why I tend to use the term addict rather than alcoholic. For any addict, the particular substance is of little significance compared to the process. Addiction is the process of using ANY type of substance or addictive behavior to avoid coping with whatever they find mentally or emotionally too painful in life.

Addicts can be (and many are) cross-addicted to multiple substances. So just because you haven’t been addicted to this type of medicationin the past means nothing. All it signifies is that it wasn’t your substance of choice in the past. Doesn’t mean it can’t become that in the future.

That kind of thinking just lulls into a false sense of security. ANY addict has the potential to become addicted to ANY substance.

My younger brother, many years ago, thought that he could maintain his sobriety as an alcoholic even if he continued a small bit of pot smoking. He quickly found out that one was an easy substitute for the other.

Obviously there are people who are NOT addicts who can manage to use pot without it interfering in the balance of their life. But that’s because they aren’t addicts. Totally different scenario.

For an addict, any mind altering substance is a minefield with addiction potential.

keobooks's avatar

I’ve been clean and sober .. gads about 17 years now. I used to go to meetings, but it’s been a while. Let me tell you. There is lots of good strong stuff that goes on in the meetings. And also lots of bogus crap.

People keep reminding you in meetings that you are NOT “terminally unique”. Well, remember this—that works outside of the rooms as well. Your doctor most likely isn’t naiive. He or She has probably worked with addicts before and has had experience. If they don’t, they can refer you to someone who has. So they CAN work with you.

First of all, talk to the doctor about your concerns about narcotics. Tell them that you wish to use them only as a last resort. There may be several other options available that are non-narcotics.

I still ask for non-narcotic painkillers and I almost always get them. I think there were two times that I didn’t. One was after dental surgery and the other was when I had a really nasty cough and I went through everything but nothing could suppress the cough but codeine.

IF you do get prescribed narcotics you can do two things—either talk to your doctor about your concerns and see what sort of solution you can come up with.. OR have someone else hold the pills. Get someone you trust but can be available every X number of hours. Have them hold the pills and give them to you as you need them only when you need them.

You need to trust that they won’t take the pills themselves, of course. But someone out there can do it.

If you are perscribed narcotics as a last resort or because it’s the only viable option—trust me. You’ll feel WAY too crappy to notice any “good” effects from the drugs. When I had my dental surgery, I was in so much pain that all the drugs did was make me not feel any pain. I didn’t feel high at all. Just slightly sleepy.

truecomedian's avatar

@Buttonstc
So you’re saying that an addict is different somehow?
That there is something different about an addict that makes them use substances to their destruction?
I have read the Big Book, three times, and it says how there is an allergy, but I cant find where it says it’s a disease.

Hawaii_Jake's avatar

I’ve been sober for 11 years and am still very active in a 12 step program. Taking medication as prescribed by a doctor is not a “slip”, as they’re called.

Talk to your sponsor about it, if it bothers you.

truecomedian's avatar

I get Ritalin and Klonopin, and upper and a downer. I find it odd that I use them as prescribed having a history of addiction. The shitty thing is, I couldnt piss clean if I needed too. I take the benzo as needed for panic attacks, that I dont really get anymore, so I dont take them much anymore. I take the Ritalin cause I’m ADD and to counteract the fatigue from Hep C treatment, which I just quit after three months because I couldnt handle the side affects. It was awful. Just to expound on why I asked this. I really appreciate the answers, this info is really important to me.

Buttonstc's avatar

@tc

I don’t recall saying it was a disease and I personally think it’s futile to get into a debate about semantics and terminology. I just don’t find it helpful.

I do think that addiction is a complex situation. There is also a generic component, but I don’t believe that biology is destiny.

There is the viewpoint that genetics loads the gun but lifestyle pulls the trigger. There are all types of conditions to which there are generic predispositions, diabetes or heart conditions to name just two. But some people have successfully countered those by the lifestyle choices they’ve made.

I think the primary thing that makes addicts different from the rest of the population is that they develop the habit of escaping from mental and emotional problems in their lives by using something that alters their perception of it

Instead of going through it and dealing with the turbulence of the emotions, they anesthetize themselves.

It’s not the healthiest coping mechanism for life because it doesn’t really deal with the issues at hand. It just makes everything worse and eventually creates a complete downhill slide.

So to simplify a very complex problem, I’d say that basically addicts try to alter their life by altering their perceptions of it.

This creates a very unhealthy pattern and does nothing constructive to deal with or change whats happening. This does lot of damage to both themselves and anyone in their families.

Recovery is not abstinence. Abstinence is just the necessary requirement for allowing recovery to begin.

The essence of recovery is learning how to develop coping skills to deal with life without crawling into a bottle (metaphorically speaking) or using whatever else to escape reality.

That’s what growth is all about. And that’s what non-addicts do as a matter of course because that’s what life is all about——growth, learning, and celebration and enjoyment of each little victory in that process and learning from any setbacks.

As long as they are in active addiction, they deprive themselves of all of that. Recovery is simply the ongoing procesd gaining all of that progressively back.

When people first begin going to meetings it’s many times just to keep themselves from using again that first time. Eventually they keep going back and/or go to a therapist in order to do the work of self-knowledge and developing the coping skills to get through it without using their substance of choice as a crutch.

truecomedian's avatar

@Buttonstc
Do you think that you can use a substance to expand your mind, like LSD in the sixties, or that something that makes you see things differently doesn’t necessarily give you false reality? And further, do you think everyone that “uses” is an addict?

Buttonstc's avatar

No, I think it’s quite obvious that not everyone who uses is an addict. History proves that because of the prevalent drug culture of the 60s and 70s.

There are tons of people who did drugs in the 60s and 70s who never became addicts. It was just recreational and a part of their youth. Eventually they got to a stage in their life (usually work or a career that they were passionate about) where drug taking interfered with their life and their ability to function too much, so that part of their life got phased out.

But there are certainly others who either died tragically at a far too young an age or sabotaged a good portion of their life and relationships with their obsessive drug use.

These are the ones who started out recreationally but ended up with being addicted or dead.

The biggest problem with using drugs is that it’s like playing Russian Roulette. You just dont know ahead of time whether you will be the addict or the one who grows out of that phase And for those with a history of addiction in their biological relatives, it’s like playing RR with five chambers loaded instead of just one.

I think that there are SOME people who can takeLSD or other “mind expanders” and be fine afterwards. I think the risk far outweighs the benefits tho.

Nobody can know ahead of time if they will be one of the fortunate SOME or not.

Everybody has to decide that for themselves, but I think that someone with a history of addiction (either personally or in their family) would be extremely foolish to do so.

There are plenty of better ways to expand one’s mind other than pharmacologically.

keobooks's avatar

Ahh.. ADHD meds, while not narcotic, do pose a big controversy in the rooms. I take Adderall myself (when I’m not pregnant or nursing) It took me several years to finally bone up and try it. I tried taking Welbutrin, which isn’t nearly as strong, but can’t really be used for recreational purposes. It several years and several lost jobs (I’m so disorganized and scatterbrained naturally that I have a lot of trouble performing basic tasks that others have no difficulty completing.) to finally give it a go. I’d heard about people becoming psychologically and physically addicted to the stuff. I’ve heard about people getting high off it.

I took it exactly as prescribed and because I actually needed it and took it like I was supposed to, I never got a high from it. People talk about getting super pumped up on it and being able to work several hours and be hyper-productive. It just made me kind of normal, and able to notice minor errors and details that I always missed in the past. It was kind of “boring” but it helped out a lot. I could organize and actually get SOMETHING done.

I never really had the desire to abuse the drug. Speedy feelings were the opposite of what I chased, so I never really had the urge to take more than prescribed.

I think you need to ask yourself how tempted are you to abuse the drugs given to you? If you get the notion in your head to double up just to see what it’s like, you probably are in some danger.

As for the klonopin. I don’t know much about it except that many herion addicts take it as a kinder alternative to methadone. I never met a junkie who abused it—but when I think about it, they were all in rehab while they were on it and never had a chance to dose themselves.

It’s not about passing a drug test or winning the approval of people in the room. It’s about freedom from active addiction, and gradually losing the desire to chase a destructive lifestyle in favor of becoming a responsible, productive member of society. If you keep that in mind and write or talk about how you honestly feel about having Ritalin (or klonopin) lying around the house and how tempted you are to abuse it—you’ll have a better grasp of what you want to do.

truecomedian's avatar

@Buttonstc
Thank you for your response, it was well put and methodical. I agree with much of it, but lean a little towards the “better living through chemistry” camp. Maybe I shouldn’t say that. But I do regularly take a medication that allows me to function better. See, that’s why I asked this question this way, I feel something like shame, for having to take a medication to be ok. I get manic, and panic attacks, and I take something for that, and it works. Worried as to how it will affect me long term, so maybe I was hoping for some miracle answer that could get me off all pills. Thank you everyone for your answers.

perspicacious's avatar

It would seem best to not take anything with the potential of addiction. I would talk to my doctor if I were in that position.

Buttonstc's avatar

@tv

My comments were based upon your initial question about narcotics (Klonopin is not a narcotic) and your follow up question about mind expanders such as LSD (ADHD meds are in no way related to LSD) but I have a couple of key questions for you.

Are Ritalin and Klonopin the only two psychoactive medications you are taking? (in your initial question you also mentioned “and an upper and a downer” and it wasn’t really clear from the way it was worded whether it was describing these two meds or talking about ADDITIONAL ones. The word “and” was a little confusing in it’s placement in the sentence.)

To what extent is your prescribing Dr. aware of your addiction history and current recovery efforts?

Are all of the meds you take being prescribed by one Dr. ?

Are any of the meds from sources other than a Drs. prescription ?

I also think that keobooks comments are spot on and contain much wisdom.

truecomedian's avatar

@Buttonstc
Ugh, Yes I am on the up and up, and that isn’t a pun. My doctor is fully aware of my past drug history, I’m open about that. I’m not so sure I actively pursue recovery, but if you mean that I’m trying to get stuff back, then yes I am. Yes all my meds are from one doctor. I know what your getting at. No I only take meds from my doctor, as prescribed. Good questions, a little too good. You have experience with addicts? You just made me realize that I am happy cause Im doing better, and Im doing better cause Im honest with myself, to the best of my ability.

Buttonstc's avatar

Then I don’t think you need to be overly concerned with the opinions of others about what meds you take or to feel shame about needing them.

One of my closest friends from college is severely bi-polar and without the right balance of meds his life (and that of his wife and kids) would be a total train wreck. He has such a severe case (genetically inherited from his Father) that it resulted in his medical retirement from the military back in the days when treatment meds were a lot less sophisticated and effective.

He went through years of misery and instability before getting stabilized on the right combo of meds.

So “better living through chemistry” is not automatically a bad thing.

So, I think the basic advice I gave earlier still stands regardless of what it is you are taking. It’s not necessarily a case of how much or how often, but WHY.

People can deceive themselves easily by making it a numbers game. But if you stay honest with yourself, you’ll be fine. That’s the true essence of recovery. Rigorous self honesty.

And as keobooks mentioned, it’s not about passing drug tests or what others think (other than your Dr.) about what meds you take. It’s about your intent and the quality of life and whether it’s heading uphill or downhill.

If you stay honest with him and with yourself, that’s it in a nutshell.

Yes I’m very well aware of addiction issues. I spent my childhood in the chaos of an alcoholic family system.

I also spent numerous years in therapy as well as Al Anon and ACOA groups (as well as recommended attendance at regular AA meetings as well)

One primary focus in all of that was to understand fully the dynamics of addiction so that I wouldn’t end up following in their footsteps.

I’ve also learned a lot from a couple of friendships with a few AA people with a long track record of their own personal sobriety ( 20–30+ yrs)
Folks like that have a lot of wisdom not just on addiction issues but just regular life issues.

Latch on to a couple of folks like that for advice cuz they are past the judgemental automatic-answers stage and take a more nuanced approach to the type of issues you’re facing.

But above all, just stay honest with yourself.

wundayatta's avatar

A lot of people with bipolar disorder (is this relevant to you?) self-medicate before they ever get a diagnosis. It is extremely important that bipolar folks take their meds. If you can’t control that disorder, I don’t see how you can control any addiction.

The interesting thing I just learned from a bipolar expert who just came to my last group meeting, is that a lot of these newer drugs that are used for other purposes are turning out to be good for bipolar. I think risperdal and adderal were mentioned, among others, but my memory for names is not very good. Some originally were used as anti-convulsants and also turn out to be good mood stabilizers.

I think it’s good that you worry about this. I think that as long as you are worried, you don’t need to worry.

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