It’s important that there are no gaps in medication treatment, especially when moving from one program to another. Examples include moving from residential care or rehab to an intensive outpatient program or to individual counseling with a psychiatrist or advanced practice nurse.
Your loved one should have enough medication and/or a script to carry them through to their next appointment. Many programs will set up an appointment with a new prescriber if your loved one doesn’t have one before discharging them to a lower level of care.
Make sure that all medications being prescribed are affordable. Sometimes, what is provided and covered in inpatient treatment can be very costly in outpatient settings.
Many manufacturers of medication offer co-pay assistance programs. An online search of the medication name can help you find the manufacturer and cost-savings programs if offered. If medication cost is an issue, ask the treatment provider to recommend a different medication before discharging.
In addition, while it may be uncomfortable, your loved one needs to share their substance use diagnosis with all of their healthcare providers (e.g., primary care doctors, dentists, mental health providers, etc.). They may avoid prescribing certain medications that can be misused. These include:
- Benzodiazepines – e.g., Xanax, Valium, Ativan, Klonopin
- Attention Deficit Hyperactivity Disorder – e.g., Adderall, Concerta, Ritalin
- Sleep medications – e.g., Ambien, Lunesta
- Pain Relievers – e.g., Oxycontin, Vicodin, Percocet, Tylenol with Codeine
If your loved one is prescribed medications to treat an opioid use disorder like naltrexone (e.g., Vivitrol), buprenorphine (e.g., Suboxone or Zubsolv) or methadone, have an alternative pain/injury management plan in place. Non-addictive alternatives to opioids are recommended to treat pain. If opioids can’t be avoided, having another person dispense the medication with extra monitoring can be helpful.
Also, your loved one ought to carry a card or wear a bracelet to let first responders and/or ER personnel know they are taking any of these medications. Again, this is because different pain management options may be needed.
While no one wants a relapse to occur, it’s good to have naloxone (e.g., Narcan) on hand as a safety measure. It can reverse an opioid overdose if used in time. You can get naloxone at most pharmacies without a prescription. In addition, many community organizations offer training and naloxone kits free of charge.
Medications are intended to help with recovery. At times, just the notion of having to take medications, unwanted side effects or not feeling any benefit can contribute to a decision to stop. It can be a shock to the brain and body if certain medications are discontinued without gradually reducing them. Stopping suddenly or not taking medications as prescribed can also result in a relapse.
Sometimes people in recovery think:
- “I was doing fine, so I thought what’s the point of taking medications I don’t need anymore.”
- “I really didn’t see myself as that sick.”
- “The meds made me feel terrible and the cocaine (or whatever substance) made me feel better.”
- “I don’t like taking pills — they taste awful.”
- “I took it for a week and there was no change — they really weren’t working for me.”
- “I’m much better. I don’t think I’ll ever be addicted (or depressed, anxious, etc.) again.”
- “A person in my meeting told me I shouldn’t be taking any medications.”
Encourage your loved one to share any concerns they have about their medications with their prescriber before problems occur. You may wish to offer assistance with managing their medications (e.g., taking it as prescribed, reminders about refills, etc.) as well.
With a release of information, you can share any concerns or symptoms that you’ve noticed with their healthcare provider. Given this information, they can adjust the medication (e.g., increase or decrease it, change the time of day it’s taken, split the dose, etc.) or suggest another medication to address problems.
Providers can also help people discontinue medication if necessary in a safe manner.
And if your loved one doesn’t think that their provider is the right fit, be proactive and look for another one. A trusting, open relationship with a healthcare provider can make a big difference in terms of your loved one’s well-being.