Author: Lauren Sawyer

Can I Take Anxiety Medication in Recovery?

If anxiety has been an underlying contributor to addiction, wouldn’t anxiety medication in recovery make sense? Or, does taking medication risk further substance use?

Anxiety is one of the main reasons I drank and ultimately developed an alcohol use disorder. I was an anxious child and felt uncomfortable in social situations. I always felt uneasy in my body.

The anxiety caused me to be socially withdrawn. I retreated to my room and didn’t want to be part of family activities. I discovered comfort eating, then by my teenage years, I discovered that alcohol helped to take my anxiety away.

Getting sober, however, was like ripping off the Band-Aid of anxiety. I was no longer able to numb those feelings of anxiousness. I found myself feeling exposed, raw, nervous, and socially awkward.

I’d sit in meetings and constantly fidget. When everyone had coffee after the meeting, my mind would race about what to say and I always avoided eye contact.

Sobriety was rough for my anxiety. I had to do something about it. I tried exercise, which helped. But exercise only got me so far. I had to seek medical help.

After talking to my doctor, I was diagnosed with a generalized anxiety disorder. And I’m not alone. Looking back, taking anxiety medication in recovery helped me to sustain my sobriety.

The Relationship Between Anxiety and Substance Use Disorder

Anxiety disorders and substance use disorders commonly co-occur. This is also true for individuals struggling with post-traumatic stress disorder (PTSD), social phobia, panic disorder, and obsessive-compulsive disorder.

Researchers studying co-occurring anxiety disorders and addiction found:

• Eighteen percent of people with addiction also met the criteria for generalized anxiety disorder.
• People with opioid addiction also typically struggled with anxiety: 12 percent of men and 21 percent of women.

Researchers found that social anxieties appeared in about 80 percent of cases before the development of alcohol addiction.

What is Generalized Anxiety Disorder?

Generalized anxiety disorder (GAD) is one of the most common anxiety disorders. And it’s the most common type of anxiety disorder that co-occurs with addiction.

GAD is described by the Anxiety and Depression Association of America as a persistent and excessive worry about things. People with GAD may worry about money, family, work, health, or other concerns like a disaster.

GAD isn’t just regular concern. The symptoms include:

• Feeling nervous, irritable, or on edge
• Having a sense of impending danger, panic, or doom
• Increased heart rate
• Rapid breathing
• Sweating or trembling
• Difficulty concentrating
• Insomnia
• Upset stomach/irritable bowels

General anxiety disorder is usually diagnosed when a person worries on more days than not over six months. In early recovery, it can be tricky to diagnose generalized anxiety disorder and substance use disorder because symptoms of anxiety may be due to withdrawal.

Before thinking about taking anxiety medication in recovery, it’s generally recommended that the person be sober for around six months. This will provide enough time to objectively assess and diagnose an anxiety disorder.

Choosing the Right Anxiety Medication in Recovery

The treatment of anxiety disorders in recovery from addiction can be challenging. Some medications to treat anxiety, like benzodiazepines, can be misused. So, is taking anxiety medication in recovery a good idea?

Some researchers report that evidence for the abuse of benzodiazepines is lacking and that benzodiazepines can be used safely to treat anxiety disorders in SUD patients*.

Other common medications used to treat anxiety disorders with a co-occurring substance use disorder include:

• Buspirone: This medication specifically treats anxiety.
• Antihistamines: Some antihistamines are used to treat anxiety, such as hydroxyzine or Benadryl.
• Beta-blockers: The medication is typically used to slow the heart rate but can be used to reduce anxiety.
• SSRIs (selective serotonin reuptake inhibitors): Some SSRIs, which treat depression, have been shown to improve anxiety. These include Zoloft, Fluoxetine, Lexapro, Celexa, Cymbalta, and Venlafaxine.
• SNRIs (serotonin and norepinephrine reuptake inhibitors): These are medications such as Tofranil and Effexor.
• Psychological treatments like cognitive-behavioral therapy
• Education on healthy sleeping habits, relaxation techniques, coping skills, and problem-solving

In my experience, I have found a range of medications helpful. Hydroxyzine helps me sleep and reduces my overall anxiety. Prozac helps to reduce depression and anxiety. When I experience panic attacks, I take a benzodiazepine.

Benzodiazepine: Anxiety Medication in Recovery

I want to acknowledge that not everyone should take benzodiazepines. If you have a history of substance use, medical providers may avoid prescribing anxiety medication during your recovery.

However, in my case, I had a very frank discussion with my provider. I was having regular panic attacks after my mom died. I felt my level of anxiety was unmanageable.

I asked my provider to prescribe these medications based on several important factors:

• I was in long-term sobriety (eight years).
• I had no history of misusing benzodiazepines.
• I was able to meet regularly with my provider to check in about my use of medications and my anxiety.
• I asked for a restricted supply (only 10 tablets per prescription) with no refills unless I met with my provider.

For me, those were enough precautions to support my recovery, and I use benzodiazepine sparingly.

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In my mind, benzodiazepines are a safety net that provides reassurance. If I do feel like I’m having a panic attack, I have medication to help me overcome it.

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As someone with an anxiety disorder characterized by panic and impending disasters, that reassurance is critical to my recovery process.

I also firmly believe in the right of patients to self-determine. I try to make the right choices about my recovery that center on what is best for my overall health and wellness.

I don’t believe in putting my entire trust into a physician, either. I think it’s a collaboration between myself and my medical provider.

In my experience, I believe that you can take anxiety medication in recovery.

*We want to highlight that although we are listing common medications used by people with co-occurring anxiety and substance use disorders, the decision about the right medication can only be decided between you and your medical health provider.