Mar 15, 2000 Table of Contents

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor.org, the AAFP patient education Web site.

Information from Your Family Doctor

Alcohol or Drug Abuse Recovery: Your Doctor Can Help You

Am Fam Physician. 2000 Mar 15;61(6):1883-1884.

Why do I need to tell my doctor that I am in recovery?

The decision to stop using alcohol or other drugs (as well as a history of previous use) is very important to your health. If your doctor knows that you have made this decision, he or she can help you in your recovery. By working with your doctor, you can increase your chance of having long-term sobriety. Your doctor can give you emotional support during your recovery and can treat any medical problems that may occur during your recovery.

What are the medical consequences of alcohol or drug abuse?

Alcohol and other drugs can cause or worsen many medical problems. Alcohol, for example, increases the risk of some stomach and heart diseases. Some people get gastritis (inflammation of the stomach lining) or high blood pressure because of drinking too much alcohol. Also, if you were taking a medicine, such as blood pressure medicine, during the time when you were drinking or using drugs, it is likely that the dose of this medicine may need to be lowered now that you're not drinking or using drugs.

Mood changes such as irritability, anger, depression and anxiety, and problems with sleeping and sexual function are common in the first few months of recovery. If you have any of these problems and discuss them with your doctor, he or she can help you.

Is it safe to take medicines for pain or anxiety if I have these problems?

In general, taking medicines for anxiety or pain for a long time can increase your risk of a relapse. For this reason, your doctor may want you to try other ways of relieving any pain, anxiety, depression or insomnia you may have. For example, instead of using medicine to relieve pain, your doctor may suggest that you try physical therapy, relaxation techniques, local ice or heat, and massage. These methods are often helpful. Nonnarcotic pain medicines can also be helpful in relieving pain if the other methods don't work. Using relaxation techniques, like deep breathing and meditation, may help with your feelings of stress and anxiety.

Tranquilizers and some muscle relaxants, such as benzodiazepines, barbiturates and meprobamate (brand names: Equanil, Miltown), should be avoided if at all possible. Narcotic medicines, including pain killers, analgesics and opiates, increase the risk of relapse, particularly if you have previously abused a narcotic such as heroin, codeine, morphine or oxycodone (brand name: Percodan). None of these medicines should be used for chronic pain problems, such as chronic back pain or migraine. However, narcotics, tranquilizers or muscle relaxants may be prescribed for a few days to manage pain from an injury, surgery or a dental procedure.

What if I ever need a strong pain medicine?

When tranquilizers and narcotics are the only option (such as after an injury or surgery), your condition can be managed the right way and your risk of relapse can be lessened if you are open and honest with your doctor. The two of you can work together to find the safest treatment for you.

The smallest possible dose of a tranquilizer or narcotic medicine should be used. The medicine should be taken for as short a time as possible. If you are active in a 12-step program or another self-help support program, you should let your fellow members know that you are taking these medicines.

Is it safe to take antidepressants if depression is a problem during my recovery?

Depression can be a problem for some patients during recovery. Many patients in recovery are concerned about taking antidepressants. Major depression is a significant medical condition and often must be treated with one of these medicines.

Based on your recovery status, your doctor will be able to tell if you need to take an antidepressant. During the first few months of recovery, you may find that participation in a self-help group like Alcoholics Anonymous or Narcotics Anonymous can help with certain feelings of depression. It is essential that you let your doctor know that you are involved in such a group. When appropriately prescribed, antidepressants do not carry a risk of relapse.

Why is it important for me to be honest with my doctor about my history of alcohol or drug abuse?

Honesty and strict attention to the process of recovery are among the keys to long-term success. For these reasons, it is important for you to be honest with your doctor.

In the past, you may not have been open with your doctor about how much, how often and how long you used alcohol or other drugs. You may be uncomfortable about telling your doctor that you have used prescription medicines in ways for which they were not intended. Perhaps you're afraid that sharing this information with your doctor may result in your doctor not prescribing medicines to you when you need them.

No matter what your past relationship with your doctor was—whether or not you were open about your alcohol or drug problem—your future relationship needs to be based on trust and willingness to work together to support your long-term recovery. Just as you can learn something from your doctor, your doctor can learn something from you. For example, you may be involved in a 12-step program, and your doctor may not know as much about how these approaches work as you do. He or she will be eager to learn from you and to help you in your journey to recovery.


This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Copyright © 2000 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

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