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Hospitals are places where people go to get better, but they often dispense powerful medications and anyone at risk from addiction should take precautions to protect themselves from situations that could lead to relapse. Hospital staff are well aware of the dangers inherent in the drugs they use (which are powerful because they need to be so), but they may not be aware that you have any history of addiction or recovery unless you tell them.
High-Risk Situations in Hospital
Hospitals are places of care, but they can also be dangerous. Even in the best-run establishments it is possible to pick up an infection or, perhaps worse, an addiction. There are sensible precautions that you should take especially if your life has already been affected by addiction. While substance addiction can occur in any setting, we should remember that the majority of patients do not develop addiction issues during their hospital stays. However, there are situations where the risk significantly increases, such as:
- Pre-existing Substance Abuse: People with a history of substance abuse are at a higher risk of developing problems with medications during their hospital stay.
- Lengthy Hospitalisations: extended stays in hospital can increase exposure to medications, potentially raising the risk of dependence.
- Pain Management: patients experiencing severe or chronic pain may require especially strong medications, such as opioids, which carry a higher risk of addiction.
- Mental Health Conditions: patients with co-occurring mental health disorders, such as anxiety or depression, may be more vulnerable to developing addiction issues while in the hospital.
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Which Medications Are the Most Dangerous?
Several common hospital medications are potentially dangerous for people in addiction recovery, as they may pose a risk of triggering a relapse or exacerbating addiction-related issues. However, it’s important to note that the specific risks vary depending on the individual, their addiction history, and the circumstances. Here are some examples of drugs that could be concerning:
- Opioids such as morphine, oxycodone, and fentanyl, are potent painkillers often used in hospitals for severe cases. These drugs have a high potential for addiction and are clearly risky for people with a history of opioid addiction.
- Benzodiazepines such as diazepam(Valium) or lorazepam(Ativan), are sometimes prescribed for anxiety, insomnia, or sedation. They can easily become habit-forming and may pose a risk if readily available in clinical settings, especially since so many people have already been prescribed them in the past and may not consider them to be dangerously addictive.
- Stimulants – medications such as amphetamines or methylphenidate (Ritalin) are sometimes used for conditions such as attention deficit hyperactivity disorder (ADHD) or narcolepsy. These drugs can be addictive and obviously problematic for individuals with a history of stimulant abuse.
- Alcohol-based medications – some liquid medications, such as cough syrups or mouthwashes, may contain alcohol and this is sometimes hard to see on the label. For people with any history of alcohol addiction, even small amounts of alcohol can be triggering and should be avoided.
- Sedatives/hypnotics – sedative medications which are neither opioids nor benzodiazepines such as Zopiclone can also be addictive and may cause dependence or worsen pre-existing addiction issues.
How to Prepare for a Hospital Visit
It’s crucial to inform everyone involved in your hospital treatment about your addiction history and any concerns you have. They can work with you to develop treatment procedures that minimise the risks of addiction and provide alternative medications or approaches when necessary. Additionally, they can monitor your medication usage closely and provide the appropriate support and resources to ensure your safety and recovery. Here are some recommended steps that you can take:
- Openly communicate with doctors, nurses, and other healthcare providers about your concerns regarding addiction. Be honest about your history of addiction or any predisposition you may have. They can take your situation into account when prescribing and provide alternative options if necessary.
- Advocate for yourself- if you feel that certain medications may pose a risk of addiction for you, discuss this with your healthcare team. A lot of people are reluctant at first to question medical advice, believing that the doctor is always right, but in some cases, this may not be so, especially if the doctor is not fully aware of your history. Ask for non-addictive alternatives or inquire about strategies to reduce your exposure to potentially addictive drugs.
- Understand your medications – educate yourself about the drugs you’re being prescribed. Learn about their potential side effects, addictive properties, and the recommended dosage. This knowledge will help you make informed decisions and recognise warning signs.
- Follow the prescribed regimen – it’s crucial to take your medications as prescribed. Do not exceed the recommended dosage or alter the frequency without consulting a professional. If you’re experiencing discomfort or side effects, discuss these before making any changes.
- Build a support system – inform family members, trusted friends, or a support group such as your local AA or NA group about your concerns. Having a strong support system can provide emotional assistance and accountability during your recovery process and someone to contact in moments of stress when you need guidance and understanding of what you are experiencing.
- Request non-pharmacological alternatives – in some cases, different approaches may be effective alternatives for pain management or other conditions. These can include physiotherapy, acupuncture, massage therapy, or relaxation techniques for example. Talk about incorporating these options into your treatment plan.
Which Is the Most Addictive Drug You May Be Prescribed in Hospital?
It is unlikely that in hospital you will be ever prescribed certain highly addictive drugs such as cocaine, crystal meth or nicotine but you may well be offered others equally addictive. Broadly speaking, the most danger lies in three groups:
- Opioids such as morphine, oxycodone, and fentanyl, are potent pain relievers. They are often listed as the most addictive of all drugs as their euphoric effect can quickly lead to physical and psychological dependence.
- Benzodiazepines – diazepam (Valium) or lorazepam (Ativan), are commonly prescribed for anxiety, sedation, or sleep disorders. These work deceptively to build dependence through their ability to soothe and relieve stress rather than by providing euphoric highs.
- Stimulants that may have been prescribed to treat fatigue, depression or sleep problems can become addictive over long periods especially if the recommended dose is exceeded. They stimulate the production of dopamine in the brain, leading to a desirable feel-good sensation.
Pain Management for People in Recovery
Although statistics are hard to come by, the most concern among recovering addicts and healthcare professionals appears to relate to the effects of painkiller medication upon those at risk of relapse into substance abuse. Hospital procedures often require powerful analgesics such as morphine which clearly pose great danger to opioid addicts in recovery. According to a post by the Faculty of Pain Medicine at the Royal College of Physicians, acute pain management must be given priority and follow certain principles:
- Empathic communication with the patient and reassurance that pain will be managed optimally.
- Comprehensive assessment including physical and emotional comorbidities.
- Liaison with other healthcare providers and those supporting the patient.
- Objective confirmation of substance misuse.
- Prompt provision of appropriate opioid therapy to avoid withdrawal.
- Assessment and management of anxiety.
- Use of multimodal analgesia including analgesic drugs of different classes, local anaesthesia and general measures to minimise pain.
- A clear plan for dose tapering as acute pain subsides.
They go on to make it clear that acute pain management in patients in recovery from opioid addiction is particularly important, citing the following important considerations:
- Risk of relapse may occur both with the use of opioids and under-treatment of pain.
- Use non-opioid interventions where possible.
- A careful explanation of the risks and benefits of the proposed treatment plan should be discussed with the patient.
- Anxiety should be assessed and managed, if necessary with medication.
- Patients may have firmly held beliefs regarding opioid therapy and these should be respected.
Addiction to Prescription Drugs Is a Growing Problem
According to US statistics from the CDC (Centers For Disease Control and Prevention), the serious problem of prescription drug addiction is on the increase. At Castle Craig, we see growing numbers of people seeking help for prescription drug addiction, some of which have originated during hospital admission. Situations that have the potential for relapse can be managed when the situation is properly assessed and communicated – healthcare workers already have a good understanding of the dangers. Ensuring that you and everyone involved in your hospital treatment are fully aware of your circumstances is crucial for a safe and proper approach to your medication needs.
If you think you or someone you know could have a prescription drug problem, please don’t hesitate to contact us in the strictest of confidence – we will be glad to listen and discuss your best options. Call us 24/7 on 0808 271 7500