Anxiety and addiction are closely related. If you're in recovery, anxiety can be a significant obstacle — it can trigger a relapse, keep you from going to 12-step meetings or IOP, make it difficult to manage cravings, and generally make you miserable.
Unfortunately, benzodiazepines like Xanax — the most commonly prescribed type of anxiety medication — are highly addictive and dangerous. Detoxing from benzodiazepines can even be deadly.
Luckily, several non-addictive anxiety medications exist that can help you deal with your anxiety and transition back into a happy and healthy way of life.
Anxiety is an extremely common mental health condition that affects millions of people worldwide. Anxiety often co-occurs with addiction, and people with anxiety are more likely to develop a substance use disorder.
Likewise, addiction can cause anxiety — this is known as substance-induced anxiety. In most cases, this type of anxiety goes away on its own, but if you had anxiety issues before you started abusing drugs or alcohol, it’s likely those issues will remain when you get sober.
Benzodiazepines, often called benzos for short, are extremely good at relieving anxiety. Benzos work by increasing the activity of GABA, a neurotransmitter that reduces brain activity and produces a calming effect.
However, as mentioned, the risk of addiction with these medications is high, especially if you have a history of drug abuse. Even people who have never had addiction issues can become quickly addicted to these medications, which is why most doctors won’t prescribe them for more than a few weeks or on an as-needed basis.
Benzodiazepines are one of the most dangerous medications to try to detox from — withdrawals often cause severe seizures that can result in death. Psychosis is also a common symptom of benzo withdrawal.
Fortunately, non-addictive alternatives to benzos are available, and when combined with some form of therapy, like cognitive behavioral therapy (CBT), they can significantly reduce your symptoms and help you get back into life.
These medications work differently from benzos and have a lower risk of addiction and dependence. Some non-benzo anxiety medications include buspirone, hydroxyzine, beta-blockers, pregabalin, and gabapentin.
Buspirone works by increasing the activity of serotonin, a neurotransmitter that regulates mood. Buspirone has a lower risk of addiction than benzos and is less sedating. Hydroxyzine works by blocking histamine, a chemical in the body that produces allergy symptoms.
Beta-blockers are medications that can help by reducing the physical symptoms of anxiety, such as rapid heartbeat and trembling. Beta-blockers work by blocking the effects of adrenaline, a hormone that produces the fight-or-flight response.
Anticonvulsants, such as pregabalin and gabapentin, can help by reducing the release of the neurotransmitters that cause anxiety; however, they do have a higher risk of addiction than some of the other non-narcotic anxiety medications on this list.
Non-benzo anxiety medications can be effective, but because they are not as potent as benzos, they often take longer to work and have less noticeable effects, which is why they’re best combined with therapy.
Managing anxiety in recovery is essential to maintaining sobriety. Beyond medication, there are a number of things you can do to manage your symptoms.
Regular exercise can help reduce anxiety symptoms by releasing endorphins, a chemical in the body that produces a euphoric effect. Exercise can also generally help addicts and alcoholics as the rush of endorphins can improve your mood when you’re having a down day.
And, if you’re experiencing cravings, exercise can be a great way to redirect your attention and distract yourself in a healthy way until the craving goes away.
Many addicts and alcoholics get severely out of shape when in the depths of their addiction — exercise can help you get back into shape, which in turn will make you feel better about yourself and the progress you’re making in sobriety.
Mindfulness is all about the present moment, about accepting and acknowledging thoughts and feelings without attaching other emotions or judgments to them. Mindfulness is a very difficult practice to wrap your head around at first, but with practice, it can be uniquely beneficial.
Mindfulness is used or recommended in one way or another, sometimes under different names, by many treatment modalities, including the 12 steps and many forms of therapy. It’s also common in many religions.
Closely connected to the idea of mindfulness is the practice of meditation, which can help reduce anxiety symptoms by promoting relaxation and reducing stress.
In meditation, your goal is to clear away your thoughts and feelings or focus intently on one thing, like a simple thought or prayer (which will then clear away other thoughts and feelings).
Meditation usually involves sitting still and focusing, but meditation as a part of exercise, including yoga or even walking meditation, is also a possibility you can explore. Chanting mantras is another form of meditation that can be easier for beginners.
Meditation also comes in many forms and is a part of many religions, including Christianity, Buddhism, and Hinduism. It’s also recommended as a part of the 12 steps and is often recommended by therapists.
Meditation goes hand-in-hand with breathing techniques, such as deep breathing and diaphragmatic breathing. These can promote relaxation on their own, and they can also help you get into a meditative state more easily.
Combining therapy and medication is often the most effective approach to recovery. Therapy can address the underlying causes of both your addiction and your anxiety, while medication can manage the symptoms and reduce the severity of anxiety when it occurs.
Cognitive-behavioral therapy is extremely helpful for those suffering from addiction and anxiety because it can help identify negative thought patterns that are causing you harm. As you identify them, you work on replacing them with positive ones.
This can not only help prevent the self-defeating behaviors that cause relapse, but it can also help you get through anxiety attacks by using a variety of coping skills and relaxation techniques.
Ultimately, it’s always helpful to talk to a medical professional who can prescribe non-narcotic medications and recommend a good therapist. A medical professional can also monitor for any adverse side effects and adjust your treatment plan as necessary.
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Cristal Clark, LPC-S, is the Medical Reviewer for ASIC Recovery Services. She reviews all website content for quality and medical accuracy. She is a master’s level Licensed Professional Counselor Supervisor and graduated from Liberty University in 2011. She has worked in the behavioral and mental health field for over 12 years and has a passion for helping others. She has been clinical director and CEO of a 200 plus bed facility, PHP, and IOP, with experience managing a team of counselors, individual/group/and family therapy, and coordinating continuum of care. Cristal is trained in EMDR and certified in non-violent intervention. She is a member of American Counseling Association and American Association of Christian Counselors.