I’d like to share a few thoughts about the use of controlled substances (narcotics, benzodiazepines, stimulants, sedatives, etc). Controlled substances in general are not recommended for long term use. There are a few exceptions to this rule, notably stimulants, when used appropriately, and possibly medication assisted therapies such as Suboxone.
There are numerous reasons why controlled substances are to be used sparingly. These medications are more likely than medications that aren’t controlled in nature to result in dependence, tolerance, and if abruptly discontinued, withdrawal. Withdrawal can be as simple as feeling a little off, to as extreme as seizures, coma, and death.
As a psychiatric nurse practitioner, my primary call is to heal, not harm. Sometimes these medications become harmful. They are likely to result in negative feedback loops of feeling relief from symptoms after taking them. Then, as the drug begins to wear off, symptoms return, leading to taking the drug again, only to feel symptoms return yet again when the medication wears off. Over time this feedback loop leads to needing higher and higher doses to feel relief of symptoms. Sometimes a person is left having to take the medications, not because there is any therapeutic benefit, but simply to prevent symptoms of withdrawal. All of that is unpleasant and unnecessary.
More importantly, using medications like these don’t allow you to process your experiences fully. If you are suppressing symptoms of anxiety, there is no need or ability to learn how to work through the anxiety, process its causes, realize the safety of ourselves, and feel the power of our own innate healing. Often it’s helpful to have a partner in walking through stages of anxiety and I strongly encourage forming a therapeutic alliance with a therapist to help you become your own super power….not a drug.
If you are using sedatives for sleep, you rob your body and brain of its own ability to restore natural sleep. Using therapies like CBT-I, yoga, mindfulness, meditation, hypnosis, and some medications that are not controlled to help with sleep is a much better plan for sustained, overall health and healing.
When it comes to stimulants, they are an accepted part of managing symptoms of ADD/ADHD. However, daily medication will never be a magic key that fixes it all. Learning organizational techniques, time management, mindfulness, and self regulation are all going to be important pieces of the puzzle and, when combined with medication, this will provide the best outcome.
Moving forward my policy around use of controlled substances will be even more thoughtful. Short term use may be appropriate, but we will look at all alternative avenues before resorting to a controlled medication that is going to dull you, lead to negative feedback loops, and not support your ultimate healing. This is a conversation we can have in more detail when we meet for an appointment.
Most importantly, I look forward to supporting your ultimate journey to wellness.