I am approaching an age when I need to start thinking about how to approach taking medicines while preserving my sobriety. How do we decide which medications or chemicals are ok and which ones aren’t? I have thought about a couple different approaches and their inadequacies:
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Mental effect
We want to avoid substances which cause euphoria or any other mental effect similar to those we sought with drugs and alcohol. This approach seems solid, but has some drawbacks. For example, we would obviously not want to do meth (because it is a potent stimulant) but caffeine and nicotine have similar effects, although they are much milder. I think most people would agree that someone who smokes and drinks coffee but remains otherwise abstinent would be considered sober. -
Motivation in taking chemical
Does intent matter? If I take a Benadryl for allergies, that’s one thing, but if I take it because I am agitated and irritable and just want to be knocked out, that’s another kettle of fish. Taken to a logical extreme, this view would allow a sober person to take narcotics for acute relief of physical pain. -
Neuropharmacological mechanisms
Should we avoid medications that act on the same neurotransmitters that made drugs and alcohol so effective? For example, LSD works on serotonin receptors, but does that mean I should avoid antidepressants?
What prompts me to write this now is that I have a medical condition called Restless Legs Syndrome and the medications used for it are (in order of effectiveness): gabapentin and related compounds, dopamine agonists, and benzodiazepines (eg Ativan). Gabapentin and benzos both work on promoting activity of the neurotransmitter GABA, but gabapentin does not commonly cause the intoxication often seen with benzos. Dopamine plays a huge role in addiction, but dopamine agonists themselves are not addictive and are not intoxicating.
At any rate, how do you all approach these issues? Is there any simple answer?
