Anxiety Management During Treatment

MastHead Outline
June 8, 2020

There are many patients in medication-assisted treatment (MAT) programs that are dealing with a dual-diagnosis of addiction along with mental illness. While anxiety seems to be a part of daily life for nearly everyone these days, those in recovery often must face anxiety triggers surrounding sobriety, relapse, and other fears related to trying to rebuild their lives while treating addiction. There are ways medical providers deal with those who have particularly severe cases of anxiety, along with depression and PTSD, and it’s important to understand how various medications may counteract each other for those in MAT.

MAT Side-Effects  

Outside of mental health factors, some patients enrolled in MAT may feel side-effects from the medications utilized which include methadone and Suboxone®. Psychological side effects can include moodiness and anxiety. Those who are new to the treatment are also prone to feeling the anxiety effects of withdrawal that will subside once the medication is dosed correctly. Dosage requires adjustment in the early phases of treatment. Anyone experiencing sudden or acute anxiety during treatment that feels out of normal range should speak to their provider immediately or seek emergency services.

MAT and Anti-Anxiety Medication

Benzodiazepines, commonly referred to as “benzos,” are frequently prescribed to people who struggle with anxiety. Due to their highly addictive nature, providers must be careful with treating patients with anxiety disorders in MAT. There are also possibilities of adverse drug interactions that can occur when mixing, for example, Suboxone® and Xanax®. The mixture of these two medications could prove very dangerous as Xanax® can depress the central nervous system, leading to potential overdose or respiratory failure. Patients need to be transparent with their provider about what medications they are taking, whether they are being prescribed or taken illicitly without consulting a psychiatrist or physician.

Alternative Anxiety Disorder Medications

Patients in an MAT program, along with a co-occurring disorder such as general anxiety disorder, PTSD, or other forms of anxiety in combination with depression, must carefully plan and manage their medications. There are alternatives to benzodiazepines that can significantly improve a patient’s life while in MAT, and even after treatment. Providers can speak with patients suffering from constant anxiety about SSRI medications, such as Prozac®, to help with symptoms. These medications work differently from benzos as they don’t have an immediate release or instant effect; they are taken over a period of time until the medication is built up in the body, helping the brain process serotonin, helping reduce anxiety and depression.

When enrolling in MAT, all patients are screened from alcohol and drug use that falls outside of the scope of opioid to ensure that there are no negative interactions when beginning treatment. A provider will advise people who were previously mixing medications with opioids on a better method of dealing with a co-occurring mental illness and the most effective and safe way to go about treating it while enrolled in MAT.

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