Dealing with Anxiety in Recovery

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June 8, 2020

Coping with anxiety disorder while in addiction recovery doesn’t have to be difficult.  

There are many patients in medication-assisted treatment (MAT) programs who deal with a dual diagnosis of addiction along with mental illness. Those in recovery often face anxiety triggers surrounding sobriety, relapse, and other fears related to addiction.  

There are various ways to treat those who have particularly severe cases of anxiety, along with depression and post-traumatic stress disorder (PTSD). Still, those in MAT need to understand how multiple medications may counteract each other. 

A woman reflects somberly against a window, her expression conveying anxiety and the struggle of dealing with her condition during addiction recovery.

MAT Side-Effects   

Outside of mental health factors, some patients enrolled in MAT may feel side effects from the medications utilized to help them. While methadone and Suboxone generally only have mild-to-moderate adverse side effects, every person is different. Psychological side effects of these two medications can include moodiness and anxiety.  

Those who are new to the treatment are also prone to feeling the anxiety effects of withdrawal. Thankfully, these feelings generally subside once the medication dosage is correct. 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. If they cannot reach their provider or MAT center, they should seek emergency services. 

What are Benzodiazepines?  

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 when treating patients with anxiety disorders in MAT.  

There are also possibilities of adverse drug interactions that can occur when mixing medications. For example, mixing Suboxone and Xanax could prove very dangerous. Xanax can depress the central nervous system, leading to potential overdose or respiratory failure.  

Patients need to be transparent with their providers about what medications they are taking at all times. Whether they are being prescribed or taken illicitly without consulting a psychiatrist or physician, safety measures are necessary. 

Pills scattered on a wooden surface, symbolizing medication used to help patients manage anxiety in addiction recovery.

Alternative Anti-Anxiety Medication to Take in Recovery

Patients in MAT who have a co-occurring mental illness must plan their treatment carefully. General anxiety disorder, PTSD, or other forms of anxiety, in combination with depression, often require additional medications.  

Because the combination of benzos and opioids is dangerous, providers will usually opt for a different method of anxiety management. This reduces the chances of potentially fatal drug interactions and accidental overdose or possible misuse.  

The alternatives to benzodiazepines can significantly improve a patient’s life while in MAT and even after treatment. Providers can speak with patients suffering from constant anxiety about other anxiolytic options to help with symptoms:   


These medications work differently from benzos as they don’t have an immediate release or instant effect. This lowers the risk of overdose and misuse for those in recovery. They are taken over a period of time until the medication builds up in the body. The medications help the brain process serotonin, helping reduce anxiety and depression. Examples of SSRI medications include Prozac, Zoloft, Paxil and Lexapro. 


These medications work by raising serotonin and norepinephrine levels in the brain. They can help control energy levels, mood and responses to stress. SNRIs are very effective in treating depression and anxiety, although SSRIs are usually the first line of defense. Some patients have found that SNRIs can also help with chronic pain. Those who suffer from chronic pain and opioid use disorder can significantly benefit from these medications. Examples of SNRIs include Pristiq, Cymbalta, Fetzima and Effexor.  


These medications are also antidepressants, but they work differently from the rest. They’re not better or worse than SSRIs, but they can be a good alternative for certain patients. NDRIs work to control levels of norepinephrine and dopamine in the brain. This function helps manage mood and mental functioning. Patients with ADHD and anxiety often primarily benefit from NDRI medications while in treatment. The only NDRI approved to treat depression currently is Wellbutrin, also known as bupropion. Some providers may prescribe an NDRI called methylphenidate, which primarily treats ADHD and anxiety caused by the disorder.  

It’s important to note that the NDRI, Wellbutrin, is sometimes prescribed to help with smoke cessation. Patients have found that the medication has also helped them reduce cravings for other substances. This medication has been beneficial for those with addiction and mental illness.  

Each type of anxiety medication carries its own side effects. However, the three alternative routes are generally safe to take with Suboxone. The main goal of prescribing these types of medicines to patients in MAT is to help them succeed in recovery.

A man in a gray cardigan listens attentively as his physician discusses ways on managing anxiety during addiction recovery.

Treating Anxiety in Recovery Through MAT

When enrolled in MAT, patients go through screening for alcohol and drug use that falls outside of the scope of opioid use. This ensures that there are no negative interactions when beginning treatment. A provider will advise those who were previously mixing benzos with opioids to find a better method.  

It’s absolutely vital to address underlying anxiety disorder during MAT. It can negatively impact a patient’s chances of success in recovery if left untreated. Specialized providers can find a way to deal with co-occurring mental illness. They know which medications are most effective and safe to treat these conditions while enrolled in MAT. 

Patients who feel that their anxiety is a major factor that drives their opioid misuse will benefit from additional medication. With the addition of substance use counseling, those who suffer from anxiety while in MAT can find refuge. Medication for both anxiety and addiction becomes even more effective with the help of psychotherapy.  

AppleGate Recovery is Here to Help You!

If you or someone you know is facing opioid addiction, getting appropriate treatment is essential to turning your life around. AppleGate Recovery provides evidence-based addiction treatment to get you on the path to recovery. You deserve a happy, healthy life out of the shadow of opioid addiction. To speak to one of our compassionate staff members, call (888) 488-5337 or get in touch through our contact form