Medications and Judgments

There’s an issue I keep hearing about when I read and listen to the stories of dual diagnosis folks in recovery. An issue I haven’t written about yet because it feels so important and I keep waiting to be at my best to tackle it. Since I can feel my perfectionism rearing its pristine head, I am going to fight it by opening the subject anyway. Therefore, please assume that this post is not comprehensive and that this subject will most likely be revisited and expanded in the future.

Here goes.

I want to talk about the misunderstandings and judgments that go on between several groups of people on the issue of psychiatric medications in recovery. My opinions and feelings associated with it come from education, personal experience and the experiences of people I care about. They are my personal opinions and not those of any group; they are also not professional advice. That being said:

I wish to hell people would stop saying that anyone who takes psych meds isn’t clean or sober or fully working a program of recovery.

In recent years, the climate in the recovery community has become somewhat more accepting about the issue, but there is still far to go. There’s also a major lack of awareness about different classes of psych meds and the fact that some types have the potential to be addictive and some do not. There still tends to be a general perception that if you take any type of pill that affects your brain, you are doing it to get out of dealing with reality and with your emotions.

There exists a 12-step fellowship called Dual Recovery Anonymous, devoted to dual diagnosis people. I’m really glad about that, but there are so many of us that I want us to be able to thrive in every fellowship and use all of the support that’s out there. Depending on what study you’re reading, somewhere between 20 and 50 percent–possibly more–of substance abuse patients have co-occurring mental health issues. If you look only at chronic relapsers, who have sought treatment multiple times and can’t seem to put more than a short span together, the percentage probably goes up. Forget the perfectionism and the cleaner-than-thou debates; what is the potential benefit to society if this population becomes more able to make recovery stick?

I’ve been told to stop taking my meds before. Five or six years ago, during one of my short-lived stretches of recovery, I wanted to be accepted so badly that I took the advice. It didn’t turn out well. I was luckier than some…I “only” ended up using drugs again. Some people end up in the psych ward or jail. Or the morgue.

If you’re a person in recovery…please, please, think carefully before you give advice on this issue. Before you make blanket statements about what constitutes recovery and what doesn’t. Before you get up and brag about how your Higher Power or your positive attitude or your dedication to the Steps has removed your need for a “crutch.” Even if your desire is to spread a message of hope and possibility, realize you are telling your own story only.

Jump off tall things. Works for me!

Jump off tall things. Works for me!

Yes, brain chemistry changes with more time away from substances, and treatment needs can change or even diminish in recovery. Yes, attitude and lifestyle make a positive impact as well. But improvement may not be to the point of no longer needing any treatment. Mental illness has a complex array of causes and symptoms, on a wide spectrum of severity, and none of us is qualified to judge the contents of someone else’s head. Understand that someone with a mental illness has been on the receiving end of so much stigma and shame that your words have a lot of power. Celebrate your blessings and triumphs, but do it in a spirit of gratitude and not superiority.

If you’re a sponsor or a close recovery friend of a dual diagnosis person, ask them to tell you about exactly what they take and what it’s for. Understand that in many cases, the time to worry is if they neglect their meds, and that taking their meds consistently is an important part of their recovery. Ask them if their doctor knows they are in recovery, and encourage them to tell if they have not. Help them apply the Steps and their other spiritual tools to the challenges and feelings that come with managing their condition.


If you’re a medical professional who is helping a person in recovery manage their mental health issues, treat them with respect and don’t make them regret telling you the truth. Have a real dialogue with them about their former behaviors. Educate them about their meds and help them understand that antidepressants and bipolar meds are long-acting and will not make them high. Educate them about the dangers of the addictive types of meds such as tranquilizers. Help them avoid these if possible, and help them be accountable if these are absolutely required.

It’s not an easy situation for anyone, but I hear so much pain and frustration around it that I think the only way to go is up. Lastly, if you, like me, are a dual diagnosis person in recovery: don’t run away from the recovery community because of judgment you encounter. Don’t do it. We need you. I need you. Here’s what you do instead: you work with professionals with whom you are totally honest about your history. Having arrived at an appropriate plan, you take your meds as prescribed; you keep all your appointments and you stay accountable to a sponsor (who, sometimes after much effort, you found and educated.) You show up to your fellowship; you work the Steps and do service and stay clean/sober/whatever. You rack up some years and then you start sponsoring others like you!

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