Substance Use and Medication: You're Not Broken, You're Human

Let's start with the obvious:
If you're here reading about substance use and medication, it probably means something hasn't been working.

Maybe you've tried to stop before: once, twice, twenty times. Maybe you're not even sure you want to stop. You just want to stop feeling this way. Maybe you're a parent, a partner, a nurse, a construction worker, a college student. Maybe you don't "look like" the stereotype. Or maybe you do, and it doesn't matter either way.

What matters is this: you are not weak, broken, or hopeless.

Substance use doesn't make you a bad person. It makes you a person who's been using something, alcohol, pills, weed, stimulants, opiates, whatever, to cope. Maybe to survive. Maybe because your brain just needed something to feel okay for five minutes.

We're not here to judge that. We're here to talk about help. And yes, that might include medication. Substance Use Is Not Just a "Bad Habit".

First things first, let's ditch the old-school language. This isn't about "addicts" or "junkies" or "willpower". Substance Use Disorder (SUD) is a real, diagnosable medical condition that affects the brain's reward system, stress response, and decision-making circuits. It's not about moral failure. It's about neurobiology.

You're not choosing chaos. Your brain has learned that substance = relief.

That might be physical, emotional, social, or all of the above.

Substance use often starts for a reason:

• Trauma

• Anxiety or depression

• Chronic pain

• ADHD or bipolar disorder

• Social pressure or survival

• Just trying to feel something (or nothing)

If that's you or someone you love, you're not alone. And more importantly: it's treatable.

So, What Is Medication-Assisted Treatment (MAT)?

Let's get into the heart of it: Medication-Assisted Treatment (MAT) is a fancy phrase that means using medication—alongside therapy and support—to help people reduce or stop substance use.

It's not replacing one drug with another. It's supporting your brain while it heals. Think of it this way, if someone broke their leg, we'd give them crutches and pain meds while the bone set. If someone had diabetes, we'd offer insulin. With substance use, medication can help reduce cravings, prevent relapse, and make recovery feel actually possible, not like a white-knuckle uphill climb every single day.

Common Medications by Substance

Let's break it down by what someone's using, because the brain and body respond differently depending on the substance.

1. Opioids (Heroin, Fentanyl, Oxycodone, etc.)

Medications that help:

• Buprenorphine (Suboxone): Reduces cravings and withdrawal without creating a high. Can be taken daily at home. It's game-changing for many people.

• Methadone: Long-acting, taken at clinics. Helps stabilize people who've used high doses for a long time.

• Naltrexone (Vivitrol): A monthly shot that blocks the effects of opioids completely: no high, no use. Requires full detox first.

🧠 These meds reduce relapse, lower overdose risk, and help people return to school, jobs, families, life.

2. Alcohol

Medications that help:

• Naltrexone: Reduces cravings and the pleasure from drinking. Can be taken daily or as a monthly shot.

• Acamprosate (Campral): Helps balance brain chemicals after you stop drinking, especially helpful for mood and sleep.

• Disulfiram (Antabuse): Makes you sick if you drink. More of a deterrent than a craving reducer. Works best with strong external support.

These meds don't "make you sober". They help your brain not scream for a drink every five seconds so that you can actually do the work of healing.

3. Stimulants (Cocaine, Meth, Adderall Misuse)

There's no FDA-approved MAT for stimulant use yet, but…

• Some antidepressants (like bupropion) can help with the crash, depression, and cravings.

• N-acetylcysteine (NAC), a supplement, is being studied for its effects on reducing urges.

• ADHD medications may be considered in folks who were self-medicating undiagnosed attention issues.

The key is to treat what's underneath: trauma, impulse control, boredom, lack of structure. Stimulant recovery requires deep emotional work plus solid support.

4. Cannabis

People often think "you can't be addicted to weed" but let's be real, it can be very habit-forming for some.

There's no formal MAT yet, but:

• Gabapentin, antidepressants, or sleep support can help with withdrawal and mood symptoms.

• Therapy is huge here, especially for folks using cannabis to manage trauma, anxiety, or emotional dysregulation.

Quitting or cutting back isn't about moral purity. It's about asking, "Is this helping me feel more like myself, or less?"

"But Isn't Medication Just Another Crutch?"

This one's worth pausing on.

We've been fed the idea that "true recovery" means complete abstinence, no medication, no shortcuts. Just grit and 12 steps.

And for some people? That works beautifully.
But for many others, especially those with trauma, chronic mental health conditions, or high relapse risk, MAT saves lives.

You're not "cheating" if you use medication. You're surviving. You're healing your brain with the tools that make healing possible.

And you can still do therapy, step work, healing circles, prayer, yoga, all of it.

Medication doesn’t take away your recovery. It can support it.

What About Side Effects?

All medications come with possible side effects. The most common with MAT:

• Nausea

• Headaches

• Fatigue

• Constipation

• Sleep changes

• Emotional blunting (sometimes with long-term methadone)

But these are often temporary and manageable. And your provider can adjust the dose or switch meds if needed. You don't have to tough it out.

Do I Have to Take It Forever?

Nope. Not unless you want to.

Some folks stay on meds for months. Others, for years. Some taper off when they feel stable. Some stay on indefinitely because it works and keeps them safe.

This is your journey. Not your cousin's, not your sponsor's, not your judge's.

The goal isn't to "get off medication".
The goal is to feel whole. To stay alive. To build a life you don’t want to escape from.

What About Co-Occurring Mental Health Stuff?

Many folks who use substances are also living with:

• PTSD

• Depression

• Anxiety

• ADHD

• Bipolar disorder

• Personality disorders

If you've ever used a substance to stop thinking, stop remembering, or just feel okay, you're not alone.

The good news? We can treat both. Often, treating the underlying mental health issue helps reduce the pull of substances.

Therapy + medication = double the support, half the shame.

Final Thoughts: You Deserve Peace, Not Punishment

If you've been beating yourself up for "not being able to stop,"
If you've been hiding your use out of fear,
If you've tried to quit so many times you lost count...

Just know this:

You are not a failure.
You are not beyond help.
And you deserve a recovery that feels possible, not impossible.

Medication doesn’t erase your story.
It doesn't mean you're "weak" or doing it wrong.
It means you're asking your brain to heal in a way that's grounded, supported, and survivable.

Whether you're sober-curious, in early recovery, deep in relapse, or just wondering if this is "a problem", you matter. Your healing matters.

Talk to a provider. Ask about medication. Get curious, not ashamed.

This isn't about perfection.
It's about possibility.

And you, my friend, deserve every ounce of that.