Mental health

Anxiety medications and addiction risk: Which are safe in recovery?

Published April 8, 2025 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

Anxiety is extremely common in recovery but treating it with addictive medications creates serious risk. Understanding which medications are safe matters.

Avoid in recovery

Benzodiazepines (Xanax, Klonopin, Ativan, Valium): highly addictive, cross-reactive with alcohol, and the most commonly abused anxiety medications. Z-drugs (Ambien, Lunesta): similar mechanism and addiction risk.

Safe options

SSRIs (sertraline, escitalopram): first-line anxiety treatment, non-addictive. SNRIs (venlafaxine, duloxetine): effective for anxiety, non-addictive. Buspirone: specifically for anxiety, non-addictive, no sedation. Hydroxyzine: antihistamine with anti-anxiety properties, non-addictive. Gabapentin: may help anxiety but has emerging abuse concerns in some populations.

Non-medication approaches

CBT for anxiety (most effective long-term treatment). Mindfulness and meditation. Exercise. Progressive muscle relaxation. Therapy addressing the anxiety that substances were managing.

Authoritative sources

This article references guidelines from: NIH · NAMI · APA

Frequently asked questions

Can I take anxiety medication in recovery?

Yes, but avoid benzodiazepines. SSRIs, buspirone, and hydroxyzine are safe non-addictive options.

Why are benzos dangerous in recovery?

Benzodiazepines are addictive, produce tolerance, have dangerous withdrawal, and cross-react with alcohol. They replace one addiction with another.

Will anxiety go away in recovery?

Anxiety typically worsens in early recovery then improves significantly as the brain heals. Within 4-8 weeks, baseline anxiety often decreases below pre-addiction levels.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.