What Happens if You Take Drugs While on Suboxone?
What is Suboxone?
Suboxone is a brand-name prescription medication that contains a combination of buprenorphine and naloxone. This drug is used for the treatment of opioid dependency and is often part of a comprehensive recovery program for opioid addiction referred to as medication-assisted therapy.
The buprenorphine component allows the drug to bind opioid receptors and prevent withdrawal symptoms once the user stops taking opioids. The drug has a “ceiling effect” that limits the person’s reaction to the drug, even with increased dose. This produces much weaker effects, like euphoria, when compared to other opioid drugs.1 As a result there is a decreased risk of dangerous side effects such as slowed or stopped breathing. These properties of buprenorphine lower the potential for misuse and lower the effects of physical dependency to opioids, which help the user slowly wean off opioids safely.
The naloxone component works by attaching to opiod receptors and blocking other opioids such as heroin, oxycodone and fentanyl from producing the addictive euphoric sensations.2
If suboxone is abused in an effort to get high, the naloxone will inhibit the buprenorphine component of the drug from binding to the opioid receptors, making the person experience the unpleasant symptoms of withdrawal.
Through its actions, suboxone is able to effectively negate the euphoric effects of opioids, prevent withdrawal symptoms and cravings, and allow individuals with opioid addiction to transition back to a healthy life of sobriety.
What Drugs Can Interact With Suboxone?
If you are taking Suboxone or your doctor is considering prescribing this medication to you, it is important to fully understand if the drug will react negatively when taken with other drugs. This is especially true for drugs that act on the central nervous system.
It is extremely dangerous to take benzodiazepines, like Xanax or Valium, while receiving suboxone treatment. Benzodiazepines and suboxone both depress the central nervous system and can cause impairment, unconsciousness, respiratory failure, coma, or even death if taken together.3
According to data reviewed by the U.S. Food and Drug Administration, during the period of 2004-2011 the combined abuse of opioids and benzodiazepines significantly increased the rate of emergency department visits and nearly tripled the number of overdose deaths.4 The dangers of mixing these drugs was also demonstrated in findings from a recent study that showed 82% of buprenorphine overdose deaths involved the use of benzodiazepines.5
People are also warned against mixing suboxone and cocaine. There is evidence that combining these drugs can reduce the effectiveness of suboxone.6 People who combine these drugs demonstrate low motivations to stay clean and are at increased risk for developing a multi-drug addiction.
Alcohol is a depressant, and when mixed with Suboxone, it can cause increased depression of the central nervous system. The effects of mixing alcohol and suboxone can include:3
- Low blood pressure
- Slowed breathing
- Deep sedation
The findings from one study looking at opioid-associated deaths showed that alcohol was involved in more than half of all buprenorphine poisonings that resulted in overdose death.5
Suboxone can be very beneficial as a replacement drug that has a safer profile than other opioid drugs. Although it is a key part of medication-assisted therapy designed to transition people off of their addiction to opioids, there are risks associated with its use. The buprenorphine component of suboxone can be habit-forming, as it is an opioid agonist that elicits many of the same effects as other opioid drugs, and some people can end up abusing this drug.1 However, if used as prescribed suboxone can be a highly effective treatment for individuals suffering from opioid addiction.
Combined with proper treatment plans from addiction specialists, Suboxone can be an effective part in helping those dependent on opioids overcome their addiction. It is important to ensure your treatment and use of Suboxone is monitored closely to ensure long-term success.
- Substance Abuse and Mental Health Services Administration. (2019). Buprenorphine.
- National Institute on Drug Abuse. (2018). Opioid Overdose Reversal with Naloxone (Narcan, Evzio).
- Indivior Inc. (2018). Suboxone prescribing information.
- U.S. Food and Drug Administration. (2016). FDA requires strong warnings for opioid analgesics, prescription opioid cough products, and benzodiazepine labeling related to serious risks and death from combined use.
- Häkkinen, M., Launiainen, T., Vuori, E., & Ojanperä, I. (2012). Benzodiazepines and alcohol are associated with cases of fatal buprenorphine poisoning. European Journal of Clinical Pharmacology, 68(3), 301-309.
- Copenhaver, M.M., Bruce, R.D., & Altice, F.L. (2007). Behavioral counseling content for optimizing the use of buprenorphine for treatment of opioid dependence in community-based settings: a review of the empirical evidence. American Journal of Drug and Alcohol Abuse, 33(5), 643-654.