Suboxone is a prescription medication generally prescribed to treat opioid use disorders, especially those involving heroin. Warning labels on opioid drugs such as Suboxone urge persons who use these drugs not to do so in combination with alcohol. Even so, many individuals in recovery from opioids do drink alcohol, potentially at the expense of their health and well-being.
What Is Suboxone?
Suboxone consists of the active ingredients buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, meaning it binds to the same brain receptors as other opioids, but it does not produce the full effects of these other drugs. People who suffer from opioid use disorders will not experience the same “high” from buprenorphine that they are used to relate to their drug of choice.
Those who use buprenorphine will also not encounter the same severity of withdrawal effects upon discontinuation as with stronger, full opioid agonists. The Drug Enforcement Administration (DEA) categorizes buprenorphine as a Schedule III controlled substance, indicating it has some medical value and also the potential for abuse and dependence.
Naloxone is an opioid antagonist, which means that it also binds to opioid receptors in the brain but does not activate them. This medication also does not allow any other drugs to attach to these receptors and displaces any that are already bound. Once the drug’s effect onsets, people will immediately undergo opioid withdrawal.
Naloxone is included in Suboxone as an additional safeguard intended to keep individuals from abusing Suboxone and only becomes active if the medication is crushed, tampered with, or abused somehow. Naloxone is also frequently used as a standalone remedy to reverse life-threatening overdose effects, such as profound respiratory depression.
Suboxone was developed to be an opioid replacement to help those dependent on “harder” or street opioid drugs endure the withdrawal process with much less discomfort. However, because Suboxone contains an opioid, it can also be prescribed to manage pain and effectively relieve that which is mild to moderate.
Buprenorphine produces some mild euphoric effects, but Suboxone has a maximum or “ceiling” effect in place as an abuse prevention measure. This means that using other opioid-derived substances while on Suboxone or taking excessive amounts of the drug will not lead to euphoric feelings. Because Suboxone is a relatively long-acting medication, it only requires use once per day in most instances.
Despite these safeguards, buprenorphine can be abused. According to statistics from the Substance Abuse and Mental Health Services Administration (SAMHSA), from 2006 to 2011, there was a significant increase in emergency departments due to the recreational use of buprenorphine. These visits involved mostly younger persons, with the 18-25 age group having the most admissions, followed by individuals aged 26-34 and 35-54.
The misuse of buprenorphine is not nearly as common as abuse of other prescription and illicit opioids, such as hydrocodone and heroin. That said, a significant amount of prescription drug abuse occurs among those who have friends or family with prescriptions for the drug. According to SAMHSA, over half of prescription pain medication abuse involves those persons who obtain the medication from a friend or relative.
It’s of little surprise that alcohol use is the most common form of substance abuse in the United States due to its legal status. Alcohol and Suboxone are central nervous system depressants, meaning that their primary actions decrease brain and spinal cord activity. Combining alcohol with any opioid, including Suboxone, is extremely risky and can even be life-threatening.
Combining Alcohol and Suboxone
As noted, warning labels on opioid medications strongly advise individuals who are prescribed them to take them in combination with alcohol. Also, doctors must instruct patients to abstain from drinking while using these substances. Although buprenorphine is not a full opioid agonist, the same risks associated with other opioids also apply to this drug.
Because both alcohol and buprenorphine are CNS depressants, using them concurrently can intensify their overall effects. Side effects associated with buprenorphine use can be significantly increased in number and intensity when the medication is used in combination with alcohol.
These side effects include the following:
- Nausea and vomiting
- Blurry vision
- Fainting spells
- Profuse sweating
- Heart palpitations
- High or low blood pressure
- Impaired motor skills
- Prolonged reflex time
- Impaired cognition/judgment
Because CNS depressants like buprenorphine and alcohol reduce the brain and spinal cord activity, these drugs can contribute many potentially dangerous conditions when used together for a prolonged period and may include the following:
- Lung infections and tissue and organ damage as a result of reduced blood flow as well as a lack of oxygen and nutrients being rendered to organs and other tissues
- Hypoxic brain damage resulting from long-term complications related to respiratory depression
- Altered thinking that increases the potential for involvement in accidents and engagement in dangerous behaviors, such as intentional self-harm, when depression is present
- Unconscious states that occur due to the suppression of brain neurons that regulate automatic functions such as heart rate and respiration
These conditions can be life-threatening or cause severe damage to the brain and other bodily organs.
The long-term use of Suboxone and alcohol in combination can also lead to other adverse severe health consequences, including the following:
- Increased risk for several types of cancer, including those related to the liver, kidneys, breast, and gastrointestinal system
- Increased risk for liver disease, ulcers, stroke
- Increased risk for heart disease
- Increased risk of contracting any number of diseases as a result of a compromised immune system or engaging in unsafe behaviors
- Development of chemical or psychological dependence on one or both substances
Treatment for Drug and Alcohol Abuse
There are many potential risks of using Suboxone and alcohol for an extended period, or even just using them together occasionally. Individuals prescribed Suboxone as an opioid replacement who drink alcohol may undermine their recovery and incur many severe long-term consequences.
Just Believe Detox and Just Believe Recovery offer comprehensive programs for those struggling with substance use disorders. We employ highly-skilled compassionate addiction specialists who provide individuals in our care with the knowledge, education, tools, and support they need to achieve prolonged abstinence, avoid relapse, and foster long-term well-being and sobriety.
We offer therapeutic services proven beneficial to the recovery process, including psychotherapy, individual and family counseling, group support, experiential activities, mindfulness therapy, aftercare planning, and more. Our professional staff delivers these methodologies to those we treat with kindness and expertise. We are committed to helping any individual we treat to free themselves from addiction’s grips and begin to foster the healthy and fulfilling life they deserve!