It depends. Combining two sedating substances (like buprenorphine and alcohol) can increase risk for overdose.
If you’re tempted to drink alcohol while undergoing Medication for Addiction Treatment (MAT), ask yourself a few questions first: Are you drinking one glass to celebrate at a wedding? Or are you drinking daily to substitute opioids for alcohol?
Keep reading to find out why some people drink alcohol while taking Suboxone to better understand the risks of combining alcohol and Suboxone.
Is It Okay to Drink Alcohol While Going Through MAT?
Both Buprenorphine (the active ingredient in Suboxone) and alcohol are sedating substances. Take them together, and their strength combines. You could feel much more intoxicated than you would if drinking without Suboxone.
Of overdose deaths attributed to buprenorphine, 41% also involved alcohol. Each time you mix alcohol and buprenorphine, you could be increasing your risk of overdose.
Is It Common for People to Drink While Using Suboxone?
While mixing alcohol and Suboxone isn’t smart, it’s unfortunately common.
About a third of people using MAT also have an alcohol use disorder. And some drink more while in MAT than they did before because they use alcohol in place of opioids that they were previously using.
It’s of course ok to have an occasional drink while on Suboxone therapy, particularly once your dose is very stable and your body is used to the medication.
However, if you notice that you’re using significantly more alcohol while in MAT, it’s possible that you’re developing a dependence on alcohol. In addition, using other substances including alcohol can increase your risk for relapse to opioid use. 
What Does Alcohol Use Disorder Look Like?
Spotting problem drinking isn’t always easy, especially for people who spend a lot of time in social situations where drinking is common. People with alcohol use disorder tend to have some hallmark signs, such as:
- Loss of control: You drink more than you intend to. You want to stop drinking, but you can’t.
- Alcohol at the center: You think about alcohol to the exclusion of other things. You risk your family, friends, and job to drink. You spend most of your time thinking about, getting, or using alcohol.
- Rising impact: Your continued drinking causes problems with your relationships, your health, or both. You keep drinking, even though it causes you problems.
- Physical changes: When your drink wears off, you feel sick or shaky. You need to drink more to feel the same effect.
If you notice these signs in yourself, it might be a sign that drinking is a problem for you. No matter whether you’re using MAT or not, your relationship with alcohol might be unhealthy.
If you’ve been drinking heavily for a while, consult a physician before you suddenly stop drinking. If you stop suddenly on your own, you could develop life-threatening withdrawal symptoms. A doctor can help you to stop drinking safely.
What Do Bicycle Doctors Advise?
At Bicycle, we want to see people thrive. For our patients using MAT, occasional drinking is fine, particularly if you are very stable on your Suboxone dose.
We recommend avoiding drinking altogether at least at first when you are starting your medication, to ensure that your body can tolerate Suboxone well and you are not overly sedated.
Once you are stable on Suboxone, you can drink alcohol socially, but always in moderation. Drinking heavily while also on Suboxone or other sedating medications is dangerous and inadvisable.
If you decide to drink while on Suboxone, speak to your doctor beforehand and minimize alcohol consumption to as little as possible. A glass of wine at a wedding is generally okay. Daily drinking or binge drinking is of course more concerning.
If you’re wondering what you can and can’t drink safely while taking Suboxone, talk with your doctor. Together, you can determine what’s best for you and your situation as you go through recovery with Suboxone therapy.
- Buprenorphine Reduces Alcohol Drinking Through Activation of the Nociceptin/Orphanin FQ-NOP Receptor System. Biological Psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035814/. February 2011. Accessed July 2022.
- Concomitant Drugs with Buprenorphine User Deaths. Drug and Alcohol Dependence. https://www.sciencedirect.com/science/article/abs/pii/S037687162030510X. January 2021. Accessed July 2022.
- Alcohol Use Disorders in Opioid Maintenance Therapy: Prevalence, Clinical Correlates, and Treatment. Karger. https://www.karger.com/Article/Fulltext/363232. 2015. Accessed July 2022.
- Alcohol Use in Opioid Agonist Treatment. Addiction Science and Clinical Practice. https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-016-0065-6. December 2016. Accessed July 2022.
- What Are the Symptoms of Alcohol Use Disorder (AUD)? National Institutes of Health. https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/whats-the-harm/what-Are-Symptoms-Of-alcohol-Use-Disorder.aspx. Accessed July 2022.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More