Suboxone (buprenorphine/naloxone) is not considered a treatment for anxiety, per se. However, studies show that Suboxone reduces anxiety when used for the treatment of opioid use disorder (OUD) as a component of Medication for Addiction Treatment (MAT).
Does Suboxone reduce anxiety?
There are several reasons why Suboxone might help people feel less anxious. The first reason is that Suboxone is a partial opioid agonist that occupies and activates the same receptors in the brain that opioids activate. Anxiety can be a prominent symptoms of opioid withdrawal, and Suboxone can therefore prevent withdrawal-related anxiety.
The brain opioid system plays an important role in anxiety modulation. Any medication that activates brain opioid receptors, especially mu-opioid receptors, blocks anxious behavior and induces relaxation.
Suboxone is a first-line, evidence-based treatment for OUD. Studies repeatedly have shown that Suboxone helps people stop using opioids and prevents overdose or death from opioids.
Reduced engagement in the lifestyle, and the repeated cycles of intoxication and withdrawal, restore mental health in numerous ways.
Should You Treat Anxiety Separately From Opioid Use Disorder?
Yes, you should. People with both substance use and mental health issues such as anxiety disorders have so-called co-occurring disorders. It is very common to have both an opioid use disorder and an anxiety disorder at the same time.
While it is true that treating one may lead to improvements in the other, we should think of them as two separate disorders that both require treatment. The first line treatments for opioid use disorder are MAT (including Methadone, Suboxone and Naltrexone). The first line treatments for anxiety disorders are different medications (Usually SSRIs or SNRIs).
While anxiety and OUDs often occur at the same time, just about half of people with both conditions get treatment for their opioid misuse.
Treating both issues at once can mean the following:
- You identify the cause. Why did you start using drugs? Was anxiety one of the reasons you started misusing drugs in the first place? If so, controlling anxiety disorder is key in controlling your substance use.
- You find relief. Treatment can ease your anxiety, making you less likely to relapse to drugs to self-medicate.
While treating two conditions is more complicated than addressing just one, it’s best to tackle your drug use holistically. By addressing your anxiety, you may be getting at the root causes of why you were using drugs in the first place. This is key in helping you maintain abstinence in the long term.
Other Ways to Treat Anxiety
Your Suboxone therapy can relieve anxiety related to drug cravings and withdrawal. But a comprehensive program offers more than just Suboxone treatment.
People with anxiety can benefit from two types of treatment: psychotherapy and medications. Evidence shows that people who engage in both medications and psychotherapy have the greatest improvements in their anxiety. 
Your doctor can tailor your therapy to address your specific form of anxiety. You might work through a specific fear that’s troubling you, or you might discuss ways to seem calm and relaxed in the face of any form of anxiety.
There are many classes of antidepressants and anxiolytics (anti-anxiety medications) that are used with great efficacy to treat anxiety disorders. Some medications can interact with your Suboxone dose, so your team must watch your progress carefully. Together, you can decide on a treatment plan that’s right for you.
- Co-Occurring Disorders and Other Health Conditions. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/co-occurring-disorders. April 2022. Accessed July 2022.
- Prevalence of Mental Health Disorders Among Individuals Enrolled in an Emergency Response Program for Treatment of Opioid Use Disorder. Substance Abuse: Research and Treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756048/. 2020. Accessed July 2022.
- Anxiety Disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders. April 2022. 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