Recent research suggests that cannabis can elevate the levels of buprenorphine/naloxone (Suboxone) in the blood. (1) We also know that both marijuana and Suboxone are depressant drugs, so they suppress the central nervous system and could potentially lead to respiratory depression (slowing or stopping breathing), coma, and even death. The dangers of combining Suboxone with cannabis are not as significant as combining Suboxone with benzodiazepines (like xanax, klonopin, ativan, valium) or with alcohol. However, patients should be aware of this potential threat, especially if they take other sedatives or have underlying lung conditions. If a patient is taking medical marijuana with Suboxone, it is important they let their providers know so that the patient can be appropriately monitored.
There is also some research that suggests that using cannabis can increase the risk for developing an opioid addiction (related to the way the brain processes dopamine). So patients using marijuana should be aware of this risk and reach out for help if they are concerned about developing an opioid addiction.
(1) Vierke C, Marxen B, Boettcher M, et al. Buprenorphine–cannabis interaction in patients undergoing opioid maintenance therapy.European Archives of Psychiatry and and Clinical Neuroscience. 2020.