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Does Suboxone interact with cannabis?

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.

Citations:

(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.

Randi Sokol, MD, MPH, MMedEd

Randi Sokol, MD, MPH, MMedEd, is an Assistant Professor at the Tufts Family Medicine Residency Program and Instructor at Harvard Medical School. She is Board Certified in both Family Medicine and Addiction Medicine. She earned her B.A. at the University of Pennsylvania, her Medical Degree and Masters in Public Health from Tulane University, completed Family Medicine Residency at UC-Davis, and earned a Masters in Medical Education through the University of Dundee.

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