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Does Suboxone Weaken Your Immune System?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Feb 25, 2024 • 8 cited sources

Since at least 2006, researchers have pointed out that opioids can alter the immune system.[3] However, most of these studies have been conducted with morphine as the opioid.[6]

While the buprenorphine in Suboxone is a weak opioid, it works differently than other medications in its class. The research on buprenorphine’s impact on the immune system is limited, but the available studies suggest that the medication won’t harm your immune system like other opioids do.[6]

Understanding Suboxone

Suboxone is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder (OUD). Two medications are inside each dose.[7]

Buprenorphine in Suboxone is a partial opioid agonist. It latches weakly to the same receptors used by drugs like heroin and OxyContin. When it’s connected, it triggers chemical reactions that ease withdrawal symptoms and cravings. 

People with OUD don’t get high on Suboxone. Instead, they feel more comfortable and calm. They may be more likely to stay in OUD treatment as a result.

Naloxone in Suboxone is an opioid antagonist, capable of rendering high doses of buprenorphine inactive. At therapeutic doses, the naloxone has no effect. However, if people misuse their medications, it can become active and offer some overdose protection.[7]

While the buprenorphine in Suboxone is technically an opioid, researchers say it has complex interactions with opioid receptors. In studies conducted on animals, researchers didn’t see signs of immune system depression as they did with other opioid medications. Further, when people with who were actively using heroin transitioned to treatment with buprenorphine, their immune system improved.[6] 

Researchers say opioids typically cause immune system problems because they alter communication between the brain and the immune system. When they’re active, they reduce the body’s ability to produce antibodies and white blood cells. Buprenorphine doesn’t cause these problems, potentially because it doesn’t link as strongly to opioid receptors as other drugs do.[2]

Opioid Addiction & Your Immune System

Street drugs like heroin and some prescription painkillers like morphine can suppress your immune system. Studies of people recovering from surgery make that point clear.[3] Buprenorphine doesn’t work the same way.

Ongoing drug use can impair your immunity in other ways too.

OUD causes dose increases. You need larger amounts of opioids to get and maintain the same high or pain relief. Escalations can mean suppressing your central nervous system and your breathing rates. Plenty of infectious diseases, including COVID, attack the lungs. Breathing slowly and shallowly could allow these illnesses to worsen.[1]

Many illnesses (including hepatitis B, hepatitis C and HIV) have been linked to drug use, especially in people who share needles.[5] The longer you leave your OUD unchecked, the more likely it is that you’ll be exposed to these devastating illnesses. When your body is recovering from these issues, you may not have the energy to fight off other infections.

People with ongoing opioid misuse issues may also be in poor health. Researchers say opioid misuse and a preference for sweet foods are linked, sometimes leading to weight gain and diabetes. 

Opioid misuse can also lead to nutrient deficiencies and poor gastrointestinal health.[8] These factors can further weaken the immune system and make future sickness more likely.

Can You Take Suboxone With a Weak Immune System?

The FDA creates a list of contraindications, or conditions that could make medications riskier. Suboxone’s FDA-approved label contains no mention of immune system deficiencies.[7] As a result, it’s not considered dangerous for people with poor immune systems to take Suboxone.

Experts even suggest that people who need an opioid for pain due to an immune-suppressing disease (like cancer) should use buprenorphine instead of other opioid painkillers to minimize risks of long-term dependence and overdose.[2]

If you’ve been living with a chronic illness that suppresses your immune system, talk to your doctor about whether Suboxone might be right for you.  

Never take Suboxone that you’ve purchased without a doctor’s prescription. Drugs you buy from illicit sources could contain other substances (like fentanyl) that are both stronger and more dangerous for your immune system.[6]

Your doctor can write you a prescription for Suboxone that you can fill at a pharmacy, ensuring you get medical-grade medication under the watchful eye of experts. If your medication makes you feel sick or unwell, talk with your doctor and ask what you should do next.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. A Double-Edged Sword of Using Opioids and COVID-19: A Toxicological View. Substance Abuse Treatment, Prevention, and Policy. https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-020-00333-y. December 2020. Accessed July 2022.
  2. Buprenorphine: An Attractive Opioid With Underutilized Potential in Treatment of Chronic Pain. Journal of Pain Research. https://www.dovepress.com/buprenorphine-ndash-an-attractive-opioid-with-underutilized-potential–peer-reviewed-fulltext-article-JPR. December 2015. Accessed July 2022.
  3. Opioids and the Immune System. Palliative Medicine. https://pubmed.ncbi.nlm.nih.gov/16764216/. 2006. Accessed July 2022.
  4. Buprenorphine and Methadone Maintenance Treatment of Heroin Addicts Preserves Immune Function. Brain Behavior and Immunity. https://www.researchgate.net/publication/5557047_Buprenorphine_and_methadone_maintenance_treatment_of_heroin_addicts_preserves_immune_function. June 2008. Accessed July 2022.
  5. Infectious Diseases, Opioids, and Injection Drug Use. Centers for Disease Control and Prevention. https://www.cdc.gov/pwid/opioid-use.html. August 2021. Accessed July 2022.
  6. Do All Opioid Drugs Share the Same Immunomodulatory Properties? A Review from Animal and Human Studies. Frontiers in Immunology. https://www.frontiersin.org/articles/10.3389/fimmu.2019.02914/full. December 2019. Accessed January 2024.
  7. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf. March 2021. Accessed January 2024.
  8. A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health. Hypothesis and Theory. https://www.frontiersin.org/articles/10.3389/fpubh.2019.00193/full. July 2019. Accessed January 2024.

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