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Suboxone and Alcohol: How Do They Interact?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Dec 13, 2023 • 7 cited sources

Suboxone and alcohol are both central nervous system (CNS) depressants, which means they slow breathing and heart rates. Combining alcohol and Suboxone can increase the risk of experiencing distressing side effects as well as life-threatening consequences like profound respiratory depression, sedation and coma. You should never mix alcohol and Suboxone, under any circumstances.

Can You Drink Alcohol While Taking Suboxone?

Quick Answer

Mixing alcohol with opioids like buprenorphine or Suboxone can be very dangerous due to the risk of oversedation, respiratory arrest, overdose, coma, hypoxia, brain damage and more.

Is It Dangerous to Drink Alcohol While Taking Suboxone?

Yes, it can be dangerous to drink alcohol while taking Suboxone for OUD. No amount of alcohol is considered entirely “safe,” according to the Centers for Disease Control and Prevention.[1] This is especially true for those taking prescription medications with sedative effects like Suboxone.

Buprenorphine and Alcohol: CNS Depressants

Suboxone contains two ingredients: buprenorphine (a partial opioid agonist) and naloxone (a misuse deterrent). When used as directed, Suboxone is a very safe and effective way to treat an opioid use disorder (OUD). But it can cause respiratory depression.

The alcohol in your system is also a central nervous system depressant, slowing your breathing and reaction times. Combine it with Suboxone, and the effect is stronger. You could experience a life-threatening overdose by combining these drugs. 

Combining Suboxone and alcohol could cause:

  • Sedation
  • Severe drowsiness
  • Decreased respiratory drive
  • Decreased awareness of surroundings
  • Breathing problems
  • Overdose
  • Death

Prescription guidelines from the U.S. Food and Drug Administration state that people can experience serious side effects when combining alcohol and Suboxone.[2] Doctors are encouraged to tell patients not to mix these substances.

And if you do ask your doctor about drinking, you’ll likely be advised to remain sober while using Suboxone. The risk of serious problems is simply too great. Since Suboxone stays in your body for 24 hours or longer, there’s no way to stagger your drinking and maintain control over your OUD. 

risks of drinking alcohol while on suboxone

4 Major Risks of Mixing Alcohol and Suboxone

Mixing alcohol and Suboxone can lead to unpleasant symptoms. You may experience very strong intoxication signs, including dizziness, lack of coordination and nausea. 

Alcohol use disorders increase your risk of fatal opioid overdose. People who use multiple substances like this have a 10- to 20-fold higher mortality risk than their peers.[4]

1. Coma

Buprenorphine and alcohol are both CNS depressants. When combined, there is a risk of enhancing each other’s sedative effects.

You might experience the following:

  • Severe drowsiness
  • Slowed or stopped breathing
  • Inability to stay awake
  • Decreased awareness 
  • Coma

Slow breathing deprives brain cells of the oxygen they need to survive and thrive—this is called hypoxia and can cause brain damage. 

Take too much of either or both substances, and you could slip into a coma-like state. Buprenorphine-related overdoses often involve other substances, such as alcohol.[5]

2. Enhanced Relapse Risks 

Entering OUD recovery isn’t easy, and many people struggle with emotions they’ve long numbed with drugs. While alcohol might seem helpful, drinking can alter brain chemistry and increase your risk of depression.[6]

Poor mental health is a known relapse risk. If you keep drinking, you could return to opioids to ease your distress. 

3. Reduced Inhibitions 

Combining alcohol with Suboxone could slow down brain functions that regulate decision-making. Things you would never do while sober (like having sex with strangers or fighting with your spouse) can seem like good ideas when you’re intoxicated.

Some of these decisions could affect your health. For example, if you have unprotected sex, you could develop a sexually transmitted disease.

4. Poor Physical Health

Long-term alcohol misuse is associated with many health problems, including the following:[7]

  • Cardiovascular disease: High blood pressure, heart disease and stroke are all associated with alcohol misuse.
  • Cancer: People who misuse alcohol may develop cancer of the breast, mouth, esophagus, throat, liver, colon or rectum. 
  • Poor immune system: A weakened ability to fight off infections could leave you feeling sick all of the time. 
  • Mental changes: Depression and anxiety are common in people who drink. You may also develop learning and memory problems. 

Does Suboxone Block the Effect of Alcohol?

Suboxone doesn’t dampen the effect of alcohol like it does with other opioids. Instead, people who mix these substances often experience stronger intoxication symptoms while drinking an amount they once considered safe. 

If you’re struggling with alcohol misuse, attending counseling alongside Suboxone treatment is the best approach. Your rehabilitation program must know to provide counseling for alcohol use disorder and OUD.

Suboxone is a treatment for opioid use disorder, not alcohol use disorder. However, some limited research conducted in rodents suggests that buprenorphine may reduce alcohol drinking through certain brain activities associated with some opioid receptors.[3] It remains unclear if this finding would translate to humans, though.

In addition, we know that preventing the use of one substance also helps prevent the use of others. Many individuals tend to use multiple drugs at the same time. Thus, if an individual uses Suboxone to avoid opioids, they may also spend less time drinking alcohol.

While Suboxone doesn’t directly treat alcohol use disorder, it may lend itself to preventing individuals from being in situations where they are drinking or consuming other substances.

How Alcohol Affects Your Opioid Recovery 

Combatting your OUD means learning how to live without self-medication. If you’re leaning on alcohol during recovery, you’re not truly taking advantage of your therapy and rebuilding your life.

Alcohol can put your recovery at risk by enhancing your cravings. Since drinking lowers your inhibitions, you may believe that one dose of opioids or other drugs is not only safe but reasonable. If you attempt to maximize this lapse by bingeing, you could overdose on these drugs and die. 

An overdose is a medical emergency. If you or someone you love is overdosing, call 911 and stay with the person until help arrives. After the overdose, the person should seek help. Bicycle Health’s support group for patients is a good place to start. 

Frequently Asked Questions About Combining Suboxone & Alcohol

Is it dangerous to mix alcohol with opioids?

Combining alcohol with the opioids in your system can lead to life-threatening sedation. Without prompt treatment, you can die during these episodes.

What are the signs of someone using Suboxone and alcohol together?

Extreme sedation is a common symptom people who drink and use Suboxone experience. Someone who began to show signs of OUD recovery from Suboxone may also slide back into their prior bad habits, such as spending time in isolation, skipping work, and neglecting their appearance.

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

  1. Dietary guidelines for alcohol. Centers for Disease Control and Prevention. Published April 19, 2022. Accessed June 28, 2023.
  2. Suboxone prescribing information. U.S. Food and Drug Administration. Published March 2021. Accessed June 28, 2023.
  3. Ciccocioppo R, Economidou D, Rimondini R, Sommer W, Massi M, Heilig M. Buprenorphine reduces alcohol drinking through activation of the nociceptin/orphanin FQ-NOP receptor system. Biol Psychiatry. 2007;61(1):4-12.
  4. Soyka M. Alcohol use disorders in opioid maintenance therapy: Prevalence, clinical correlates and treatment. Eur Addict Res. January 1, 2015; 21 (2): 78–87.
  5. THD finds some overdose deaths associated with buprenorphine. Tennessee Department of Health. Published January 8, 2018. Accessed June 28, 2023.
  6. Alcohol and depression. Royal College of Psychiatrists. Published October 2018. Accessed June 28, 2023.
  7. Alcohol use and your health. Centers for Disease Control and Prevention. Published 

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