How Does Suboxone Interact With Alcohol?

Suboxone is a prescription medication containing buprenorphine, a partial opioid agonist. Drugs in this class should never be mixed with alcohol, as severe sedation leads to coma-like states, and death can occur. 

When you start taking Suboxone, your doctor will tell you to eliminate your alcohol consumption. Even so, about a third of people using medications like Suboxone increase their alcohol use as they address an opioid use disorder (OUD).[1]

If you’re drinking while using Suboxone, talk to your doctor. Mixing these two medications is both serious and not recommended. Your doctor can help you develop healthy habits to maintain your sobriety. 

Can You Drink Alcohol While on Suboxone?

No amount of alcohol is considered entirely “safe,” according to the Centers for Disease Control and Prevention (CDC).[2] This is especially true for those taking prescription medications with sedative effects like Suboxone.

Prescription guidelines from the U.S. Food and Drug Administration state that people can experience serious side effects when combining alcohol and Suboxone.[3] Doctors are encouraged to tell patients not to mix these medications without talking to their doctors first. 

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.

What Happens When You Mix Alcohol & Suboxone?

Each person’s body is different, and the issues you might experience vary depending on how much Suboxone you take and how much alcohol you drink. But in general, mixing these two substances can cause severe health issues. 

Increased Sedation 

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

You might experience the following:

• Severe drowsiness
• Decreased awareness of surroundings
• Breathing problems

Take too much of either or both substances, and you could slip into a coma-like state and die. Buprenorphine-related overdoses often involve other substances, such as alcohol.[4]

Reduced Inhibitions 

Combining alcohol with Suboxone could slow down brain sections 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 imperil your health. For example, if you have unprotected sex, you could develop a sexually transmitted disease or get pregnant. 

Poor Mental Health 

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.[5]

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

Enhanced Relapse Risks 

Alcohol use while taking Suboxone complicates the ability of buprenorphine to help you overcome substance misuse patterns. This is called polysubstance use.[6]

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. 

Does Suboxone Block the Effects of Alcohol?

No, Suboxone does not dampen the effects of alcohol. If anything, a person may have more sedation and intoxication with the same amount of alcohol they used to consume once they start taking Suboxone.

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 studies suggest that buprenorphine can reduce alcohol drinking through certain brain activities associated with some opioid receptors.[7]

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.

Sources

1. Alcohol Use Disorders in Opioid Maintenance Therapy: Prevalence, Clinical Correlates, and Treatment. European Addiction Research. https://www.karger.com/Article/FullText/363232. 2015. Accessed January 2023.
2. Dietary Guidelines for Alcohol. Centers for Disease Control and Prevention. https://www.cdc.gov/alcohol/fact-sheets/moderate-drinking.htm. April 2022. Accessed January 2023.
3. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf. March 2021. Accessed January 2023.
4. TDH Finds Some Overdose Deaths Associated With Buprenorphine. Tennessee Department of Health. https://www.tn.gov/health/news/2018/1/8/tdh-finds-some-overdose-deaths-associated-with-buprenorphine.html. January 2018. Accessed January 2023.
5. Alcohol and Depression. Royal College of Psychiatrists. https://www.rcpsych.ac.uk/mental-health/problems-disorders/alcohol-and-depression. October 2021. Accessed January 2023.
6. Polydrug Use: Health and Social Responses. European Monitoring Centre for Drugs and Drug Addiction. https://www.emcdda.europa.eu/publications/mini-guides/polydrug-use-health-and-social-responses_en. October 2021. Accessed January 2023.
7. Buprenorphine Reduces Alcohol Drinking Through Activation of the Nociceptin/Orphanin FQ-NOP Receptor System. Biological Psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3035814/. January 2007. Accessed January 2023.