More than 19% of Americans struggle with anxiety disorders every year. Anxiety disorders are very treatable. Most common anti-anxiety medications are safe to use with Suboxone, but there may be some increased risks of side effects.
Talk with your doctor about your mental health and all the medications you take. Together, you can find a combination that helps you stay safe and in remission.
What Is Anxiety?
Anxiety is a common mental health disorder characterized by feelings of fear, dread, and uneasiness. People with anxiety frequently have intrusive thoughts or concerns that may cause them to avoid certain situations due to worry.
Anxiety also can cause physical symptoms, such as these:
- Fast heart rate
- Feeling weak or tired
- Rapid breathing
- Trouble concentrating or rapid thoughts
Anxiety is a normal emotion that is experienced by all human beings. However, when anxiety symptoms begin to impair functioning and quality of life, we call this an anxiety “disorder”.
Mixing Suboxone & Benzos
One class of medications that is sometimes used to treat severe anxiety is called Benzodiazepines. Benzodiazepines are usually used short term for severe anxiety, as they have risks including addiction/dependency as well as respiratory depression and sedation. Benzodiazepines, sometimes referred to simply as “benzos”, include medications such as Clonazepam (Klonipin), Lorazepam (Ativan), and Alprazolam (Zanax).
More than 22% of people with anxiety have been treated with benzodiazepines, and of those people, more than 88% took them for more than 12 weeks. Many of the 4 million people who take benzodiazepines daily meet the criteria for substance dependence. Taking the drug daily, even for just one month, can lead to withdrawal symptoms.
Because both medications are potentially sedating, they can cause oversedation and respiratory depression. In 2020, 16% of all opioid-involved overdoses also involved benzodiazepines.
Benzodiazepines can be taken with Suboxone in appropriate circumstances, but patients using this strategy should be carefully monitored by a mental health or addiction professional. Taking these medications together should be done slowly and at the lowest doses possible to effectively treat both the OUD and the anxiety disorder.
Which Anxiety Medications Are Safe to Take With Suboxone?
The good news is that first line medications for anxiety are not benzodiazepines and are generally safe to combine with Suboxone. They are usually several other classes of anxiolytics including:
- Selective serotonin reuptake inhibitors (SSRIs)
- Selective serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants
Talk With Your Doctor
Since certain anti-anxiety medications can have interactions with Suboxone, your doctor should closely monitor you when you initiate anxiolytics and Suboxone together. In general, it is best to try first line options such as SSRIs, SNRIs, or tricyclic antidepressants prior to resorting to benzodiazepines, which have more risks when combined with Suboxone.
If you or someone you know is on Suboxone but also struggling with an anxiety disorder, contact your healthcare provider to discuss your treatment options.
- Anxiety Disorders: Facts and Statistics. Anxiety and Depression Association of America. https://adaa.org/understanding-anxiety/facts-statistics. Accessed January 2023.
- Anxiety. National Library of Medicine. https://medlineplus.gov/anxiety.html. May 2020. Accessed January 2023.
- Patterns of Benzodiazepines Use in Primary Care Adults with Anxiety Disorders. Heliyon. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039319/. July 2018. Accessed January 2023.
- Risks Associated with Long-Term Benzodiazepine Use. American Family Physician. https://www.aafp.org/pubs/afp/issues/2013/0815/p224.html. August 2013. Accessed January 2023.
- Benzodiazepines and Opioids. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids. November 2022. Accessed January 2023.
- Benzodiazepines for the Long-Term Treatment of Anxiety Disorders. The Lancet. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00934-X/fulltext. July 2021. Accessed January 2023.
By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More