Are Suboxone and Xanax Safe to Combine?

Virtually every medication, including Suboxone and Xanax, comes with the potential for side effects that can be compounded when multiple medications are combined. It’s not uncommon for those who have an opioid addiction to also struggle with anxiety, insomnia, or other problems that may warrant a benzodiazepine prescription.

And, unfortunately, some people who are using Suboxone may abuse Xanax without a prescription. They may do so for mostly recreational purposes, or because they are self-medicating other mental health issues.

What Is Suboxone?

Suboxone is a prescription medication primarily used to treat opioid addiction. The medication comes in tablet form and contains both buprenorphine and naloxone.

Buprenorphine is a long-acting opioid agonist that binds to the same receptors in the brain that heroin and prescription painkillers do. For this reason, it blocks other opioids from attaching to receptors and is effective for treating opioid addiction. As buprenorphine occupies these receptors, withdrawal symptoms are prevented from occurring when a person stops using their drug of choice, such as heroin.

Suboxone also includes naloxone, a medication that works to reverse the effects of an opioid overdose. Moreover, if a person attempts to abuse Suboxone in high doses, the naloxone will remove buprenorphine from the opioid receptors and take its place. In doing so, this will cause the person to go into withdrawal, which is highly undesirable.

Moreover, Suboxone will prevent opioid withdrawal symptoms only if used as directed. Despite its effectiveness, as with any drug, Suboxone has the potential for side effects, which include the following:

  • General pain
  • Headache
  • Nausea
  • Sweating
  • Sleep disturbances
  • Depression

What Are Benzodiazepines?

Are Suboxone and Xanax Safe to Combine?

Benzodiazepines are a class of drugs that can cause profound depression of the central nervous system (CNS). Benzos are most commonly used to treat anxiety, panic attacks, or insomnia. Xanax is a short-acting benzo that is thought to have a high potential for abuse, despite its relatively low classification as a Schedule IV substance.

A low to moderate dose of Xanax can result in the following side effects:

  • Drowsiness
  • Impaired motor function
  • Depression
  • Impaired vision
  • Vertigo
  • Tremors
  • Nausea
  • Respiratory depression

When used in high doses, Xanax use can lead to slowed reflexes, erratic thinking and behavior, mood alteration, and euphoria. Euphoric effects, which are characterized by feelings of well-being and relaxation, often lead to the abuse of Xanax. Unfortunately, abuse of benzos has become extremely common in the United States.

Long-term effects from the use of benzos may include impaired memory and judgment, physical weakness, and disorientation or confusion.

A chemical dependence on Xanax can develop rapidly, which is why they are typically only intended for short-term use. Once dependence has formed, benzo withdrawal can cause uncomfortable side effects. Similar to alcohol withdrawal, these effects, such as seizures, can be life-threatening. 

As a result, medical detox is always recommended for those undergoing Xanax withdrawal. Often, a supervising doctor or addiction specialist will gradually wean a patient off of Xanax by lowering the dosage over time. This method helps to relieve withdrawal symptoms until the discontinuation of use is safe and comfortable.

Simultaneous Use of Suboxone and Xanax

Simultaneous use of Suboxone and benzos is not uncommon despite the risks and dangers. One study found that two-thirds of people who reported using buprenorphine did so in conjunction with benzos. This number is remarkably high and worrisome, as the two drugs can interact with each other adversely and can present a dangerous situation for the person who uses them together.

Combining opioid medications and benzos can result in coma and death, and they do so frequently. According to recent statistics, more than 11,000 overdose deaths in 2017 involved the use of both opioids and benzos.

Perhaps one reason why these two substances are so often combined is that those who have been prescribed Suboxone have already had trouble with substance abuse. To elaborate, this means that a person using Suboxone is at a higher risk of abusing benzos than those without a history of substance abuse.

Of note, it’s extremely dangerous to operate a motor vehicle or machinery when under the influence of this combination of drugs. Slowed reaction time, drowsiness, and other intoxicating effects significantly increase the chances of an accident.

Are Suboxone and Xanax Safe to Combine?

Abuse of Suboxone and Xanax Is Very Dangerous

Using these two medications as prescribed in conjunction poses some risks. However, abusing either drug in excessive amounts is much more likely to result in severe complications and overdose. The greatest threat to an individual who uses these drugs is respiratory failure, which is more likely to occur when different types of CNS depressants are combined.

Benzos such as Xanax are more commonly abused in this scenario, however, because the overuse of Suboxone can cause adverse effects that can prompt immediate withdrawal symptoms. Buprenorphine itself is thought to have a relatively low potential for abuse, and with the addition of naloxone, this decreases even further. Xanax, on the other hand, is a prevalent drug of abuse, but if it is abused alone, it is unlikely to result in death.

For this reason, people who use Suboxone and Xanax may not realize that there may be dire consequences of doing so. Overdose notwithstanding, concurrent abuse also places an individual at a higher risk of experiencing adverse effects and complications in both the short- and long-term. 

Combining Suboxone with any benzo can lead to profound sedation, and excessive sleepiness is common. Also, users may be at high risk of experiencing respiratory depression and perilously low heart rate and blood pressure. Overdoses are survivable if addressed using emergency medical intervention early, but if a person has lacked oxygen for a prolonged period, this can result in permanent brain damage.

Concurrent abuse of these two substances has also been found to reduce the likelihood that the person in “recovery” will be able to sustain long-lasting sobriety. Indeed, relapse is more likely when an individual has a history of polysubstance abuse. Also, if a person continues to abuse Xanax when Suboxone has been discontinued, this in and of itself can contribute to a relapse.

In conclusion, combining Suboxone and Xanax should generally be avoided due to the risks involves, unless they are taken as directed by a physician. If a doctor prescribes either to a patient, the patient should notify this physician if he or she is using any other substances. Abuse of either Suboxone or Xanax has been associated with serious risks and should be avoided at all costs.

Getting Help for Addiction

If you’ve been prescribed Suboxone to help prevent the use of more powerful opioids and you are misusing it, we urge you to seek further care in a specialized treatment center. Regardless of whether you are abusing Suboxone, Xanax, other drugs, or alcohol, these behaviors must be addressed before it’s too late. Regardless of the reasons for abuse, it is hazardous and can result in severe health complications, up to and including coma and death.

Recovery in Tune offers both intensive outpatient and regular outpatient programs that include evidence-based treatments that are vital to the process of recovery. 

If you or someone you love is struggling with substance abuse or addiction, contact us as soon as possible to find out how we can help!

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