Powered By
If you’re taking buprenorphine/naloxone (sold as Suboxone and Zubsolv) for opioid use disorder (OUD), you may be wondering whether it’s OK to have a drink now and then. While it might seem harmless, mixing buprenorphine/naloxone with alcohol can be much riskier than many people realize.
Buprenorphine/naloxone and alcohol both affect the central nervous system (CNS), which includes the brain and the spinal cord. When buprenorphine/naloxone and alcohol are used together, their effects can combine in unpredictable ways, increasing the risk of:
Here’s what you should know about why these substances interact, who may be at higher risk, and what to do if alcohol is consumed while taking buprenorphine/naloxone.
Buprenorphine/naloxone is a medication commonly prescribed to treat OUD.
Buprenorphine is what’s called a partial opioid agonist. It attaches to the same opioid receptors as drugs like heroin, fentanyl, oxycodone, and morphine but activates them only partially. This helps reduce cravings and withdrawal symptoms while lowering the risk of misuse compared with full opioid agonists.
Naloxone is an opioid antagonist included mainly to discourage injection misuse. When the medication is taken as prescribed under the tongue or inside the cheek, very little naloxone is absorbed.
Alcohol is a central nervous system depressant. It slows activity in the brain and nervous system, leading to effects like relaxation, sleepiness, slower reaction times, and poor coordination.
Buprenorphine also has depressant effects. When alcohol and buprenorphine are combined, their effects can build on each other, making them stronger than either one alone.
Instead of simply making someone feel more relaxed, the combination can interfere with breathing, alertness, judgment, and consciousness in potentially dangerous ways.
This means that someone who feels only mildly intoxicated after drinking alcohol alone could experience stronger effects, including extreme sleepiness and slowed breathing, when combining buprenorphine/naloxone with alcohol.
Below are some of the potential effects of drinking when taking buprenorphine/naloxone.
One of the earliest signs of an interaction is sedation (extreme drowsiness). People may become unusually sleepy, be difficult to wake, or be unable to stay alert for extended periods.
Alcohol already affects decision-making and coordination. Adding buprenorphine can make it even harder to think clearly, keep your balance, and react quickly. These effects can increase the risk of falls, car crashes, and other serious accidents.
Respiratory depression is one of the most serious concerns around combining buprenorphine/naloxone and alcohol. Breathing may become slow or shallow, or it may stop altogether. Oxygen levels can fall to dangerous levels, leading to permanent brain injury or death if not treated quickly.
Although buprenorphine alone carries a lower overdose risk than many other opioids, combining it with alcohol substantially increases that risk. The danger becomes even greater if other sedating medications or drugs are also involved at the same time.
Fatal overdose involving buprenorphine frequently involves additional CNS depressants, such as alcohol or benzodiazepines, rather than buprenorphine alone. That’s why it’s especially important to be aware of the dangers of mixing buprenorphine with other substances.
Yes. The amount of alcohol matters, but there’s no established amount that’s considered safe while taking buprenorphine/naloxone. Several factors influence risk, including:
Someone who has only one drink could experience serious side effects, while another person might not notice immediate symptoms. Unfortunately, there’s no reliable way to predict who will have a dangerous reaction, which is why caution is strongly advised.
Many people ask whether one drink or moderate alcohol use is acceptable while taking buprenorphine/naloxone.
Current prescribing information and treatment guidelines generally advise avoiding alcohol during treatment, because even moderate drinking may increase the risk of sedation and respiratory depression.
Since people respond differently to both alcohol and buprenorphine, there’s no universally safe amount that can be recommended.
It’s also worth remembering that alcohol is present in some over-the-counter products, including certain cough syrups and liquid medications. Reading labels carefully and asking a pharmacist if you’re unsure can help prevent accidental exposure.
If you’ve consumed alcohol while taking your medication, don’t panic, but take the situation seriously and pay close attention to how you feel.
Stop drinking immediately and avoid drinking additional alcohol or using other substances that cause drowsiness. Stay with someone who can monitor you if possible, especially if you’ve consumed more than a small amount or are feeling unusually sleepy or unwell.
Do not drive or operate machinery under any circumstances.
If you develop concerning symptoms, seek emergency medical care immediately rather than waiting for symptoms to improve on their own.
Call 911 or your local emergency services right away if someone taking buprenorphine/naloxone and alcohol experiences:
If opioid overdose is suspected, administer naloxone if it’s available while waiting for emergency responders, even if you suspect alcohol contributed to the current emergency. Even if naloxone improves symptoms, give additional doses as directed and continue rescue breathing or other emergency support until responders arrive. Buprenorphine-related respiratory depression may respond incompletely to naloxone.
Emergency evaluation is still necessary, because additional medical care may be needed.
If you’ve been drinking alcohol while taking buprenorphine/naloxone, don’t stop your medication on your own out of fear or embarrassment.
Stopping treatment abruptly can increase cravings, trigger opioid withdrawal, and raise the risk of returning to opioid use. Instead, tell your healthcare provider honestly about your alcohol use. Their goal is to help you stay safe and supported, not to judge you.
Your provider may recommend strategies to reduce or stop alcohol use, adjust your treatment plan if needed, talk with you about whether alcohol has become a problem, or connect you with additional counseling or support services.
Open communication helps your healthcare team provide the safest and most effective care possible.
On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.
What steps do you take to stay safe while taking buprenorphine/naloxone? Let others know in the comments below.
Get updates directly to your inbox.
Continue with Facebook
Continue with Email
Continue with Facebook
Continue with Email
Become a member to get even more
Join
Your Privacy Choices
This is a member-feature!
Sign up for free to view article comments.
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.