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What happens if you take opiates on Suboxone?

Medically reviewed by Sally Chao, MD. Last updated on April 16, 2021.

Official Answer

by Drugs.com

If you use opiates while on Suboxone (a combination of buprenorphine and naloxone), the strong effects or “high” of the opiates will be dulled or blocked.

When you take Suboxone consistently and at the proper dosage, the buprenorphine in the drug binds easily to opioid receptors in your brain, preventing other opiates you use from binding to these receptors themselves, and disabling their ability to trigger a high.

Similarly, if you take Suboxone after you’ve recently used other opioids, the buprenorphine will replace the opioids that are binding to the brain’s opioid receptors at the time. The quick elimination of the other opioids in your brain can send your body into precipitated withdrawal—a sudden onset of intense withdrawal symptoms. As a result, patients usually have to wait around 12 to 24 hours after using opioids to begin treatment with Suboxone.

If Suboxone is combined with other drugs, it may also result in overdose and death. In particular, using or abusing alcohol, benzodiazepines, illicit drugs, and other opioids or sedatives in combination with Suboxone can be dangerous. In rare cases, when people do overdose while taking Suboxone or buprenorphine, it is usually a combination of substances that likely contributed to the death.

Also, if one attempts to abuse Suboxone by injecting it, the naloxone will block the brain’s opioid receptors and prevent the buprenorphine from triggering a high, and it can cause intense and uncomfortable symptoms of withdrawal.

When taken alone, this medication has a low risk of overdose compared to other opioids because of a “ceiling effect” in the drug, but it can happen, and is often related to taking other drugs at the same time. It should only be taken under the advice and supervision of your doctor.

References
  1. Zoorob R, Kowalchuk A, Mejia de Grubb M. Buprenorphine Therapy for Opioid Use Disorder. Am Fam Physician. 2018;97(5):313-320. Available at: https://www.aafp.org/afp/2018/0301/p313.html
  2. University of Massachusetts Medical School Center for Integrated Primary Care. Fact Sheet: Buprenorphine. Available at: https://www.umassmed.edu/globalassets/center-for-integrated-primary-care/amber/final-fact-sheet-on-buprenorphine-final.pdf. [Accessed March 24, 2021].
  3. Substance Abuse and Mental Health Services Administration (SAMHSA). Buprenorphine. Last updated March 12, 2021. Available at: https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. [Accessed March 24, 2021].
  4. American Society of Addiction Medicine (ASAM). National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. 2020. Available at: https://www.asam.org/docs/default-source/quality-science/npg-jam-supplement.pdf?sfvrsn=a00a52c2_2. [Accessed March 24, 2021].
  5. Wightman R, Perrone J, Scagos R. Opioid Overdose Deaths with Buprenorphine Detected in Postmortem Toxicology: a Retrospective Analysis. J. Med. Toxicol. 17, 10-15 (2021). https://doi.org/10.1007/s13181-020-00795-3
  6. Drugs.com. Can you overdose on Suboxone? Available at: https://www.drugs.com/medical-answers/you-overdose-suboxone-3536143/. [Accessed March 30, 2021].

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