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Can you overdose on Suboxone?

Medically reviewed by Carmen Fookes, BPharm Last updated on Apr 6, 2020.

Official Answer

by Drugs.com
  • Yes, you can overdose on Suboxone. However, if Suboxone is taken as directed by your doctor, overdosage is unlikely because buprenorphine has a ceiling effect and naloxone prevents misuse.
  • Overdosage is more likely to occur in people who take Suboxone who have never taken opioids before, older people, or in those who take Suboxone with alcohol, benzodiazepines, or some other drugs.
  • Symptoms of a Suboxone overdosage resemble those of other opioid overdosages and emergency medical treatment should be sought. Naloxone should also be administered if available.

Suboxone contains buprenorphine and naloxone and it has become one of the preferred treatments for opioid addiction. It is usually taken once a day.

The naloxone component is there to discourage misuse of Suboxone, and to reduce the potential of overdose, because injecting Suboxone will cause people to experience uncomfortable withdrawal symptoms as naloxone will bind to the opioid receptors instead of buprenorphine.

Because buprenorphine is a partial opioid agonist, it does not activate opioid receptors to the same extent as full agonists (such as oxycodone, heroin or methadone). This gives it a ceiling or maximum effect, so even if you take more buprenorphine, you won’t see any increase in effects.

When used to treat opioid addiction, buprenorphine satisfies the brain’s need for opioids without causing the “high” experienced by other full opioids. However, overdose can occur if Suboxone is taken by people who are not used to taking opioids, or in those who mix Suboxone with other drugs, or in older people. Of note:

  • There have been deaths reported in people who have never taken opioids before who receive a 2mg sublingual dose of Suboxone
  • Benzodiazepines and other CNS depressants increase the risk of adverse reactions such as breathing difficulties and overdosage in individuals who also take Suboxone or other medications containing buprenorphine
  • People over the age of 65 are more at risk of Suboxone overdosage due to possible decreased liver, kidney, or heart function, or the presence of other medical conditions that alter the effects of Suboxone.

What drugs interact with Suboxone and are more likely to cause overdose?

The following drugs interact with Suboxone and can increase the risk of overdose:

  • Alcohol
  • Benzodiazepines (eg, clonazepam, diazepam, or lorazepam)
  • Antidepressants
  • Barbiturates
  • Cocaine
  • Dextromethorphan
  • Hormonal contraceptives
  • Ketamine
  • Meth
  • Opiates, such as heroin and hydroxycodone
  • PCP
  • Phenobarbital and other epilepsy treatments
  • Synthetic cannabinoids.

What are the symptoms of Suboxone overdose?

Symptoms are similar to an overdose of any other opioid drug and may include:

  • Abdominal pain
  • Anxiety, irritability, and mood swings
  • Appearance of being drugged or drunk
  • Depressed or shallow breathing
  • Difficulty concentrating or a poor memory
  • Loss of physical coordination
  • Nausea and vomiting
  • Sleepiness
  • Slowed heartbeat
  • Seizures
  • Coma
  • Death.

What do I do if someone has overdosed on Suboxone?

Call 911 immediately if you suspect somebody has overdosed on Suboxone or mixed it with other medications, such as benzodiazepines, or alcohol.

Emergency medical attention is the only way somebody will survive a Suboxone overdose.

If you have naloxone, administer it, because it will temporarily stop the overdose; however, its effects will wear off.

 

References
  • Grinspoon P. 5 myths about using Suboxone to treat opiate addiction Harvard Health March 20, 2018 https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496
  • Can You Overdose on Suboxone? American Addiction Centers Feb 3, 2020. https://americanaddictioncenters.org/suboxone/can-you-overdose
  • What is Suboxone? Addiction Center Dec 6 2019. https://www.addictioncenter.com/treatment/medications/suboxone/

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