Can I Take Adderall With Suboxone?

With a doctor’s supervision and monitoring, you can take Suboxone (buprenorphine/naloxone) and Adderall (amphetamine/dextroamphetamine) together. Taking both may be helpful and necessary if you have co-occurring opioid use disorder (OUD) and attention-deficit/hyperactivity disorder (ADHD).

But if you’re misusing one or the other without a doctor’s knowledge or support, you could experience many harmful consequences and effects.

Does Suboxone Block Adderall?

Can You Take Adderall With Suboxone? 

If your doctor supervises your prescriptions and recovery, you can take Adderall and Suboxone together. In some cases, it’s wise to do so, and can help you maintain long-term sobriety. 

Many people with an opioid use disorder (OUD) also have co-occurring ADHD).[1] 

An underlying mental health issue can make addressing an OUD more difficult. Untreated ADHD can increase the risk of relapse. Simultaneously, untreated OUD can worsen symptoms of ADHD. 

Treating your ADHD and your OUD at the same time may therefore be essential. This may mean taking Adderall or other stimulant medications at the same time as taking a buprenorphine medication like Suboxone. 

Comparing Suboxone & Adderall 

Suboxone and Adderall are both prescription medications with many benefits and risks.

What Is Adderall?

Adderall is a prescription stimulant medication containing dextroamphetamine and amphetamine salts.[2] The medication is structurally similar to street drugs like methamphetamine, which is another example of a potent stimulant. 

Stimulant medications like Adderall boost the release of two key brain chemicals:[3] dopamine and norepinephrine. These neurotransmitters give us energy and produce feelings of pleasure and reward. In this way, stimulant drugs can be addictive and have the potential for misuse, which is why they are tightly controlled and require a prescription.

In people with ADHD, the stimulant causes the release of neurotransmitters that can help people feel more awake and “focused” when they often otherwise feel chronically distracted. For individuals with ADHD, when taken properly as prescribed, the medication should not cause a “high.” Instead, patients feel more focused and able to concentrate. 

Adderall Misuse Potential

Some people with ADHD do misuse their medications. In fact, in a study of college students, about 25% of those with ADHD admitted they took their medications in higher quantities or more frequently than prescribed. [4] 

People without ADHD may also misuse Adderall because they think it will make them smarter or more easily able to study or perform academically. Some parents may even be willing to give ADHD drugs to their healthy kids in an effort to make them perform better in school.[5] This can be dangerous for many reasons as stimulant medications can have dangerous or even life-threatening side effects. 

What Is Suboxone?

Suboxone is a prescription medication used to treat OUD. It contains two ingredients:

• Buprenorphine: This long-acting partial opioid agonist prevents symptoms of opioid withdrawal, and eases cravings. [6]
• Naloxone: This opioid antagonist can prevent opioid overdose and deter Suboxone misuse. When taken sublingually as prescribed, the naloxone is essentially inactive. But if someone attempts to inject their Suboxone, it does enter the bloodstream and becomes active, preventing an overdose and causing immediate precipitated withdrawal. In this way, it is included in Suboxone strips to act as a safety mechanism/misuse deterrent. [6]

Suboxone is proven effective in people with OUD. In one study, 75% of people using buprenorphine products like Suboxone avoided relapse one year later. [6]

How Do Suboxone & Adderall Interact When Taken Together?

Because Suboxone contains buprenorphine, an opioid medication, it is a central nervous system (CNS) depressant, which means it slows brain activity, breathing rate and heart rate. Meanwhile, Adderall is a CNS stimulant, which means it speeds up these functions.

Researchers say combining opioids and stimulants can mask an opioid overdose.[12] People may not notice that they’re breathing slower or feeling overly sedated, and bystanders may not intervene with life-saving medications, as they don’t notice the changes either.

Researchers also say one possible reason the combination is so dangerous is that stimulants like Adderall cause blood vessels to dilate, so tissues require more oxygen. At the same time, opioids like Suboxone slow breathing rates, making it harder for the body to supply excess oxygen. The result is brain tissue death.[11]

What Are the Dangers of Taking Suboxone & Adderall Together? 

While you can take Suboxone and Adderall together with your doctor’s recommendation, risks are involved. 

The dangers include the following:

• Misuse potential: LIke buprenorphine, Adderall has the potential for misuse, dependence and the formation of a substance use disorder.
  
• Overdose: In 2014, nearly 9 in 10 deaths involving stimulants also involved opioid drugs in a Massachusetts study.[8] Therefore mixing different medications does increase the risk of accidental overdose. Using stimulant medication with buprenorphine is associated with a 19% increased risk of drug-related poisoning.[7]
  
  Researchers say people who misuse both types of drugs face twice the risks of fatal overdose, when compared to people who use opioids only.[10] Some experts consider the combination of illicit opioids (like fentanyl) with illicit stimulants (like methamphetamine) a “fourth wave” in the United State’s opioid overdose epidemic. People combining these illicit drugs can face risks that others just don’t, including an enhanced chance their next dose will lead to an overdose.[11]
  
• Heart damage: Stimulants cause the release of norepinephrine and dopamine, which cause the heart to beat faster and put increased oxygen demand on the tissues of the heart. Over time, this can raise the risk of heart disease.[9] Acutely, high doses can increase the risk of heart attack or arrhythmia.

• Infections: Experts have tied stimulant and opioid misuse to a rise in HIV and hepatitis infections. People using needles for these drugs may also have soft tissue infections and heart disease caused by infection.[13] If you’re using prescription medications appropriately, you may not face these risks. However, if you’re using street drugs, you might.

Conversely, people using Adderall to properly address their ADHD are also more likely to stay in OUD treatment. The benefits of taking both medications in individuals who have both ADHD and OUD may therefore outweigh the risks.[7]

Pullquote: “People using Adderall for ADHD are more likely to stay in OUD treatment. The benefits of taking Suboxone and Adderall in individuals who have both ADHD and OUD may therefore outweigh the risks.”

Things to Consider Before Mixing Suboxone & Adderall 

If you have a diagnosis of co-occurring ADHD and OUD, you may need to take Adderall and Suboxone together. While there are some risks to taking both a stimulant medication (Adderall) and an opioid medication (Suboxone) together, it can be done safely with proper medical supervision. 

Ask your doctor the following questions:

• Should I take these medications at the same time, or should I spread out my doses?
• How will I know if this combination is helping me?
• What side effects should I expect?
• What side effects should prompt me to call you or to seek more urgent care?
• Is there anything I should avoid while taking these medications?
• Are there any over-the-counter medications I should avoid?
• Is it safe for me to quit one of these drugs if I am uncomfortable? If so, should I do it immediately or slowly over time?

Ask yourself the following questions:

• Do you have any concerns about your own misuse of these medications?
• Do you feel like you know how to properly and safely take these medications in combination?
• Can a housemate, friend or relative help you to remember how to take these medications properly?
• Are you using other drugs or medications you haven’t told your doctor about?
• Have you tried to quit opioids and failed in the past? Would medications be a new approach for you?

Talk to your doctor about the risks and benefits of combining these medications. Together, you can create a plan that works for you. 

Can You Safely Mix Both Medications? 

If your doctor says you can use Adderall and Suboxone at the same time, you can take these medications together. 

There are of course always risks, but working with your doctor ensures you can take both medications safely and minimize any complications. 

Talk openly with your doctor and the rest of your treatment team about which medications, including stimulants, you are taking while on Suboxone.