Benzodiazepines and Suboxone can be mixed. There are certainly individuals that have a clinical indication for taking both drugs at the same time. However, both medications are sedating and can cause over sedation, respiratory depression and potentially overdose. Thus, taking these medications together should never be done recreationally, and should ideally be done under the careful supervision of a physician.
Key Facts About Benzodiazepines & Suboxone
- Overdose from Suboxone misuse alone is very rare, but it becomes much easier to overdose if Suboxone is taken with other drugs that can cause respiratory depression, including benzodiazepines.
- Benzodiazepines and Suboxone have legitimate medical purposes, and they may be prescribed together in some circumstances.
- A large number of overdose deaths in the United States involve benzodiazepine use, generally mixed with other drugs, with over 12,000 overdose deaths involving benzodiazepines in 2020.[1]
Understanding Benzodiazepines & Suboxone
The following is a brief description of benzodiazepines and Suboxone:
Benzodiazepines
Benzodiazepines are a class of medications with sedative-hypnotic effects, calming activity in the brain.[2] When used as intended, they help to reduce abnormal brain activity. They are used clinically for a couple conditions, including seizures, alcohol withdrawal, or short term for severe anxiety.
When used for acute anxiety or alcohol withdrawal, we try to use them for as short a course as possible, as dependence tends to develop if used long term.
Suboxone
Suboxone is a brand name drug that combines buprenorphine and naloxone.[3] Buprenorphine is a partial opioid agonist, acting similarly to full opioid agonists like morphine or heroin but without the associated euphoric effects and with a much lower risk of physical dependency and respiratory depression/overdose risk.
As a result, Suboxone can suppress withdrawal and drug cravings without giving the intense high associated with those drugs. Suboxone is used for several indications, most commonly as part of a Medication for Addiction Treatment (MAT) program for opioid use disorder (OUD). In addition, it is also used more and more these days as a pain medication, particularly for individuals who have a history of opioid dependency and want to avoid full opioids or for patients that prefer safer pain medications with less addiction potential than a full opioid.
Can You Mix Benzodiazepines & Suboxone?
Yes, although with caution. These drugs can be dangerous if misused together. Both can weaken your breathing and potentially cause you to be unable to draw in enough air to provide your brain with the oxygen it needs. This can result in a life-threatening overdose. You should never mix Suboxone and benzodiazepines recreationally on your own.
However, some patients may have a condition that warrants both medications to be taken at the same time. This can be done safely so long as you are monitored carefully and you report symptoms of over-sedation to your doctor so your dose can be adjusted or alternative therapies can be found.
Potential Side Effects of Mixing These Drugs
There are several risks to mixing these drugs, including overdose and accidental injury.[4]
Benzodiazepines can cause a person’s motor skills and coordination to become impaired, increasing their risk of falls, motor vehicle accidents, or other accidental injuries. This is why it is important to monitor how you feel and never drive or operate heavy machinery when on benzodiazepines.
Additionally, many people taking benzodiazepines with Suboxone are in recovery from addiction. These individuals are at higher risk of misusing benzodiazepines, which also have a high misuse and addiction potential. For this reason, it is important that both a prescriber and patient only mix these drugs with significant care.
Get Medical Support Before Mixing These Drugs
There are some scenarios when the benefits of mixing these two drugs can outweigh the risks.
Mixing any prescription medications carries some level of risk. These two drugs in particular can combine to create a significant level of respiratory depression that can become life-threatening. This is in addition to the misuse and addiction potential that benzodiazepines can present to people trying to recover from addiction.
If you do need both Suboxone and benzodiazepines simultaneously, talk openly and honestly with your doctor about the risks and benefits. Together you can come up with a safe and effective treatment plan.
Sources
- Overdose Death Rates. National Institute on Drug Abuse. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates. January 2022. Accessed November 2022.
- Addiction: Part I. Benzodiazepines — Side Effects, Abuse Risk and Alternatives. American Family Physician. https://www.aafp.org/pubs/afp/issues/2000/0401/p2121.html. April 2000. Accessed November 2022.
- Suboxone. Indivior UK Limited. https://www.suboxone.com/. Accessed November 2022.
- Benzodiazepine Use During Buprenorphine Treatment for Opioid Dependence: Clinical and Safety Outcomes. Drug and Alcohol Dependence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3916951/. October 2014. Accessed November 2022.
Medically Reviewed By Elena Hill, MD, MPH
Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More
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