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Can Suboxone Be Used to Treat Alcohol Addiction?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Feb 25, 2024 • 9 cited sources

No, Suboxone is not used or prescribed to treat alcohol use disorder (AUD). It is a medication used to treat opioid use disorder (OUD). 

That being said, some people who have co-occurring AUD and OUD may find that they are drinking less while on Suboxone simply because they are also using opioids less. In this way, being on Suboxone may help to decrease the frequency of alcohol use if you are using primarily when also taking opioids. 

However, Suboxone alone has not been shown to decrease alcohol use or treat alcohol use disorder. There are several pharmacological therapies for AUD, including naltrexone (Vivitrol), acamprosate (Campral), and disulfiram (Antabuse). [1]

Does Suboxone Help with Alcohol Cravings?

Quick Answer

No, it’s not generally believed that Suboxone can reduce alcohol cravings since it’s a medication for opioid use disorder. Nor is it prescribed to manage alcohol cravings. However, one study found that higher doses of buprenorphine reduced drinking in rats.[3]

Suboxone is Used to Treat Opioid Use Disorder

Suboxone is not used to treat alcohol addiction or alcohol dependence—rather, it is an effective medication for opioid use disorder.

Suboxone helps to normalize brain chemistry that’s been disrupted by opioid misuse, as well as other benefits like:[5]

  • Relieve opioid cravings
  • Alleviate opioid withdrawal symptoms
  • Block the euphoric effects of opioids
  • Normalize body functions

Medications for Alcohol Use Disorder

There are several evidence-based medications prescribed to treat alcohol use disorder, including:[4]

  • Naltrexone (long-acting injection is Vivitrol)
  • Acamprosate (Campral)
  • Disulfiram (Antabuse)

Much like with Suboxone, these medications are prescribed in conjunction with counseling to provide comprehensive AUD treatment.

Addiction treatment should be customized to your individual needs. While the treatments you receive should always be evidence-based, there is no one “perfect” treatment plan that works for everyone. 

Does Suboxone Help Treat Alcohol Addiction?

No, doctors do not prescribe Suboxone to treat alcohol use disorder. Suboxone is one of several buprenorphine-based medications that are used to treat OUD.[2] 

People who struggle with comorbid opioid misuse and alcohol misuse may drink less while taking Suboxone if they were used to using the drugs at the same time. However, Suboxone alone has not been shown to decrease alcohol use or treat alcohol use disorder.

There have been some very preliminary studies in rats that show Suboxone may help decrease alcohol use, however, much more research is needed to confirm the connection and to test if the findings would translate to humans. [3] Few, if any doctors, would recommend Suboxone as a treatment for alcohol use disorder alone. 

If you are also using opioids and you start using Suboxone, you might find that, because you are no longer misusing opioids, you are consuming less alcohol while on Suboxone. 

Medication Management Differences Explained

Alcohol use disorder is very different from opioid use disorder, and as such, it is treated with different medications. This table explains their differences:[8,9]

MedicationWhat Is It Used For?What Does It Do?
SuboxoneOpioid use disorderReduces withdrawal symptoms and cravings
NaltrexoneOpioid use disorder and alcohol use disorderBlocks euphoric and sedative effects of alcohol and opioids
AcamprosateAlcohol use disorderAdjusts brain chemistry imbalances (including GABAergic systems) making alcohol less rewarding
DisulfiramAlcohol use disorderBlocks alcohol’s breakdown, causing physical reactions (flushing, headaches, vomiting) when combined with alcohol

How Does Suboxone Work?

Suboxone contains buprenorphine, a partial opioid agonist. It latches to both mu-opioid and kappa-opioid receptors in the brain. When it’s connected, Suboxone eases opioid withdrawal signs and symptoms. The medication can also ease cravings for opioid drugs. 

Suboxone was specifically designed to help people addicted to opioids, and it’s not FDA approved for any other purpose.[9]

How Do Alcohol Medications Work?


Three medications have been FDA approved to help people overcome alcohol use disorder, and they all work a little differently.[8]

  • Acamprosate amends brain imbalances caused by alcohol misuse, making a return to drinking less rewarding.
  • Disulfiram causes severe unpleasant reactions when combined with alcohol, making drinking an extremely uncomfortable experience.
  • Naltrexone blocks opiate receptors involved with the rewarding impact of drinking and alcohol cravings.

None of these medications are designed to help people move through alcohol withdrawal. People with alcohol use disorders must complete detox before they get started with these therapies.

Understand Alcohol Withdrawal Syndrome

Alcohol withdrawal syndrome occurs when long-time drinkers suddenly decrease their intake. Symptoms can be severe, and up to 5% of people experiencing the most significant type of withdrawal die from it.[7]

Alcohol is a central nervous system depressant that inhibits electrical activity in the brain. When long-time drinkers quit and brain cells awaken, they become overly excited, and withdrawal symptoms develop.[7]

Alcohol withdrawal symptoms typically begin within about six hours of quitting and can include the following:[7]

  • Nausea
  • Anxiety
  • Hallucinations
  • Agitation
  • Sweating
  • Shaking
  • Seizures

If you are dependent on alcohol, do not try to quit alcohol cold turkey on your own or self-medicate using Suboxone or otherwise. The safest setting for alcohol withdrawal management is medical detox, which occurs in a hospital or detox center.

Alcohol withdrawal is typically treated with benzodiazepine medications. Drugs like diazepam and lorazepam work by sedating brain cells—just as they would be sedated if the person was drinking. The dose is slowly tapered, allowing electrical activity to return without sparking withdrawal problems.[6]

Suboxone contains an opioid agonist and an opioid antagonist. These medications don’t work directly on electrical systems within the brain, and they can’t be used as a seizure preventive. Suboxone isn’t used in alcohol withdrawal management for that reason.

Can You Mix Suboxone & Alcohol?

Alcohol is a central nervous system depressant, just like the buprenorphine in Suboxone. Per the FDA, people should never combine Suboxone with alcoholic beverages.[9] Doing so can lead to very slow breathing rates, potentially leading to death.

If you can’t stop drinking alcohol while using Suboxone, ask your doctor for help. You may need to adjust your treatment plan to get the help you need to stay sober.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

Sources
  1. Understanding Alcohol Use Disorder. National Institute on Alcohol Abuse and Alcoholism. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder. April 2021. Accessed November 2023.
  2. Medication Prescribing and Behavioral Treatment for Substance Use Disorders in Physician Office Settings. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/sites/default/files/report_1976/ShortReport-1976.html. 2010. Accessed November 2023.
  3. Buprenorphine Reduces Alcohol Drinking Through Activation of the Nociceptin/Orphanin FQ-NOP Receptor System. Biological Psychiatry. https://pubmed.ncbi.nlm.nih.gov/16533497/.  January 2007. Accessed November 2023.
  4. Alcohol Use Disorder (AUD) Treatment. National Library of Medicine. https://medlineplus.gov/alcoholusedisorderaudtreatment.html. September 2017. Accessed November 2023.
  5. Medications for Substance Use Disorders. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medications-substance-use-disorders. October 2023. Accessed November 2023.
  6. Sachdeva A, Choudhary M, Chandra M. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. J Clin Diagn Res. 2015;9(9):VE01-VE07. doi:10.7860/JCDR/2015/13407.6538
  7. Newman R, Stobart M, Gomez A. Alcohol withdrawal. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK441882/. July 2023. Accessed January 2024.
  8. Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/sma15-4907.pdf. 2015. Accessed January 2024.
  9. Suboxone Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf. March 2021. Accessed January 2024.

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