Is Suboxone Used to Treat Alcoholism?

Suboxone is not used to treat alcoholism, but other medications are available to treat the condition. Disulfiram, acamprosate, and naltrexone are approved by the FDA to treat alcohol use disorder.[1] Suboxone is approved to treat opioid use disorder, and it is a combination of buprenorphine and naloxone.

Always make treatment decisions with the help of an addiction treatment professional. Your doctor will be able to determine if medication is a good choice to treat your substance use disorder (SUD).

What Is Suboxone?

Suboxone is a medication that combines buprenorphine and naloxone.[2] It is a medication for opioid use disorder (mOUD), and it has a significant amount of evidence supporting its use for this purpose. 

Of its two active ingredients, buprenorphine is dominant, with naloxone primarily being in Suboxone to reduce its misuse potential. Buprenorphine is a partial opioid agonist, meaning it acts chemically similar to full opioid agonists like heroin but fits imperfectly into the brain’s opioid receptors. 

Overall, Suboxone and medications like it are considered safe by the standards of prescription medications. These medications have low misuse and addiction potential. They do have some potential downsides and risks, but when used correctly, they can be of substantial help in combating opioid use disorder.

Can Suboxone Help Treat Alcoholism?

Suboxone is not used as a treatment to address alcohol use disorder. It is not approved for such use, though some studies have assessed whether it can be helpful in addressing certain symptoms of alcoholism. 

An animal study published in 2007 showed that high doses of buprenorphine, the primary ingredient of Suboxone, reduced the amount of alcohol rats trained to drink alcohol chose to drink. Notably, lower doses of buprenorphine had the opposite effect, causing them to drink more.[3]

A 2018 French study also suggested that medications like Suboxone may be helpful for alcohol use disorder (AUD) treatment, presenting relatively positive, although preliminary, findings that suggested high doses of buprenorphine could help with treatment-resistant and life-threatening AUD, even in people free of OUD.[4] This study at least produced results that warrant deeper examination. 

Again, it’s important to highlight that Suboxone and similar medications aren’t approved treatments for AUD, and there isn’t much to suggest that should change. While they may have some useful properties worth researching further, there are other medications and treatment options with stronger evidence supporting their use as primary treatment options for AUD. The current debate is the value of buprenorphine or Suboxone in helping patients with treatment-resistant AUD.

Suboxone to Ease Withdrawal Symptoms

There isn’t evidence that Suboxone or similar medications can ease alcohol withdrawal symptoms, and it shouldn’t be taken for this purpose. Suboxone can, however, help with opioid withdrawal. It is a medication worth discussing with an addiction treatment professional if you struggle with both alcohol and opioid misuse. 

One important element to note for people who struggle with both alcohol and opioids is that Suboxone shouldn’t be mixed with alcohol, as it has the potential to cause dangerous respiratory depression.[5] At the same time, the risk of dangerous respiratory depression is significantly higher if one misuses more potent opioids like fentanyl with alcohol, so Suboxone may be worth taking if it helps you avoid those drugs. 

Getting Treatment for Alcoholism

As highlighted in this article, Suboxone isn’t an approved treatment for alcohol use disorder. But there are various medications that are approved to treat AUD, and these medications can help significantly in some cases. 

Addiction is complex and no medication can cure it. In fact, there is no cure for addiction, but it can be successfully managed for life. The condition is best treated by talking to an addiction treatment professional and forming a comprehensive treatment plan that approaches the problem from multiple angles at once. 

Alcohol use disorder, like most types of addiction, is best treated with a combination of medication and therapy, such as cognitive behavioral therapy. Medication isn’t enough on its own to address substance use disorder.

Importantly, the goal isn’t just to stop drinking and successfully get through withdrawal, although this is an important step in recovery. It is also to identify why you drink and what led to heavy alcohol misuse in the first place. Then, you can work to break that pattern long-term to avoid relapsing back into destructive drinking. 

Sources

1. Evidenced-Based Pharmacotherapies for Alcohol Use Disorder: Clinical Pearls. Mayo Clinic Proceedings. https://www.mcstap.com/Docs/Evidence-Based%20Pharmacotherapies%20for%20Alcohol%20Use%20Disorder-%20Clinical%20Pearls%202020%20Mayo%20Review.pdf. September 2020. Accessed March 2023.
2. Buprenorphine Sublingual and Buccal (Opioid Dependence). National Library of Medicine. https://medlineplus.gov/druginfo/meds/a605002.html. January 2022. Accessed March 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 March 2023. 
4. High-Dose Buprenorphine: A Last Resort Drug for Treatment-Resistant Alcohol Use Disorder. Preliminary Results of a Compassionate Observational Pilot Study. French Journal of Psychiatry. https://www.sciencedirect.com/science/article/abs/pii/S2590241519303411. November 2018. Accessed March 2023. 
5. Drug Interactions of Clinical Importance Among the Opioids, Methadone and Buprenorphine, and Other Frequently Prescribed Medications: A Review. American Journal of Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334287/. April 2012. Accessed March 2023.