Most medications, including Suboxone and Xanax, come with the potential for adverse effects that can be amplified when multiple medications are used in combination. Unfortunately, some individuals using Suboxone may do so in addition to Xanax without a prescription, also known as drug diversion. They may do so for primarily recreational purposes or because they are attempting to self-medicate other mental health conditions, such as severe anxiety, panic attacks, or insomnia.
What Is Suboxone?
Suboxone is a prescription commonly used to treat opioid dependence. The medication comes in sublingual or buccal strips and tablet form and consists of both buprenorphine and naloxone.
Buprenorphine is a long-acting opioid agonist that attaches to the same neural receptors that other opioids do. For this reason, it prevents other opioids from binding to these receptors, and as it does so, withdrawal symptoms are stopped from occurring when the individual stops using their opioid drug of choice.
Suboxone also includes naloxone, a medication obtainable without a prescription that works to reverse an opioid overdose’s effects. If someone attempts to abuse Suboxone in excessive doses or tampers with it, the naloxone will effectively remove buprenorphine from the opioid receptors and take its place. In doing so, this will cause the individual to go into withdrawal and experience highly uncomfortable symptoms.
Moreover, Suboxone will prevent opioid withdrawal symptoms only if used precisely as prescribed. Despite its effectiveness, Suboxone does have the potential for adverse effects, which include the following:
- General pain
- Sleep difficulties
What Are Benzodiazepines?
Benzodiazepines (benzos) are in a class of prescription medications that can cause profound depression of the nervous system. Benzos are most commonly used to treat anxiety, panic attacks, seizures, and insomnia. Xanax is a short-acting benzo believed to have a high potential for abuse, despite its relatively low classification as a Schedule IV substance.
A low to moderate dose of Xanax can lead to the following side effects:
- Impaired motor function
- Impaired vision
- Respiratory depression
When used in excessive doses, Xanax use can lead to delayed reflexes, erratic thinking and behavior, mood alteration, and euphoria. Euphoric effects, which are hallmarked by feelings of wellness and relaxation, often lead to the abuse of Xanax, and unfortunately, abuse of benzos has become extremely common in the U.S.
Long-term effects from the use of benzos may include impaired memory and judgment, physical weakness, and confusion or disorientation.
Physical dependence on Xanax can develop rapidly, which is why they are typically only intended for short-term use. Once dependence has formed, benzo withdrawal can cause unpleasant side effects. Similar to alcohol withdrawal, these effects, which can include seizures, can be life-threatening.
As a result, medical detox is always recommended for those undergoing Xanax withdrawal. Often, a supervising health provider or addiction specialist will gradually wean a person off of Xanax by lowering the dosage over time. This method helps to alleviate withdrawal symptoms until discontinuation of use is safe and comfortable.
Concurrent Use of Suboxone and Xanax
The mixing of Suboxone and Xanax is not uncommon despite the known risks. One study found that two-thirds of persons who reported using buprenorphine did so in combination with benzos, such as Xanax. This number is remarkably high and problematic, as the two drugs can adversely interact with each other and present a dangerous situation for the individual who uses them together.
Combining opioid medications and benzos can lead to coma and death, and they do so frequently. According to recent estimates, more than 11,000 overdose fatalities in 2017 were related to the use of both benzos and opioids.
Perhaps one key reason why these two substances are so often used in conjunction is that those who have been given Suboxone have already experienced substance abuse issues. To elaborate, this means that an individual using Suboxone is at a higher risk of abusing benzos than those who do not have a history of substance abuse.
Of note, it’s extremely risky to operate a motor vehicle or heavy machinery when under the influence of this combination of drugs. Reduced reaction time, drowsiness, and other intoxicating effects significantly increase the chance of having a serious accident.
Abuse of Suboxone and Xanax Is Dangerous
Using these two medications as prescribed in combination poses some risks. However, abusing either drug in excessive amounts is much more likely to lead to severe complications and overdose. The greatest threat to any person who uses these drugs is respiratory arrest, which is more likely to occur when different CNS depressants are used in conjunction.
Benzos like Xanax may be abused in this situation because the abuse of Suboxone can result in adverse effects that can prompt immediate withdrawal symptoms. Buprenorphine itself is considered to have a relatively low potential for abuse, and with the addition of naloxone, its potential decreases even further. Conversely, Xanax is a prevalent drug of abuse, but if it is abused independently of other substances, it is unlikely to be lethal.
For this reason, individuals who use Suboxone and Xanax may not realize that there may be dire consequences of doing so. Overdose notwithstanding, combined abuse also places a person at a higher risk of experiencing adverse health consequences in both the short- and long-term.
Combining Suboxone with any benzo can cause profound sedation, and excessive sleepiness is not uncommon. Also, users may be at a heightened risk of experiencing respiratory depression and lethally low heart rate and blood pressure. Overdoses are survivable if treated using appropriate emergency medical intervention early, but if an individual lacks oxygen for an extended period, this can lead to irreversible brain damage.
Concurrent use of these two substances has also been found to reduce the likelihood that the person in recovery from another substance, such as heroin, will sustain long-lasting sobriety. Also, if an individual continues to abuse Xanax after Suboxone has been stopped, this in and of itself can contribute to a relapse.
In conclusion, combining Suboxone and Xanax should be avoided due to the risks involves unless both drugs are used as directed by a licensed health provider. If a doctor prescribes either to an individual, they are obliged to notify this physician if they are using any other substances. Abuse of either Suboxone or Xanax has been associated with serious dangers and should always be avoided.
Getting Help for Addiction
If you’ve been prescribed Suboxone and you are abusing it, we urge you to seek additional care in a specialized treatment center. Regardless of whether you are misusing Suboxone, Xanax, other drugs, or alcohol, these behaviors must be addressed before the situation worsens. Regardless of the reasons for abuse, it is risky and can lead to severe health complications, including coma and death.
Just Believe Recovery Center offers intensive treatment programs comprised of evidence-based treatments vital to the recovery process, including psychotherapy, peer group support, counseling, art and music therapy, relapse prevention, aftercare planning, and more.