Suboxone (buprenorphine/naloxone) is a prescription medication used to treat opioid dependence and addiction. It is not an easy medication to obtain as it has a very narrow range of uses and can interact negatively with a range of other drugs.

If you are taking Suboxone, you likely know that it is dangerous to take opioids while you are on the medication. However, you may find yourself tempted to use other drugs, justifying your drug use because it isn’t an opioid. But mixing Suboxone with any illicit substance comes with risks. For example, you should never mix ecstasy and Suboxone because of the potential for adverse side effects like serotonin syndrome or reduced medication effectiveness.

What is Suboxone and How Does it Work?

Suboxone is a brand-name prescription medication used to treat opioid dependence and addiction. It comes in the form of a sublingual film that dissolves under the tongue and contains two drugs: buprenorphine and naloxone.[1]

Buprenorphine is a partial opioid agonist meaning it binds to opioid receptors and activates them, but to a lesser degree than full opioid agonists do. By binding to and activating opioid receptors, buprenorphine can relieve symptoms of opioid withdrawal.

Naloxone, on the other hand, is an opioid antagonist that is added to Suboxone to deter possible buprenorphine abuse. Naloxone doesn’t do anything unless you inject buprenorphine or take another opioid. When you try to get high by taking an opioid or try injecting your Suboxone, naloxone will prevent you from getting high and may cause withdrawal symptoms.

Suboxone is most often used during detox, but it can also be used after detox to keep cravings at bay and reduce the risk of relapse. When combined with behavioral therapy, counseling, and peer support, Suboxone can improve treatment outcomes by helping you stay sober.

What is Ecstasy (MDMA)?

Ecstasy, also known as MDMA or molly is a synthetic drug composed of 3,4-methylenedioxy-methamphetamine. This substance alters mood and perception. It has both stimulant and hallucinogenic properties, often producing side effects such as increased energy, pleasure, emotional warmth, and a distorted sense of time.[2]

Ecstasy is popular in nightclubs and rave scenes, but it can be used recreationally for a number of purposes. People usually take it as a capsule, but some swallow it in liquid form or snort MDMA powder. Ecstasy is often used in combination with other drugs such as marijuana, alcohol, cocaine, or psilocybin mushrooms.

Ecstasy works by increasing the activity of three neurotransmitters in the brain:

1. Dopamine – a chemical that produces energy and acts as a reward system to reinforce certain behaviors.
2. Norepinephrine – a stress hormone that increases heart rate and blood pressure.
3. Serotonin – a hormone that affects mood, appetite, sleep, and sexual arousal. People who use MDMA often experience emotional closeness and empathy toward others, and this is thought to be caused by excess serotonin.

Other side effects of MDMA may include:

• Muscle cramping
• Teeth clenching
• Blurred vision
• Chills
• Sweating
• Impulsivity
• Irritability
• Anxiety
• Sleep problems

Risks of Taking Ecstasy While on Suboxone

Ecstasy is a mood-and-mind-altering substance, and if you are prescribed Suboxone, it is because you are struggling with addiction and trying to get sober. As a result, it isn’t a good idea to take ecstasy or any other illicit drug while you are on Suboxone.

Possible interactions and risks include:

• Diminished Effects of Ecstasy – Suboxone’s mechanism of action as an opioid partial agonist can potentially interfere with the desired effects of ecstasy. The buprenorphine in Suboxone may reduce the euphoric and empathogenic effects of ecstasy. This may encourage users to take higher doses of ecstasy, which can potentially lead to a life-threatening overdose.
• Increased Risk of Serotonin Syndrome – Both Suboxone and ecstasy can affect serotonin levels in the brain. Serotonin syndrome, a potentially life-threatening condition, can occur when serotonin levels become excessively elevated. Combining these substances may increase the risk of developing serotonin syndrome, leading to symptoms such as confusion, agitation, rapid heartbeat, high blood pressure, tremors, and even seizures.[3] Serotonin syndrome is a medical emergency.
• Relapse and Addiction Potential – Taking ecstasy while on Suboxone can potentially trigger a relapse in individuals recovering from opioid addiction. Ecstasy’s psychoactive effects and potential for addiction may undermine the progress made in substance abuse treatment.
• Unknown Drug Compositions in Ecstasy – Ecstasy purchased illicitly may contain adulterants or other substances that can pose additional health risks. Mixing unknown substances with Suboxone can lead to unpredictable and potentially dangerous interactions. For example, an overdose can easily occur if the ecstasy contains heroin or fentanyl.

If you are considering taking ecstasy while on Suboxone, you should consult with your prescribing physician or an addiction specialist. He or she can help you work through your cravings, adjust your dose of Suboxone, if needed, and modify your treatment plan to better promote sobriety.

Find Help Today

If you or a loved one have been abusing Suboxone or ecstasy, it may be time to get professional help. At Moving Mountains Recovery, our dedicated team of addiction specialists is available to help you learn about your treatment options and get connected with the right program for you. Don’t wait any longer. Call now to get started.

References:

1. U.S. Food and Drug Administration (FDA): Suboxone Highlights of Prescribing Information, Retrieved June 2023 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022410s000lbl.pdf
2. National Institute on Drug Abuse (NIDA): MDMA (Ecstasy/Molly) DrugFacts, Retrieved June 2023 from https://nida.nih.gov/publications/drugfacts/mdma-ecstasymolly
3. National Library of Medicine: Serotonin Syndrome, Retrieved June 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832/