Suboxone is a popular medication that is used to treat opioid addiction. It is prescribed during detox to alleviate withdrawal symptoms and during recovery to mitigate opioid cravings. However, Suboxone can have very serious side effects when it is taken incorrectly.
One of the most serious drug interactions regarding Suboxone is other opioids. Suboxone should never be taken while opioids are still in your system, and you should never take an opioid while you are taking Suboxone. As one of the most powerful opioids, fentanyl is a drug that should never be used with Suboxone.
What is Fentanyl?
Fentanyl is a synthetic opioid that was designed to manage severe pain associated with surgery and in people who have developed a tolerance to other opioids. Pharmaceutical fentanyl is safe and effective when used as prescribed, which typically occurs under the guidance of a healthcare professional, but it can be dangerous when abused recreationally. Medicinal fentanyl may come in various forms, such as transdermal patches, lozenges and lollipops, liquid, nasal spray, or tablets.
Most recreational fentanyl abuse involves illicitly manufactured fentanyl (IMF). IMF can vary in potency and composition and may contain a number of additives or adulterants. Illicit fentanyl usually comes in the form of a white powder or colorless liquid.
Regardless of the type of fentanyl, it is estimated to be 50 to 100 times stronger than heroin and morphine, respectively, so it is an extremely powerful, strong drug. Fentanyl and other synthetic opioids are the primary causes of the unprecedented number of opioid-related overdose deaths in the U.S. today.
Similar to other opioids, fentanyl works by binding to and activating opioid receptors throughout the brain and body. In doing so, it increases dopamine activity and interrupts pain signals, resulting in feelings of euphoria and pain relief.
Understanding Suboxone
Suboxone is a combination medication that contains buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist.
Buprenorphine partially binds to and activates opioid receptors but to a lesser degree than full opioid agonists. Naloxone blocks the effects of other opioids, so if you take an opioid while on Suboxone, naloxone will displace opioid molecules from opioid receptors and prevent you from being able to get high. Naloxone is also the reason why people experience withdrawal symptoms if they take Suboxone too early or while opioids are still in their system.
Suboxone is available for prescription only. It was approved by the FDA in 2002 for the treatment of opioid dependence and addiction.
People may start taking Suboxone 12-24 hours after their last dose of opioids to alleviate symptoms of withdrawal. Suboxone can also be used after detox to keep drug cravings under control. Suboxone is most effective when combined with a comprehensive addiction treatment program involving behavioral therapy, counseling, and peer support.
Can You Use Fentanyl While on Suboxone?
No, you should not take fentanyl while you are on Suboxone. Fentanyl is an opioid, and you cannot mix any opioid, no matter the strength, with Suboxone.
Does Suboxone Block Fentanyl?
Suboxone does indeed block fentanyl and its effects. This occurs because of the buprenorphine, which is present in Suboxone. Since fentanyl is an opioid and naloxone’s job is to displace opioids so that people don’t get high, naloxone can knock fentanyl off of opioid receptors in the brain and body all at once. Displacing all opioid molecules suddenly, as opposed to letting the opioid leave the body over a period of time, is a shock to the system and results in a condition called precipitated withdrawal.
Precipitated withdrawal occurs when medication-assisted treatment (MAT) medications, such as Suboxone, trigger withdrawal symptoms. These symptoms include:
- Severe muscle aches and pains
- Fever
- Chills
- Cramping
- Sweating
- Dilated pupils
- Insomnia
- Nausea
- Vomiting
- Restlessness
- Diarrhea
- Depression
- High blood pressure
- Rapid heartbeat
- Suicidal thoughts
In severe cases, precipitated withdrawal can be worse than regular opioid withdrawal. It can also be life-threatening without medical treatment.
If you are taking fentanyl, you should wait at least 24 hours before starting Suboxone. Be sure to tell your health provider about any medications you have taken recently. Do not start taking Suboxone until your healthcare provider has directed you to do so.
Other Dangers of Mixing Fentanyl and Suboxone
In addition to the possibility of precipitated withdrawal, other risks associated with mixing fentanyl and Suboxone include:
- Increased risk of respiratory depression and overdose
- Increased risk of seizures
- Potential sedation and accidental injury
- Experiencing precipitated withdrawal can make it harder to stay in recovery, possibly triggering a continued relapse
Get Help Now
If you or a loved one are battling fentanyl addiction, our team at Moving Mountains Recovery is here to help. We offer clients a safe and supportive environment where they can start their recovery and improve their lives. Whether you’re interested in Suboxone treatment or would like to discuss your other treatment options, please call now to speak with a trusted admissions coordinator.
References:
- Food and Drug Administration (FDA): Suboxone Prescribing Information, Retrieved June 2023 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022410s000lbl.pdf
- Centers for Disease Control and Prevention (CDC): Fentanyl Facts, Retrieved June 2023 from https://www.cdc.gov/stop-overdose/caring/fentanyl-facts.html
- Substance Abuse and Mental Health Services Administration (SAMHSA): Buprenorphine Quick Start Guide, Retrieved June 2023 from https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf
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