When it comes to prescription medications, interactions between certain pharmaceuticals can be harmful. It is vital to be honest with your doctor about any medications you are taking so you can avoid adverse interactions.

Two medications you should avoid taking at the same time are Xanax (alprazolam) and Suboxone (buprenorphine/naloxone). Xanax is a benzodiazepine anxiety medication and Suboxone is used to treat opioid use disorder, and since addiction and mental health issues often co-exist, there is a possibility of these medications being prescribed at the same time. On the other hand, some drug users who are taking Suboxone may try mixing it with benzodiazepines to get high.

Mixing Suboxone and Xanax, especially in an attempt to get high, can be extremely harmful. Taking too many of these medications at once can lead to respiratory depression, overdose, and death.

What is Xanax (Alprazolam)?

Xanax is the most widely prescribed benzodiazepine medication. It is used to treat anxiety and panic disorders as well as insomnia.

Xanax works by enhancing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that acts as an inhibitory messenger in the brain. Its primary role is to reduce the activity of nerve cells, helping to create a calming and relaxing effect. When Xanax binds to GABA-A receptors, it enhances the effects of GABA. This increased GABA activity leads to reduced neuronal firing, reducing excessive excitement in the brain and resulting in less anxiety.

Xanax is a potent medication that must be used with caution. It can be habit-forming and abruptly stopping the use of it may result in severe withdrawal symptoms. It’s important to avoid combining Xanax with alcohol or other central nervous system depressants, as this can increase the risk of dangerous side effects.

Common side effects of Xanax are:

• Drowsiness
• Dizziness
• Fatigue
• Impaired coordination
• Memory problems
• Slurred speech
• Headache
• Nausea
• Constipation
• Dry mouth
• Changes in appetite
• Changes in sex drive
• Irritability
• Blurred vision
• Muscle weakness
• Loss of balance or coordination
• Difficulty concentrating

What is Suboxone (Buprenorphine/Naloxone)?

Suboxone is a medication that contains two drugs: buprenorphine and naloxone.

Buprenorphine, an opioid partial agonist, activates the same opioid receptors in the brain that opioids like heroin or prescription painkillers target. However, buprenorphine has a ceiling effect, meaning that after a certain point, increasing the dosage doesn’t lead to stronger opioid effects, reducing the risk of overdose. Buprenorphine provides relief from withdrawal symptoms and cravings without producing the intense euphoria associated with full opioid agonists.

Naloxone is an opioid receptor agonist that is added to Suboxone to prevent misuse. It has minimal effects when taken as prescribed, but if it is crushed or injected, naloxone becomes active and quickly blocks the effects of other opioids in the system. This can result in sudden withdrawal symptoms which are thought to deter misuse.

Suboxone is used to treat opioid dependence and addiction. It may be prescribed to treat symptoms of withdrawal during detox and to reduce cravings and the risk of relapse in early recovery.

Common side effects of Suboxone are:

• Drowsiness
• Dizziness
• Fatigue
• Impaired coordination
• Memory issues
• Slurred speech
• Headache
• Nausea
• Constipation
• Dry mouth
• Excessive saliva production
• Changes in appetite
• Weight fluctuations
• Altered sex drive
• Insomnia
• Irritability
• Blurred vision
• Muscle weakness
• Balance or coordination problems

Suboxone is a central nervous system depressant and it should not be combined with other depressant drugs, including Xanax.

 

 

The Dangers of Mixing Xanax and Suboxone

Unless you are directed to do so by your doctor, you should never mix opioids like Suboxone with benzodiazepines like Xanax. Mixing opioids and benzodiazepines can increase the risk of overdose, and up to 90% of all benzodiazepine overdose deaths also involve opioids.

Suboxone and Xanax share many of the same side effects, and both suppress breathing, cause sedation, and impair your ability to think clearly. When taken together, these side effects can become enhanced, resulting in:

• Slowed brain activity
• Severe drowsiness
• Extreme dizziness
• Breathing problems
• Reduced respiratory functioning
• Sedation
• Overdose
• Coma
• Death

Respiratory depression is the most worrisome consequence of combining Xanax and Suboxone. This condition involves slow and shallow breathing, which can eventually lead to oxygen deprivation, unconsciousness, or even death. The interaction between benzodiazepines like Xanax and opioids like buprenorphine in Suboxone can significantly amplify this risk. Unfortunately, when the body’s ability to regulate breathing becomes compromised, the likelihood of a life-threatening situation increases.

Alternative Approaches for Managing Anxiety While Taking Suboxone

Healthcare professionals strongly advise against combining Xanax and Suboxone due to their potential for adverse interactions. As a result, when someone who is taking Suboxone seeks treatment for anxiety, healthcare providers typically turn to alternative methods for treatment that don’t involve benzodiazepines.

Benzodiazepines are typically avoided in people who have a history of substance use disorders due to the risk of abuse and addiction. Instead, behavioral therapies like cognitive-behavioral therapy (CBT), holistic therapies like art or yoga, and pharmaceuticals like SSRIs may be recommended.

Find the Help You Need Today

At Moving Mountains Recovery, our top priority is ensuring you receive the comprehensive dual diagnosis care you need to maintain long-term sobriety. We understand that recovery is a case-by-case process, and what works for one person may not work for another. That’s why our programs focus on individually-tailored treatment and holistic care.

Whether you’re interested in learning about Suboxone treatment or would like to discuss your other treatment options, please contact our team today,

References:

1. 1. U.S. Food and Drug Administration (FDA): Xanax Alprazolam Tablets, Retrieved August 2023 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf
   2. U.S. Food and Drug Administration (FDA): Suboxone, Retrieved August 2023 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/022410s000lbl.pdf