Suboxone and Benzodiazepine Deadly Interactions

Suboxone, a medication used in addiction treatment, is made up of buprenorphine and naloxone. Buprenorphine is derived from opioids but it causes milder effects. Naloxone inhibits the effects of opioids. Because of these properties, Suboxone is used to help treat a dependence on opioids.

Xanax, Valium and Klonopin are some of the brand names of benzodiazepines. These are central nervous system depressants that are generally used to treat insomnia and anxiety.

When they’re taken together, buprenorphine and benzodiazepines can be deadly. Because of this, it’s important to let your doctor and pharmacist know of any drugs you are taking if you are on one of these drugs. Remember, never combine any drugs unless it is a combination your doctor has approved.

Why Is This a Concern?

An April 2007 study in the journal Addiction discussed the problem of many people using both buprenorphine and benzodiazepines. Two-thirds of the people in the study used both together, showing that this is a potential problem people need to be made aware of.

The researchers in the study noted that treatment programs that use buprenorphine need to find a way to manage this combination issue. Researchers explained that it can be a problem when people are in opioid dependence treatment, since many people use more than one drug at a time. It’s important for people to know that these drugs taken together can have fatal consequences, particularly when patients aren’t honest about the drugs they are already taking.

Consequences of Combining These Drugs

Taking benzodiazepines like Xanax, Valium or Klonopin at the same time as buprenorphine, or Suboxone, can lead to serious drowsiness, unconsciousness and even overdose and toxicity. It is possible for the combination to become fatal.

A January/February 2010 article in the American Journal on Addiction found that when benzodiazepines are taken with buprenorphine by an IV injection, the combination can lead to death. These drugs are both central nervous system depressants that cause the same effects, so taken together the effects can be too strong on the body. The study explained that higher amounts of buprenorphine won’t cause greater effects when it’s used alone, but that adding the benzodiazepines changes the effect.

A September 1998 article in the journal Addiction found that six people in France died from a combination of buprenorphine and benzodiazepines. A March 2012 study in the European Journal of Clinical Pharmacology discovered that benzodiazepines were involved in many deaths associated with buprenorphine. These are not the only studies that have shown this correlation.

Additional Benzodiazepines That Interact With Suboxone

It is not only Xanax, Valium and Klonopin that negatively interact with Suboxone. These are only a few brand names of benzodiazepines. Some other benzodiazepines that can also interact with Suboxone include:

  • Tranxene
  • Librium
  • Halcion
  • Ativan
  • Serax
  • Prosom
  • Doral
  • Restoril
  • Dalmane

Talk to your doctor or pharmacist if you are taking any of these, or another type of benzodiazepine, to see if it can be safely combined with Suboxone.

Considerations

A September 2008 study in the journal Basic & Clinical Pharmacology & Toxicology discovered that not all types of benzodiazepines caused serious consequences when taken with buprenorphine. However, it noted that oftentimes the combination can lead to respiratory failure when buprenorphine is taken with high amounts of benzodiazepines.

*Deadly Interactions With Other Drugs

Suboxone and benzodiazepines not only cause deadly interactions with each other; they also can with other drugs. Benzodiazepines can cause death when they are taken with alcohol as they both affect receptors in the brain. Benzodiazepines affect GABA receptors and alcohol affects NMDA receptors. Together, this can be a fatal combination.

Suboxone can magnify drowsiness-inducing drugs, making you feel much sleepier, even to a dangerous level. These kinds of drugs can include:

  • Alcohol
  • Antidepressants
  • Sedatives
  • Antihistamines
  • Drugs for anxiety
  • Pain medications
  • Muscle relaxants

Because interactions with these drugs are so potentially dangerous, it’s important for you to be open with your doctor about anything you’re taking. This even includes herbal medicines and over-the-counter medicines, in addition to prescription medicines and street drugs.

If you’re taking both Suboxone, also known as buprenorphine, along with benzodiazepines, talk to your doctor about whether the combination you are taking is safe. If you know someone else who is combining them, make them aware of the risk and encourage them to talk to their doctor.