Suboxone and Alcohol: Is This a Risky Combination?

Suboxone (buprenorphine / naloxone) is a helpful treatment option for many people living with opioid use disorder. It’s a first-choice medication that can help manage cravings and withdrawal symptoms. But it has some important risks to be aware of, including interactions.

One medication interaction that’s often overlooked is drinking alcohol. And in the case of Suboxone, alcohol can pose life-threatening risks, such as an overdose. But what about just one drink? In short, no. You shouldn’t drink any alcohol while taking Suboxone. Let’s discuss why.

Good to know: Suboxone is a sublingual (under-the-tongue) film. The same active ingredients (buprenorphine and naloxone) are also available as a sublingual tablet called Zubsolv. The interaction with alcohol is the same for both dosage forms.

Can you take Suboxone with alcohol?

No, you shouldn’t take Suboxone with alcohol. No amount of alcohol is considered safe to drink while taking this medication.

There’s a warning about drinking alcohol on every Suboxone package insert. This is because of the buprenorphine component.

Promotion disclosure

Suboxone Film (Buprenorphine/Naloxone)

Avg retail price

$143.08(Save 75.71%)

GoodRx discount

$34.76

See all discounts

How it works

Use GoodRx to find medications, pharmacies, and discounts.

GoodRx discounts can help you pay less for your prescription.

Bring your free coupon or savings card to the pharmacy.

Buprenorphine is a partial opioid agonist. It works similar to an opioid, but it’s not as strong. Because of this, it has many of the same interactions as typical opioids, such as oxycodone (Roxicodone, OxyContin). This includes an interaction with alcohol.

How does alcohol interact with Suboxone?

Buprenorphine and alcohol are both sedatives. They slow down the central nervous system (brain and spinal cord) and cause similar side effects.

When alcohol and Suboxone are combined, it increases your risks for complications, such as:

• Drowsiness

• Dizziness

• Mental impairment

• Confusion

• Low blood pressure

• Slowed breathing

• Overdose

• Coma

• Death

Is having one or two drinks OK?

No amount of alcohol is safe to combine with Suboxone. Even a little bit may put you at risk for this dangerous interaction.

Because of this risk, it’s important to carefully read food and over-the-counter (OTC) medication labels, checking for alcohol. You should avoid foods, dental hygiene products, and medications that contain alcohol. Keep in mind that alcohol doesn’t “cook off” during the cooking process. And many dental care products, such as mouthwashes, contain alcohol.

Take extra care when selecting OTC cold and flu medications. Most “nighttime” cold medications include an antihistamine that causes drowsiness. What’s more, some contain alcohol as an inactive ingredient. For both of these reasons, nighttime cold medications can be dangerous to take with Suboxone.

EXPERT PICKS: WHAT TO READ NEXT

• Other interactions: Alcohol is just one of several things that interact with Suboxone (buprenorphine / naloxone).

• Medications to avoid with alcohol: Besides Suboxone, learn about what other medications are also risky when taken along with alcohol.

• Suboxone side effects: If you take Suboxone, it’s important to know the possible range of side effects so you can take your medication safely.

If you’re unsure if something is safe for you, ask a healthcare professional. They can help determine if these products are alcohol free. And tell your pharmacist that you need alcohol-free prescription medications.

Are there any serious side effects or risks to combining alcohol and Suboxone?

Yes. Combining alcohol with Suboxone can increase the risk of an overdose. If not treated quickly, it can be a deadly situation.

Symptoms of a Suboxone overdose include:

• Small (“pinpoint”) pupils

• Being unable to speak or respond to questions

• Trouble breathing

• Being unconscious

• Vomiting or gurgling sounds

• Limp body

• Blue skin and lips

• Slow or irregular heart rate

Get help immediately if you think someone is having an overdose. It’s sometimes impossible to know what someone has taken or why they are overdosing.

Regardless of what caused the overdose, these steps can help save a life:

1. Administer naloxone (Narcan) or nalmefene (Opvee) if you have it. These medications quickly reverse the effects of an opioid or a Suboxone overdose. And they’re not harmful if the person doesn’t have opioids in their system.

2. Call 911 immediately after administering naloxone or nalmefene. The effects of naloxone or nalmefene are temporary, and the person overdosing will still need emergency care.

3. Stay with the person, and give a second dose of naloxone or nalmefene if needed. For naloxone, you should repeat the dose in 2 to 3 minutes if the person isn’t responding. For nalmefene, you should give another dose if the person doesn’t respond in 2 to 5 minutes.

Are certain people more at risk when combining alcohol and Suboxone?

You’re at risk for a dangerous interaction anytime you combine Suboxone and alcohol. But some factors can increase your risk of serious problems even more.

The more alcohol you drink or the higher your Suboxone dosage, the higher your risk of overdose. Mixing Suboxone or alcohol with other sedatives also raises your chances of a deadly outcome. These include medications such as:

• Opioids and opiates, such as oxycodone

• Benzodiazepines, such as alprazolam (Xanax)

• Prescription sleep medications, such as zolpidem (Ambien)

• OTC sleeping medications, such as doxylamine (Unisom)

• Muscle relaxers, such as carisoprodol (Soma)

When can you start drinking after taking Suboxone?

It’s important to celebrate sobriety and treatment milestones. But check with your healthcare team before raising that glass. Even if you’ve stopped taking Suboxone, you might still need to avoid alcohol since it can interfere with ongoing opioid use disorder treatment.

If you’ve been given the OK to drink alcohol after stopping Suboxone, you’ll still need to be patient. It may take your body up to 9 days to fully clear Suboxone’s buprenorphine component. Alcohol can still interact with the medication during this time.

Does Suboxone treat alcohol use disorder?

No, Suboxone doesn’t treat alcohol use disorder.  It doesn’t block alcohol and doesn’t help with alcohol cravings or withdrawal. Suboxone treats opioid use disorder only.

A different opioid-blocking medication, naltrexone, can treat both alcohol use disorder and opioid use disorder. Naltrexone works differently than the naloxone in Suboxone. And it isn’t combined with an opioid or a partial opioid agonist, such as buprenorphine.

If you or someone you know is struggling to stop drinking, help is available. There are many free and confidential support resources available. Quitting alcohol is a healthy choice, but it’s not an easy one. It’s best to work with a healthcare professional to help you safely through your quitting journey and manage any alcohol withdrawal symptoms.

Why trust our experts?

Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Bailey E. Eason, PharmD, MS, BCPS

Bailey Eason has been licensed for 6 years and has held licenses in three states (North Carolina, Virginia, and Illinois). She has held positions as a health-system pharmacy administration resident, operating room pharmacy manager, pharmacy manager of clinical operations: surgery, neurology and controlled substances, and most recently as program director  of drug diversion for a large academic health system.

Our editorial standards

Meet our experts