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Can Suboxone and Xanax Work Together? Risk and Alternatives

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Suboxone and Xanax

Many patients have a vague belief that mixing medications can help their health issues effectively, and people dealing with anxiety are the best example of these kinds of patients. Sometimes doctors can allow when one is using normal drugs for any disorder. But in anxiety, most of the drugs are very powerful with high potential for abuse, and doctors believe one medication at a time is the safest option. Yet, some patients still think combined medications can give better results. Suboxone and Xanax are two drugs that anxiety patients believe can work, if mixed. Should both medications be taken together? Let us see.

Understanding Risks of Taking Suboxone And Xanax Together

What is Suboxone?

Suboxone is an opioid that deals with a condition called Opioid Use Disorder (OUD). It is made out of two ingredients: one is Buprenorphine, an opioid agonist that binds with opioid receptors, and the other is Naloxone, an opioid blocker that blocks the calming effects of opioids, reducing overdose. This dual mechanism helps not only opioid addiction but anxiety, too. Suboxone is a Schedule III drug that can be found in many forms, like tablets, sublingual films, and buccal films. Doctors might prescribe Suboxone for anxiety as its main component, Buprenorphine, can help with the anxiety caused out of withdrawal of opioids by its mechanism.

What is Xanax?

Xanax is a benzodiazepine used for treating Generalized Anxiety Disorder (GAD). It is a Schedule IV controlled substance, and it is highly addictive. Xanax works on GABA (gamma-aminobutyric acid) receptors by binding with them and releasing the neurotransmitters in the brain. This slows down our brain and makes us feel calm and relaxed. It is also known as Alprazolam, and can also have many unapproved off-label uses, like treating PTSD, OCD, and even irregular bowel movements. It can be found in many forms, like immediate-release (IR) or extended-release (XR) tablets, and oral solutions. Xanax can only be used as a prescription-only drug.

When To Combine Xanax and Suboxone?

In the rarest of cases, doctors might be reluctant but do combine Suboxone and Xanax. This mixed medication can only be taken under the strict supervision of healthcare professionals; only then are patients allowed to take both drugs together. This combined prescription will mostly occur when other medicines for anxiety have not been able to help the patient. Xanax could be added to the dose when one goes through extreme panic attacks. Here, providing the weakest dosage of both medications is preferred over trying to give patients the most effective ones. Doctors must be convinced that, in some particular cases, the handful of benefits that the combination of Suboxone and Xanax provides outweigh the demerits of mixing the drugs.

Can You Take Suboxone and Xanax together?

It cannot be advised to take Suboxone and Xanax together. Patients who think mixing both drugs can help their anxiety better are completely wrong. Xanax and Buprenorphine in Suboxone are CNS depressants, and if they combine, one can face serious respiratory problems, slowed or shallowed breathing, and even coma. Not only that, but patients can also have a lot of sedation, improper mobility, memory loss, and so many other issues. Doctors would never recommend this harmful combination, but some patients can take up medications like this because either they do not know the consequences, or their addiction is at its peak.

Side Effects of Suboxone and Xanax

Suboxone and Xanax, being depressants, have almost identical side effects. Most of their side effects are related to the respiratory system, but there are other repercussions, too. Combined, the side effects can be extremely dangerous.

Suboxone Side Effects

Using Suboxone has its repercussions, and one has to use it carefully. Some of the common side effects that Suboxone has are feeling drowsy, having a headache, constipation, vomiting, mouth issues like having a dry mouth, burning sensation due to redness, and swelling in limbs. Some serious effects can have breathing problems, such as shallowed breathing, liver issues, like having dark urine, heart issues, and even serotonin syndrome.

Xanax Side Effects

Xanax is a stronger depressant and definitely has more consequences to look out for. Some side effects of it are neurological, like feeling dizzy and drowsy, having fatigue, bad speech, some might have issues concentrating, and have a bad memory. Nausea, vomiting, and loss of appetite also might show up while using Xanax. Overdosing on it will lead to severe conditions like slowed breathing, depression, seizures, and even allergic reactions like itching and swelling.

Severe Side Effects of Combined Dose

Mixing Suboxone will have serious effects on our bodies. As discussed earlier, one of the first things patients will be affected by is serious respiratory issues, both depressant can even stop one’s breathing. Extreme sleepiness is one of the side effects, and it can prove to be dangerous when one is driving a vehicle. Because it slows down one’s breathing, the person can go into a coma or eventually die due lack of oxygen.

Drug Interactions of Suboxone and Xanax

Both drugs have interactions with many others. We already know how dangerous a Suboxone and Xanax interaction can be. Some of these can also be equally detrimental.

Suboxone Interactions

Xanax Interactions

  • Benadryl
  • Norco
  • Ambien
  • Lexapro
  • Lyrica
  • Zyrtec
  • Seroquel

Alternatives for Xanax and Suboxone

Due to their high potency for abuse and extreme side effects, one should consider switching to the alternatives of Suboxone and Xanax. These alternatives are either prescription-only medications or non-controlled medicines.

Suboxone Alternatives

Prescription Alternatives

  • Methadone: Helps in reducing cravings for opioids.
  • Naltrexone: Blocks receptors to stop the euphoric effects.
  • Buprenorphine-only medications: Reduce the need for daily dosage.

Non-controlled Alternatives 

  • ReVive
  • Narcan

Xanax Alternatives

Prescription Alternatives

  • Klonopin: Effects last longer than Xanax.
  • Valium: Relaxes the muscles effectively.
  • Ativan: Rapid effects in smaller amounts.
  • SNRIs: Induce relaxing effects for a longer period of time. 

Non-controlled Alternatives:

  • Magnesium: Reduces anxiety symptoms and regulates the nervous system.
  • Valerian Root: Works just like Xanax, releasing GABA chemicals in the brain.
  • Kava: Produces a lot of calmness, but must be used carefully.
  • Ashwagandha: Stabilizes stress effectively in our brain.

Conclusion

Suboxone and Xanax are very good drugs on their own, but together they are a very dangerous combination. Patients should refrain from mixing drugs without a doctor’s consultation. Suboxone is a partial depressant, and Xanax is a full depressant of the nervous system; combining them can be fatal. Overdosing on them together can lead to coma or death, so please avoid their use together.

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