Concurrent Suboxone and Alcohol and Abuse
About Alcohol and Suboxone
Alcohol is the most commonly abused substance by both teenagers and adults in the United States, according to the Centers for Disease Control (CDC). In fact, the CDC found that in any given month, 25% of high school students admit to at least one episode of binge drinking. Furthermore, these binge episodes constitute a dangerously high 90% of all underage drinking. In light of this and other evidence, alcohol abuse has become a priority issue for city, state, and federal governments. On its own, alcohol abuse has pervasive negative health effects, many which culminate in death. However, alcohol becomes even more deadly when taken with other medications.
Young alcohol abusers are significantly more likely to abuse other drugs, including prescription painkillers. The prevalence of prescription painkiller abuse has sharply risen in recent years, especially among teens and young adults (Dart et al., 2015). Treatment for opioid addiction often involves the use of medically assisted treatment (MAT), which has garnered support from the medical community for its ability to successfully treat opioid abuse. MAT involves the introduction of and eventual tapering off of certain opioid substances—used to gradually wean the patient off of opioids altogether, while minimizing withdrawal effects.
Suboxone is a a common medication used as part of MAT for opiate/opioid addiction and consists of:
- Buprenorphine – An opiate-derived substance that produces similar but weaker effects compared to prescription opioids and heroin. Lessens the effects of withdrawal and helps curb cravings.
- Naloxone – An opiate antagonist that counters the effects of opiate overdose. When misused, the naloxone in Suboxone initiates opiate withdrawal symptoms, discouraging abuse.
While effective at getting patients off heroin or prescription opioids, Suboxone can itself be abused. Some studies even show moderately high rates of opioid relapse following prescribed regimens of Suboxone-related medication (O’Brien, 2005). Some users will even use alcohol in an attempt to strengthen the weaker effects of Suboxone. This is a risky practice, as the combination of the two drugs can produce significant dangers.
Alcohol and Suboxone Abuse question 1
Signs and Symptoms of Alcohol with Suboxone
Signs of Alcohol Abuse
There are many indicators of potential alcohol abuse. Some of them are:
- Drinking at inappropriate times.
- Consistently drinking in excess.
- Overvaluation of drinking.
- Failed attempts at cutting back on drinking.
- Defensiveness when asked about drinking habits.
- Lack of interest in previously enjoyed activities.
Signs of Suboxone Abuse
Due to buprenorphine's ceiling effect – where higher doses do not bring on more intense highs – and naloxone’s withdrawal-inducing effects, it is more difficult to discern the signs and symptoms of Suboxone abuse. However, some signs may include:
- Changing moods or behavior.
- The arrival of random packages at home or work.
- Taking more than prescribed (requesting refills before their scheduled refill date).
- Use of other drugs, like alcohol, to enhance effects.
Suboxone and Alcohol: Combined Effects
Alcohol is a depressant which, when used with Suboxone (also a depressant), can have serious effects on the central nervous system. Potential combined effects include:
- Dangerously slowed breathing.
- Low blood pressure.
- Faint heartbeat.
- Decreased appetite.
- Extreme dizziness.
- Blacking out.
In extreme cases such as overdose, there is an increased risk of alcohol poisoning, coma and death (Dart et al., 2015). If an individual is suspected to have overdosed on Suboxone or are showing symptoms like those listed above, then it is imperative that they are transported to a hospital immediately. Untreated reactions between Suboxone and significant quantities of alcohol can be fatal.
Treatment for Co-Occurring Alcohol and Suboxone Addiction
There are several rehab programs and treatment options for patients suffering from concurrent addictions or poly-drug abuse of substances like alcohol and Suboxone. Depending on the severity of the addictions in question, and to address various other needs and preferences, patients will typically choose from either an inpatient/residential rehab center or a program of outpatient rehabilitation.
Hospital-based inpatient facilities keep patients overnight and provide 24-hour medical assistance while outpatient programs only require that patients check in for therapy a certain number of hours per week. In cases of particularly severe addiction where the individual has attempted to stop but eventually relapsed, inpatient treatment can provide a setting wherein those in recovery can find consistent support in an immersive therapeutic environment, free from the temptations and distractions that might occur at home.
Those who feel they cannot leave their personal obligations such as family or work may prefer an outpatient treatment program; however, it’s important to note that many employers will allow employees to take time off for rehab, so if you feel this option will provide the biggest chance of success, it’s important to investigate its viability.
Both programs offer the kind of support system and structure that many need to begin an extended period of recovery. Generally, there are several different local rehabilitation programs for patients to choose from. Make sure the one you choose is able to meet all of your specific needs.
Statistics for Alcohol and Suboxone
Alcohol and Suboxone abuse are major problems in the United States. Consider the following statistics:
- In 2013, 24.6% of people ages 18 or older reported that they engaged in binge drinking in the past month; 6.8% reported that they engaged in heavy drinking in the past month.
- Nearly 88,000 people die from alcohol-related causes annually, making it the third leading preventable cause of death in the United States.
- In 2006, problematic alcohol use cost the United States $223.5 billion.
- Emergency room visits that involved buprenorphine (the main drug in Suboxone) increased from just over 3,000 in 2005 to more than 30,000 in 2010.
- In 2010, 59% of ER visits involving buprenorphine also involved the use of other drugs like alcohol.
Resources, Articles and More Information
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- Center for Disease Control and Prevention. (2015, November 12). Alcohol and Public Health: Fact Sheets - Underage Drinking. Retrieved February 10, 2016, from http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm
- Ashton, E., & National Institute on Drug Abuse. (2008, March 1). Alcohol Abuse Makes Prescription Drug Abuse More Likely: Those Under Age 25 are Particularly Vulnerable to Dual Abuse. Retrieved February 11, 2016, from http://www.drugabuse.gov/news-events/nida-notes/2008/03/alcohol-abuse-makes-prescription-drug-abuse-more-likely
- Dart, R. C., Surratt, H. L., Cicero, T. J., Parrino, M. W., Severtson, S. G., Bucher-Bartelson, B., & Green, J. L. (2015). Trends in opioid analgesic abuse and mortality in the United States. New England Journal of Medicine, 372(3), 241-248.
- O'Brien, C. P. (2005). Anticraving medications for relapse prevention: a possible new class of psychoactive medications. American Journal of Psychiatry, 162(8), 1423-1431.
- National Institute on Alcohol Abuse and Alcoholism. (2015, March). Alcohol Fats and Statistics. Retrieved February 17, 2016, from http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics