Suboxone for Alcohol Withdrawal Symptoms: Does It Work?
Alcohol abuse is a problem affecting millions of Americans. Many people suffer from alcohol use disorder, which can wreak havoc on their health, finances, and relationships. The U.S. Centers for Disease Control and Prevention (CDC) reports an estimated 140,000 Americans die each year from excessive use of alcohol. The agency also reports that among those who died, alcohol abuse shortened the average lifespan by 26 years. The 2022 National Survey on Drug Use and Health (NSDUH), which was conducted by the National Institute on Alcohol Abuse and Alcoholism, found that an estimated 29.5 million Americans suffered from Alcohol Use Disorder (AUD) in 2022. This was an increase of almost 1 million over the 28.6 million who reported suffering from AUD in 2021.
The pervasiveness of alcohol abuse in the U.S. is a well-documented problem, underscoring the critical need for effective treatments. An important part of treatment occurs in the beginning when people stop ingesting alcohol. Alcohol withdrawal symptoms can be severe and potentially dangerous, making it important to identify effective treatments to ease symptoms while people start their journeys to recovery.
Addiction scientists and professionals have been investigating the effectiveness of suboxone in alleviating alcohol withdrawal symptoms and potentially helping with alcohol abuse. This medication is approved by the FDA to treat people suffering from opioid dependence. However, it has not been approved to treat symptoms of alcohol withdrawal or AUD. Here is some information about suboxone and research into its potential use for treating alcohol withdrawal symptoms and AUD.
Understanding Alcohol Use Disorder
Alcohol addiction is a particularly insidious problem for several reasons. Alcohol is legal, and its use is not socially stigmatized. People see commercials tying alcohol use to having fun, enjoying social activities and events, and being successful. While alcohol use in moderation is fine, it can become a real problem for both the people who become addicted to it and their families.
People who suffer from AUD continue to drink alcohol and are unable to control or stop their use even when they suffer negative health, career, or social consequences. AUD is a recognized medical disorder that results from the interaction of alcohol with the reward center of the brain. When people ingest alcohol, their brains release dopamine. This substance is a neurotransmitter that causes people to feel pleasure. The feeling of pleasure that people experience when their brains are flooded with dopamine acts as a reinforcer and leads some people to repeatedly use alcohol in an attempt to recreate the feeling. The brain eventually becomes accustomed to the continued presence of alcohol, leading to tolerance and the need for the individual to drink increasing amounts of alcohol to achieve similar results. People can then suffer symptoms of withdrawal when they stop ingesting alcohol and may experience physical and emotional consequences.
Alcohol addiction is a chronic condition. People who suffer from AUD might relapse, which can make recovery from AUD more challenging. AUD can affect every aspect of a person’s life and cause significant, negative impacts.
Common Symptoms of Alcohol Addiction
The following signs indicate an individual has developed an alcohol addiction:
- Experiencing cravings for alcohol
- Drinking more alcohol than intended
- Drinking for more hours than intended
- Unsuccessful attempts to control or cut down alcohol use
- Failure to meet obligations at home, school, or work because of ongoing alcohol use
- Avoiding recreational, social, or work activities because of alcohol use
- Continued use despite recurring interpersonal and social problems caused by alcohol use
- Using alcohol when doing so is physically dangerous
What Is Alcohol Withdrawal Syndrome?
Alcohol withdrawal syndrome (AWS) refers to the constellation of symptoms that heavy drinkers can suffer when they significantly reduce how much they drink or suddenly cease alcohol use. The symptoms can begin within a few hours of the final drink and range from mild to severe. AWS symptoms can include physical and emotional symptoms ranging from mild anxiety and fatigue to serious physical consequences that could be life-threatening.
Common Symptoms of Alcohol Withdrawal Syndrome (AWS)
The following are common symptoms of AWS when people with an alcohol addiction suddenly stop drinking:
- Shaking/tremors
- Nausea/vomiting
- Anxiety
- Fatigue
- Rapid heart rate (tachycardia)
- Headache
- Excessive sweating
- Nightmares
- Insomnia
- Confusion
- Irritability
- High blood pressure
These symptoms can worsen over two to three days.
Symptoms of Acute Alcohol Withdrawal Syndrome
People who experience severe AWS might also experience the following symptoms:
- High fever
- Seizures
- Extreme agitation
- Extreme confusion
- Tactile, visual, and auditory hallucinations
- Rapid breathing
- Excessively high blood pressure
- Very rapid heartbeat
- Delirium tremens
- Death
Severe AWS symptoms can be life threatening and are a medical emergency. People who experience severe AWS require immediate medical attention and should seek emergency care.
Current Treatments of AWS
In the past, people suffering from the symptoms of alcohol withdrawal were told to tough it out with sometimes dire consequences. Today, recovery and medical professionals use evidence-based treatment interventions to alleviate some of the symptoms of AWS. When someone is suffering from severe AWS, doctors typically administer diazepam, lorazepam, or chlordiazepoxide. These drugs are considered safe and a good way to treat severe AWS because of the following reasons:
- Alleviate and reduce the severity of AWS symptoms, including seizures, agitation, and tremors
- Substitute the effects of alcohol on the brain to ease withdrawal symptoms
- Have a good safety profile when administered in a controlled setting
- Have sedative effects that help with anxiety and insomnia
- Prevent people from developing delirium tremens
These medications are administered in combination with addiction counseling. The combination can help people deal with the psychological aspects of AUD and provide emotional support while they are beginning and continuing the recovery process.
Beyond the initial detoxification phase, people might be prescribed medications designed to help them avoid drinking. These drugs are typically prescribed after individuals have completed detox and no longer have alcohol in their system. Doctors prescribe these medications to help reduce alcohol cravings and aid the brain as it adjusts to no longer having alcohol:
- Naltrexone, which blocks the effects of alcohol on the brain and reduces cravings
- Disulfiram, which makes individuals feel nauseous if they consume alcohol
- Acamprosate, which restores the brain’s natural biochemistry
What Is Suboxone?
Suboxone is the name brand of a drug comprised of a mixture of buprenorphine and naloxone. It is only available by prescription and is approved for use in treating people suffering from opioid addictions and opioid withdrawal symptoms. The combination of buprenorphine and naloxone helps to reduce cravings, the severity of withdrawal symptoms, and the client’s long-term opioid dependence.
While suboxone has been shown to be an effective treatment for people suffering from opioid use disorder (OUD), the Food and Drug Administration (FDA) has not approved it for treating AWS or AUD. Some research has been conducted on its potential use with AWS and AUD, but more needs to be completed before it can be definitively stated to be an effective treatment for AWS or AUD.
One potentially serious issue with using Suboxone to treat AUD is that the medication is an opioid and can have severe interactions with alcohol. People who are prescribed Suboxone are advised not to ingest any alcohol. If individuals prescribed Suboxone relapse and begin drinking alcohol, they could suffer serious consequences.
Effectiveness of Suboxone for Treating Alcohol Withdrawal Syndrome
Suboxone is not a recognized treatment for alcohol withdrawal symptoms, although it might be prescribed during the detox phase for a client with co-occurring opioid and alcohol use disorders. Severe AWS symptoms can be life threatening, but opioid withdrawal symptoms are rarely fatal.
The buprenorphine in Suboxone is an opioid agonist that mimics the effects of opioids in the brain and aids in the relief of cravings. One study found that low doses of buprenorphine actually increase the use of alcohol because of the stimulation of opioid receptors in the brain. In contrast, the researchers found that high doses of buprenorphine decrease alcohol use by stimulating nociceptin/orphanon (NOP) receptors, meaning that buprenorphine has a dualistic effect on the brain. A second study found that high-dose buprenorphine might be useful in treating treatment-resistant alcohol dependence.
As far as using Suboxone for alcohol withdrawal symptoms, doctors typically do not prescribe it for this use. Suboxone is used to treat opioid dependence and withdrawal symptoms, but there hasn’t been significant research indicating its usefulness in alleviating the symptoms of AWS. People who are withdrawing from both opioids and alcohol might obtain some relief from Suboxone since it will relieve the symptoms of opioid withdrawal. However, it is generally not helpful for alcohol withdrawal symptoms. Instead, doctors typically prescribe other medications, such as benzodiazepines, to help people manage the symptoms of AWS when they do not have a co-occurring OUD and AUD.
People should avoid trying to use Suboxone or any other drug to treat the symptoms of withdrawing from alcohol without seeing a medical professional. While researchers continue to examine whether buprenorphine might be used to treat AUD, more research is needed.
Suboxone’s Interaction With Alcohol
Taking Suboxone while continuing to drink alcohol can be dangerous. Buprenorphine is a depressant that slows down the activity of the brain. Alcohol is likewise a depressant, so when the two are taken together, they can significantly slow the person’s brain and body functions beyond what either substance would do alone.
Mixing alcohol with Suboxone can lead to an increased risk of suffering an overdose and respiratory failure. The two drugs can interact to cause extreme drowsiness and potential accidents. People who combine these substances can also experience compounding effects on coordination, increased confusion and dizziness, and a higher risk of addiction to both substances.
Seek Help From Recovery Professionals
While Suboxone is an effective medication for people suffering from OUD and opioid withdrawal symptoms, it is not a recognized treatment for AWS and AUD. If you combine Suboxone with alcohol, your condition could be greatly exacerbated. If you want to quit drinking and are struggling with withdrawal symptoms, it’s important to see a doctor and follow your prescribed plan.
When you are trying to quit drinking and suffer from AUD, your strongest allies are medical and recovery professionals in a supportive environment. Resources are available to help you through detoxification and on your path to recovery. Alcohol Awareness offers a free toll-free hotline for those seeking help for themselves or their loved ones. Call (855) 955-0771 anytime, 24/7 for immediate help with alcohol abuse.