Naltrexone and Suboxone Combination: Understanding the Risks

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Addiction medications are an important part of treating addiction. They help people manage their dependencies and support their recovery. Two common medications used to treat addiction are naltrexone and Suboxone. Naltrexone is used for treating alcohol addiction, while Suboxone is used for treating opioid addiction. 

But what happens when someone has both alcohol and opioid addiction? Is it safe to take both medications together? This article will explore the benefits, risks, and implications of taking both medications at the same time.

Naltrexone vs Suboxone

Naltrexone is really good at helping people who are addicted to alcohol or opioids like painkillers and heroin. It works by making these substances less appealing, which helps people avoid going back to them. This is a big plus when someone is trying to stay away from alcohol or opioids after they’ve stopped using them.

Suboxone is a bit different. It has two parts: the first (buprenorphine) helps reduce the tough symptoms people get when they stop using opioids, like feeling really sick or having strong cravings. The second (naloxone) is there to make sure the medicine is used safely and correctly.

Reasons for Considering Both Medications

In some cases, individuals may consider using both naltrexone and Suboxone. This could stem from a desire to switch treatments, manage multiple dependencies, or other unique clinical scenarios. However, it’s imperative to understand that combining these medications should only be done under strict medical supervision due to potential risks.

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Potential Risks and Side Effects

Each medication, while beneficial, comes with its own set of side effects. Naltrexone may cause nausea, headache, dizziness, and fatigue, whereas Suboxone can cause constipation, headache, nausea, and respiratory issues. The combination of these drugs can exacerbate these effects and potentially lead to more severe complications.

What Happens if You Take Naltrexone and Suboxone Together

To understand how naltrexone and Suboxone might affect someone when taken together, let’s look at how each works in the body.

Think of naltrexone like a lock on a door. This lock stops opioids (like painkillers or heroin) and alcohol from having their usual effect on the brain. So, if someone tries to use opioids or drink alcohol while on naltrexone, they won’t feel the same pleasure or “high” they would normally expect.

Suboxone, on the other hand, is like giving a little bit of a key to that door. It gently activates the brain’s receptors, but not enough to give the full effect of opioids. This helps reduce cravings and withdrawal symptoms. The naloxone part of Suboxone acts as a safety measure —it shuts the door if someone tries to misuse opioids.

When you put the lock and the partial key together (naltrexone and Suboxone), it can get confusing for the body. Naltrexone is trying to keep the door locked, while Suboxone is trying to open it a bit. This mixed signal can lead to unexpected and possibly dangerous reactions, which is why it’s risky to take them at the same time.

Precipitated Withdrawal

The biggest worry here is called “precipitated withdrawal,” a sudden and intense onset of withdrawal symptoms. Normally, withdrawal happens gradually when someone stops using opioids, but if naltrexone and Suboxone are taken together, they can trigger these symptoms very quickly and severely. This can be both uncomfortable and potentially dangerous.

That’s why it’s really important not to mix these medications without talking to a doctor or a healthcare professional. They can guide you on the safest way to use these medications for addiction treatment.

Guidelines for Safe Use

The safest approach to using these medications is under the supervision of a healthcare professional. This includes adhering to prescribed doses, being open about all medications being taken, and regularly monitoring for side effects.

Treatment Options

If you or someone you know is struggling with addiction to alcohol or opioids, remember, you’re not alone. There are many paths to recovery, and finding the right one can make all the difference. At Ria Health, we understand the complexities of addiction and offer personalized treatment plans to suit individual needs.

We specialize in providing comprehensive care, which includes evaluating the best medication options like naltrexone and Suboxone, alongside other therapies. Our team of experts is dedicated to helping you find a safe and effective path to recovery.

Taking the first step might feel daunting, but we’re here to support you every step of the way. Contact us to discuss your situation, learn about our treatment programs, and discover how we can help you or your loved one on the recovery journey.

Don’t wait to seek help. Reach out to us today and let’s start this journey together. Your path to a healthier, alcohol-free life begins with a simple conversation.


Understanding the interaction between naltrexone and Suboxone is crucial for anyone considering their use in addiction treatment. While both have their places in therapy, their combination poses significant risks. It’s paramount that individuals seeking treatment consult healthcare professionals and rely on their guidance. Education and awareness are key in navigating the complexities of addiction treatment, and this journey should always be undertaken with professional support and care.


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Written By:
Ria Health Team
Ria Health’s editorial team is a group of experienced copywriters, researchers, and healthcare professionals dedicated to removing stigma and improving public knowledge around alcohol use disorder. Articles written by the “Ria Team” are collaborative works completed by several members of our writing team, fact-checked and edited to a high standard of empathy and accuracy.
Reviewed By:
Bruce Hodges
In a career that includes writing, editing, communication and fundraising consulting, Bruce Hodges has created and edited text for online and print publications, including proposals, press releases, and podium remarks. Among many other interests, he explores poetry and essays, and writes articles for The Strad magazine (London) and WRTI public radio (Philadelphia). “As a lifelong advocate for innovative causes, I think of friends no longer with us who struggled with alcohol. If they had access to the revolutionary science behind Ria Health, some of them might be alive today.”
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