Understanding Naltrexone and Suboxone: Why They Don't Mix

You've probably heard the phrase "the more the merrier," but when it comes to medications like naltrexone and Suboxone, that's not the case. These two drugs are often used to treat substance use disorders, but they're not the same and should never be taken together. Let's explore why.

What Is Naltrexone?

Naltrexone is an opioid antagonist, which means it blocks opioid receptors in the brain. Approved by the FDA for treating both alcohol use disorder (AUD) and opioid use disorder (OUD), it works by eliminating the pleasurable effects of alcohol and opioids. Think of it this way: if your favorite food suddenly lost its taste, you'd probably stop craving it. That's how naltrexone works—it removes the reward associated with substance use.

Naltrexone comes in two forms:

• A daily pill taken at home
• An extended-release injection (Vivitrol) administered by a healthcare provider

It's been a key part of recovery programs since the 1980s and is typically used as part of a comprehensive treatment plan.

What Is Suboxone?

Suboxone is a combination medication containing buprenorphine and naloxone. It's FDA-approved for treating OUD. Buprenorphine is a partial opioid agonist, meaning it produces mild opioid effects to reduce cravings and withdrawal symptoms. Naloxone is an opioid antagonist that blocks opioid receptors. Together, they help manage opioid dependence safely.

How Are Naltrexone and Suboxone Linked?

Although different, these medications are often discussed together for several reasons:

• Both are leading treatments for substance use disorders
• People with multiple dependencies might use one after the other during recovery
• Treatment plans may transition from one medication to the other under medical supervision

Key Differences Between Suboxone and Naltrexone

• Classification: Suboxone is a partial agonist and antagonist; naltrexone is purely an antagonist
• Mechanism: Naltrexone blocks opioids entirely; Suboxone both activates and blocks receptors
• Application: Naltrexone treats AUD and OUD; Suboxone is only for OUD

Can You Take Naltrexone With Suboxone?

No. Taking naltrexone and Suboxone together is dangerous and counterproductive. Naltrexone blocks opioid receptors, preventing Suboxone from working. This can lead to severe withdrawal symptoms and other harmful effects.

Risks of Combining Naltrexone and Suboxone

Mixing these medications can cause precipitated withdrawal—a sudden, intense onset of withdrawal symptoms. This may include:

• Depression or suicidal thoughts
• Rapid heart rate and high blood pressure
• Fever, sweating, and sleep problems

Additionally, you might experience compounded side effects like dizziness, fatigue, headaches, and muscle aches.

Navigating Recovery From Alcohol Use Disorder

Recovery is challenging, but these strategies can help:

• Practice self-care: Stay hydrated, eat well, and engage in enjoyable activities
• Exercise lightly: Physical activity boosts mood and energy
• Avoid triggers: Steer clear of situations that tempt you to drink
• Reset your nervous system: Try deep breathing, cold showers, or EFT tapping
• Seek support: Lean on professionals, loved ones, or tools like the Quitemate app

Moving Forward in Recovery

Life after dependence can be fulfilling. Focus on:

• Exploring new hobbies and interests
• Building sober social connections
• Managing stress through mindfulness, journaling, or yoga
• Prioritizing healthy habits and setting positive goals

Key Takeaway

Naltrexone and Suboxone are valuable medications, but they work in opposite ways. Combining them is unsafe and ineffective. Always follow medical advice and use these drugs as prescribed to support a healthy recovery journey.