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Mixing Buprenorphine with Alcohol

ARTICLE OVERVIEW: Mixing buprenorphine with alcohol can cause respiratory depression that may result in death. Keep reading to learn more about the side effects of combining buprenorphine and alcohol.


Why Mix the Two?

Buprenorphine is an opioid drug used for two reasons:

  1. As a painkiller.
  2. To treat stronger drug addiction.

It is one of the main active ingredients in the brand name medications Subutex and Suboxone. So when you’ve been prescribed buprenorphine, is it OK to drink at the same time?

As with other opioids, mixing buprenorphine with alcohol provokes dangerous side effects.  In fact, buprenorphine stays in your system for at least a few days after ingestion. So, it’s important that you know how to use the medication correctly.

We discuss the effects of mixing alcohol and buprenorphine below. Then, if you have any questions about these two depressant drugs, please leave them in the comment section and we’ll try to respond to you promptly.

Effects on the Brain

Buprenorphine is a long-acting, partial mu agonist and full kappa antagonist. It binds with specific receptors in the central nervous system to manage withdrawal and cravings for stronger drugs like heroin. So, it is considered to be a safe medication.

But, is it safe to mix with alcohol?


Like other opioids, buprenorphine produces a sense of euphoria, slows down respiration, and sedates the user. These effects are consistent with other painkillers. However, recent recreational use of buprenorphine is on the rise. Alcohol can increase the euphoric feelings. But what happens when you mix buprenorphine and alcohol together?

When more than one central nervous system depressant is taken at one time, the effects of both are compounded. The effect is called “drug synergy”. Since both substances produce similar effects, combined together they create synergism. They actually build up their effects.

This is the case with combining alcohol with buprenorphine. Drinking while you are using this medication can have many negative side effects, including impaired cognition and slowed heart rate or breathing.


What do users report in terms of effects when combining these two substances? People who have combined buprenorphine and alcohol and lived to tell the tale have reported these feelings:

  • euphoria
  • relaxation
  • lightheaded
  • numbness

However, recreational use and purposeful drinking while on opioid medications is incredibly risky. Dangers include overdose, intoxication, and brain damage. The most dangerous reported effect is slowed breathing, which lowers levels of oxygen to the brain. This involuntary effect – triggered by the synergistic effects of depressants – may require immediate medical attention.

Call 911 anytime you notice decreased rates of breathing or heart rate. These can be signs of an overdose.

Side Effects

In general, taking buprenorphine with alcohol may cause serious damage to your health. Some of the most common side effects include:

  • blurred vision
  • decreased motor coordination
  • headache
  • heart palpitations
  • impaired thinking processes
  • increased sweating
  • nausea and vomiting

Because both substances cause similar effects, their combination can intensify each other effects. In other words, buprenorphine mixed with alcohol is a deadly cocktail.


Since both buprenorphine and alcohol depress the central nervous system, taking them simultaneously increases the depressive effects of both substances. Combining these two can lead to:

  • blood pressure problems
  • dizziness
  • drowsiness
  • severe respiratory depression (slowed and/or difficult breathing)
  • slowed heart rate

The approved FDA label for buprenorphine reads:

Buprenorphine in combination with benzodiazepines or other CNS depressants (including alcohol), has been associated with significant respiratory depression and death.

Moreover, the same label warns people that abuse of buprenorphine poses a risk of overdose and death, and the risk is higher if buprenorphine is abused with alcohol and other substances, especially benzodiazepines.

Mixing two depressants can cause respiratory depression.


Buprenorphine is currently classified in the United States as a Schedule III controlled substance by the DEA. Though it has the potential to be addictive, medical professionals can still prescribe it for specific uses. So, when does overdose occur?

Overdose typically occurs when people try to use buprenorphine to get high. Snorting or injecting buprenorphine increase the potential for overdose, for example. In fact, the 2013 DAWN Report shows that Emergency Department visits involving buprenorphine increased drastically from around 3,000 in 2005 to over 30,000 visits in 2010. Most of the visits were classified as nonmedical use of medication. Moreover, the same report states that a combination of buprenorphine and alcohol was responsible for at least 1500 emergency room visits in 2010.

But that’s not all.

Taking buprenorphine with alcohol can greatly increase the risk of buprenorphine poisoning. In a scientific study on people who have died of buprenorphine poisoning, most blood concentrations of the medication were in therapeutic range. In other words, mixing alcohol and buprenorphine can still lead to death even without exceeding medical dosage.


Death by painkiller drugs is a national issue. According to the Center for Disease Control statistics on drug overdose, almost 2 million Americans abused or were dependent on prescription opioids in 2014, while in 2016, more than 40 people died daily from overdoses involving Rx opioids.

One of the reasons a medical professional may prescribe buprenorphine is to treat opioid addiction. However, buprenorphine itself is an opioid and a narcotic. Some other narcotics cause greater respiratory depression than buprenorphine. However, combining this substance with other substances that depress the central nervous system, such as alcohol, can lead to death.

Safety Guidelines

Is is safe to drink when you’re taking buprenorphine?

No, it is not safe to drink while taking buprenorphine, or any other opioid for that matter. Drinking alcohol is not advised in either case: taking opioids for approved medical purposes or recreationally. The combination of these two depressant substances can lead to death.

If you have a prescription for buprenorphine, please use it as directed and consult your doctor if you have any questions about drug interactions. In order to protect yourself, SAMSHA shares some tips to avoid opoid misuse and overdose. These suggestions include:

  • Use the medicine only as prescribed by your doctor.
  • Do not take more medication than instructed.
  • Do not take it more often than instructed.
  • NEVER mix opioid medicines with alcohol, sleeping pills, or illicit substances.
  • Store medicine safely where children and/or pets can’t reach it.
  • Dispose of unused medication promptly.

Signs You Need Help

If you often drink and mix buprenorphine with alcohol, you may need help. First, get honest with yourself, and admit that a problem exists. Still not sure whether you have a problem, or not? Then, stop and answer these questions from the Drug Abuse Screening Test (DAST-10):

  • Have you used drugs other than prescribed?
  • Do you use more than one drug at a time?
  • Are you able to stop taking drugs when you want to?
  • Have you had blackouts as a result of your drug use?
  • Do you feel guilty about your drug use?
  • Do your loved ones complain about your drug use?
  • Have you neglect your loved ones because of your drug use?
  • Have you engaged in illegal activities to get your drug?
  • Have you experienced withdrawal when you stopped using your drug?
  • Have you had a medical problems as a drug use result?

If you answer ‘YES’ to one or more of these questions, you may need to seek professional help. Addiction specialists such as medical doctors, psychotherapists, licensed clinical counselors, and rehab staff can help assess you. Or you can always consult with your physician.

NOTE HERE: Substance use problems are treated medically. You are not alone. You can live a normal, drug-free life.

Still Got Questions?

Wondering about concurrent drug use and drinking?

If you would like to ask any questions about mixing any drug and alcohol, we invite you to post a comment in the section below. In fact, we love to hear from our readers! We respond to all legitimate queries personally and promptly. So, let us know more about your concern. We’ll try to help.

Reference Sources: DEA: Buprenorphine
NIAAA: Harmful Interactions: Mixing Alcohol with Medicines
PubMed: Alcohol and opioids: possible interactions of clinical importance.
PubMed: Benzodiazepines and alcohol are associated with cases of fatal buprenorphine poisoning.

Leave a Reply

40 Responses to “Mixing Buprenorphine with Alcohol
6:38 pm January 29th, 2015

My husband has been on treatment so long. 2 years I feel the Drs should make sure there pts get emotional treatment as well. Alot money in this business n some Drs are jaded. He only started testing for urine analysis because it mandatory. Glad for that. Many pts mix till they get on the proper help. Drs are still giving anti depressants with suboxen really why.

11:21 pm December 21st, 2015

Please can you tell me how likely it is to die by mixing buprenorphine and alcohol regularly. Thank you

8:35 pm January 2nd, 2016

I have been mixing high doses of Buprenorohine and alcohol for about 9 months and, although I have been told it is dangerous I think it very much depends on the persons tolerance to both. I have taken the Buprenorphine sublinually, snorted it and injected it and have so far come to no harm. I do have a very high tolerance to both Opiates and alcohol. I wish that I could OD with this mixture. I’ve even tried mixing it with lots of other drugs too but I’m still here. If you have a tolerance to most drugs (like me a hide like a rhino) it takes a lot to be fatal. I have taken so called ‘overdoses’ on several occasions, have lay down and gone to sleep thinking that was it, only to wake uo 10 hours later still alive. I think for people who have high tolerances to alcohol and opiates the mix is not as dangerous as the doctors make out. Having said that I am not encouraging anyone to test out this. I might have survived but everyone is different

3:40 pm January 4th, 2016

Hello, I wrote a year ago I had forgotten until I got update. I would like to update you all VERY SAD my husband is dead. We found him on the floor nine months ago. He was mixing drugs stops your respiratory. You can’t redo life n undo death. Work as hard as you can to free yourself. All of our family is suffering beyond words. I never thought this could I was naive!!! Heartbreak I tried it all to help but his choices as they are yours. He told me he was fine and I was paranoid two day’s before his death. Best of hope to everyone Believe in yourself

Lydia @ Addiction Blog
12:04 pm January 5th, 2016

Hi, Amber. I’m really sorry for your loss. Thank you for sharing your story, hope others will get the message.

4:21 pm September 10th, 2016

I don’t think so i am taking addnok-n and drink once in a week. It is all about tolerance

4:22 pm September 16th, 2016

Thank you amber. That gave me the willies. I am all for getting help/treatment and honesty. The truth for my body is I take roughly 3mg subs per day (down from 24mg) and for over a year drank heavily, half to a whole bottle. It’s been over a year since those days. Although I feel so unhealthy, I am not dead. I wish there were literature on what it does to your kidneys and liver rather than just talk about dying. I’m very sorry for your loss amber… no disrespect intended in my post.

4:27 am December 16th, 2016

If bupinorphen is taken the afternoon after drinking maybe 5′-6 shots, is this akin to mixing them?

2:26 am February 17th, 2017

Damage to kidneys and liver while taking Buprenorphine vs taking mor opine 3/5mg per day and 4/10-325 percoset a day. Haven’t been titrated as to #per day. Again, I’m 75 normal (not thin , weigh 195. 5’4″. I AM IN PAIN , THIS IS FOR PAIN ONLY.

3:03 pm February 28th, 2017

my friend is on buprenorphine daily and is on a detox programme from codein. she told me that she is still allowed to drink and has been doing so for the last 2 mnths … 2 small bottles of wine a day – but it is creeping up. Is she telling me the truth when she says the people on the programme allow her to drink ? concerned friend

Lydia @ Addiction Blog
6:13 pm March 8th, 2017

Hi Linda. Detox programs don’t allow drinking alcohol especially mixing two substance. Please consider that your friend puts herself at risk by mixing codeine with alcohol.

4:16 pm March 22nd, 2017

tks Lydia -Everything I read about it says the same thing – However, my friend says I am over-reacting – she is still on 8mg daily, still drinking ….. sometimes creeping up to a bottle of wine daily. she apparently also has been given tablets to reduce the craving for alcohol and is taking those as well as a vitimin !!. She is a part of Project Answer and insists they are allowing this ….. ?? even more concerned now.

Lydia @ Addiction Blog
5:40 pm March 30th, 2017

Hi again Linda. I haven’t heard anything for that type of program. Maybe your friend is lying…

1:58 am April 25th, 2017

I do not agree with the acute overdose you have presented with taking buprenex & alcohol. I say this as a intractable pain patient that has been taking buprenx (0.6mg IM) 5-6 times per day. My need for the buprenex was to change from 240mg MS Contin.

My question is can a person overdose via a pure opiate such as MS Contin while they are on Buprenex IM. I assume the Buprenex will prevent the MS Contin from binding with the Mu receptor which the Buprenex doesn’t allow the pure opiate from binding to.

Thank you for your reply and expertise. Regards.

Lydia @ Addiction Blog
12:11 pm May 9th, 2017

Hi Daniel. Since MS Conin is an opioid itself, it may be less effective if you’re also using buprenorphine. However, I suggest that you consult with your doctor about the interaction between these two medications before using them.

11:02 pm May 1st, 2017

I need to know how mixing buprenorphine with alcohol affects your behavior.

Lydia @ Addiction Blog
4:57 pm May 9th, 2017

Hi Rhonda. It depends on the person itself. Everyone has different tolerance to drugs and alcohol. However, please use your medications only as prescribed by a doctor because you put yourself at risk.

6:07 am June 29th, 2017

My husband drank a beer and 4 shots of vodka then snorted 1/4 of a subutext and is severely sick. Please help as he won’t go to the er

Lydia @ Addiction Blog
12:45 pm June 29th, 2017

Hi Christy. Call 911 or call the Poison Control Center at 1-800-222-1222 for an assessment of overdose risk.

1:05 am July 1st, 2017

Can mixing them compound the effects of liver damage like some NSAIDS?

11:43 am July 14th, 2017

I’m very concerned for a friend of mine. She’s recently been upped her dose of /buprenorphine to 15 mcg to help control her pain and continues to drink alcohol (wine & hard liquor) daily. I’m not sure what to do or say to her.

Lydia @ Addiction Blog
5:06 pm July 20th, 2017

Hi Julie. If you are concerned about your friend, maybe you should talk to her.

1:09 pm July 24th, 2017

I did…she got extremely angry with me. We’re no longer speaking. She said her doctors know about her alcohol consumption. I don’t know if I believe her.

12:45 am August 2nd, 2017

My son passed away 7/2/17 of a toxic dose of suboxum. I did not know that was possible.He also drank most nights when he came home from work.Please help me understand how that is possible.

Lydia @ Addiction Blog
5:25 pm August 11th, 2017

Hi Sheila. I’m really sorry for your loss… You may want to speak with a toxicologist or a coroner about your concerns.

8:12 pm September 14th, 2017

I’ve taken suboxone in the past and drank heavy while on it and no bad side effects occurred except a hang over the next day and at the time I didn’t know mixing alcohol and suboxone was harmful untill I got prescribed suboxone a couple months ago, so since nothing bad happened in the past when u took suboxone and drank then is it safe for me to take suboxone and have some drinks while on vacation?

12:08 am September 30th, 2017

I would like to get all the information I can about this matter Thank You.


3:49 pm October 17th, 2017

I have been on bupenorphine for some time now. I take 6mg every day. I usually have one to two shots of tequila on Thursday nights when I perform…(I am a singer). I just saw a piece on the news that freaked me out. My question is, could this combination although not excessive be lethal at any given time?
Thank you!

Lydia @ Addiction Blog
1:45 pm October 20th, 2017

Hi Meredith. Mixing buprenorphine with alcohol may be lethal. So, please be careful and use your medications only as prescribed by a doctor.

9:25 am November 4th, 2017

Yes iam 30 yrs old i have been on subutex 8mg tablets for almost 4 yrs i take one tablet 3 times daily. After about the 2nd year on my meds i started drinking rum with soda daily alot… Now when i get up in the morning i feep dizzy my arms feel weird like numb an weak/ heavy.. I went to the er today an told them everything what meds iam on an how much i drink. They told me is alcohol detox. I dont get it so they gave me ativan 2mg tabs it made me feel a lil better. Also took my blood an said everything looks ok but my blood pressure was way up an heart beat was a lil fast. Iam scared baby on the way ppl need me around a while how do i stop drinking without the detox its so bad way worse then any opoid detox… Plz email me

9:20 am December 9th, 2017

I take about 1 milligram a day snorted and drink alot. I’ve been doing this for about a year with nothing bad happening. I just found out that this is dangerous. Is it really? How scared should I be? Am I playing with my life? Please get back to me with an honest answer.

Lydia @ Addiction Blog
5:04 pm December 13th, 2017

Hi Jay. Please use your medications only as prescribed by a doctor. Don’t put yourself at risk.

4:21 am January 20th, 2018

I took half of a half of subutex at 5 am it’s 9:20 pm can I drink a beer or two?

Lydia @ Addiction Blog
3:29 pm January 22nd, 2018

Hi Suzanne. Please use Subotex only as prescribed by a doctor. Mixing this medication with alcohol may lead to serious damage to your health.

8:44 pm June 12th, 2018

Hi. I’ve taken a buprenorphine tablet 26 hours ago. is it safe to drink now?

Constant Pain
12:53 am August 30th, 2018

I take Belbuca as prescribed for chronic pain. Is it possible to skip a dose if on the rare occasion I want to have a glass of champagne at a wedding or other event?

Lydia @ Addiction Blog
1:02 pm August 30th, 2018

Hi Constant Pain. Use your medications only as prescribed by a doctor.

2:07 pm October 9th, 2018

I’ve switched to Suboxone,what if I waz to not have my dose for a day or two,is it possible to drink a bit of alcohol then?

4:48 pm October 9th, 2018

Hi Joe. Please use the medication as prescribed by your doctor. Don’t put your health at risk.

9:26 pm November 10th, 2018

Ok so here’s the deal. I don’t consider myself an addict. I used to take pain pills legally from my doctor. He had me on 40 of the 80mg oxys and 120 of the 10 mg Norco a month. This went on for about 2 years u til the dea raided his office and I was sol so I checked around and found a Dr to start me on suboxone. He started me on 8mg daily of the strips. This was 7 years ago. I’ve moved since then and my Dr now still gives me 8 mg a day. I break them in 4 and take 2mg 4 times a day. He says it’s a pretty low dose right before micro grams which I guess they use to treat pain since it’s more effective that way lower dose. Anyway I don’t drink hard alcohol ever or even beer but I do enjoy wine once in a while well did enjoy it. I haven’t had a glass since I’ve been on the medicine. I mean would 1 glass or even a half a glass of wine really kill a person mixed with 8mg bup? Obviously drinking any alcohol is discouraged just given that bup is to treat opiate dependence but is it really that bad for a person that knows moderation and has a glass of wine once or twice a week with dinner? I see alot of comments of people saying they drink heavely and take their medication trying to kill themselves but that’s not me. I’m not stupid and don’t want to die just enjoy a glass of wine once in a while. Thanks. Oh not sure if it matters but I don’t take the one with naloxone anymore. It’s just the buprenorphine.

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