Suboxone (buprenorphine/naloxone) May Not Be as Safe as Previously Thought
One way I get material for this blog, and something I hope to use more in the future, is to go through the Pubmed website and read studies. While looking through it today, I happened upon an interesting study dealing with buprenorphine/Suboxone.
Suboxone is often held out to be safer than methadone. Methadone is known to stop breathing when taken in high doses or when taken in moderate doses and mixed with benzodiazepines. Suboxone, due to its status as an opiate agonist/antagonist and its "ceiling effect", is presumed to be much less deadly than methadone. The conventional wisdom is that it is nearly impossible to overdose on Suboxone alone. This may very well be so. However, a new study I happened upon showed that, at least when mixed with benzos, Suboxone is not without risk.
This study examined autopsy results where buprenorphine was present in the blood of the deceased. The autopsies showed alprazolam (Xanax) present in a full 40% of the dead, and it found some other benzo or sedative in 75% of the cases. Perhaps even more surprising, buprenorphine was the only drug found in 10% of the cases.
We can conclude two things from this study: like methadone, mixing benzos with Suboxone can kill. Furthermore, the presence of buprenorphine alone in 10% of the samples shows that it might be easier to overdose on Suboxone than is commonly thought.
I encourage people on methadone to stay away from recreational use of benzos, especially if they're taken in high doses or mixed with alcohol. This study shows that the same advice may go for those on Suboxone.