Is It Dangerous to Mix Suboxone and Methadone?

I am a MMT patient, but in my case I also have a chronic pain problem. The fellow who answered that using Suboxone will precipitate severe withdrawal is correct; but he neglected to mention that it is NOT Buprenorphine that would cause the withdrawal, but rather the presence of a second chemical in Suboxone, called Naloxone. It may be familiar to you under the title “Narcan”. Used alone, it bonds to the Opioid receptors in your brain competitively with any opiate or opioid you take into your body, and flushes the drug away from those receptors. This means that if you were to take the Suboxone, that Naloxone component would COMPLETELY, and within moments, make you more dopesick all at once than you’ve ever been. Naloxone (Narcan) is used to resuscitate people who have overdosed on drugs in the Opioid/Opiate class.

For Suboxone to work, ironically, a person must first BE in withdrawal; once that state occurs (through stopping the Methadone or opiate/opioid naturally) your Shrink or MMT clinic doc can put you on Suboxone as the final “step-down” drug to completely being clean. The Buprenorphine component is a drug that actually is one of the few that Naloxone (Narcan) cannot actually reverse completely (or prevent the Buprenorphine from bonding to the sites in your brain your drug of choice used to and what caused the high, pain relief, and other effects (slowing the gut, depressing your respiratory drive somewhat, etc.). So, the Naloxone is in Suboxone because it’s designed to prevent you from being high if you use any other drug but Buprenorphine. The “bad news”, depending on your perspective, is that Buprenorphine only partially bonds to the receptors in your brain (called a partial agonist) and thus it’s impossible to get high from Suboxone anyway.

That said, I don’t know why a person would want to use Suboxone with Methadone anyway; in most places, Suboxone is only given to people who have successfully got their addiction under control with Methadone first, and want the Suboxone to soften the step down off of Methadone to nothing. Methadone is notoriously hard to kick because the withdrawal, though mild, can last up six weeks and even beyond. They created Suboxone to allow people to much much more easily stop Methadone, or else it sometimes is used as the initial drug rather than Methadone for Opioid/Opiate dependence/addiction, but in any case you must be in a state of withdrawal before Suboxone is of much value to start.

My advice to you, is unless you have some Masochistic desire to cause yourself pain and sickness, don’t even think about using Suboxone if you’re on Methadone until you’ve been off the ‘done long enough to be a bit dopesick. In that case it’ll allow you to coast through detoxing off of Methadone much easier. I wish you well, because I assume your ultimate goal is to get clean.