What Happens If You Take Naltrexone and Suboxone Together? Discover the Surprising Interactions.11 min read

If you’re considering using Naltrexone and Suboxone together for opioid addiction treatment, it’s essential to understand the potential interactions and effects. Combining these medications may lead to unexpected outcomes, and it’s crucial to be well-informed before making any decisions. In this article, we’ll explore the key points you need to know about taking Naltrexone and Suboxone together to help you make an informed choice.

  • Understanding Naltrexone: Learn about the mechanism of action and how it affects the body’s opioid receptors.
  • Insight into Suboxone: Discover the composition of Suboxone and its role in managing opioid dependency.
  • Interaction between Naltrexone and Suboxone: Explore the potential synergistic or conflicting effects when these medications are combined.
  • Potential Risks and Side Effects: Be aware of the possible adverse reactions that may arise from taking Naltrexone and Suboxone together.
  • Medical Professional Guidance: Understand the importance of seeking expert advice and personalized treatment plans.
  • Case Studies and Research Findings: Examine real-life examples and scientific evidence regarding the effectiveness of the combination therapy.

The Mechanism of Naltrexone

Naltrexone is an opioid receptor antagonist that blocks the effects of opioids in the brain. By doing so, it helps reduce cravings and the desire to use opioids, making it useful in the treatment of opioid use disorder. Naltrexone works by binding to the opioid receptors, preventing other opioids from attaching and activating them. This action can help individuals avoid the euphoric effects of opioids and break the cycle of addiction.

Suboxone for Opioid Dependence

Suboxone, on the other hand, is a combination medication containing buprenorphine and naloxone. Buprenorphine is a partial opioid agonist that activates the opioid receptors, but to a lesser extent than full opioids. This results in reduced withdrawal symptoms and cravings, making it an effective medication for opioid dependence. Naloxone, present in Suboxone, acts as an opioid antagonist and helps prevent misuse by discouraging intravenous use.

Risks of Combining Naltrexone and Suboxone

  • Precipitated Withdrawal: If Naltrexone is administered too soon after using opioids or Suboxone, it can trigger sudden and severe withdrawal symptoms.
  • Diminished Effectiveness: Some studies suggest that taking Naltrexone and Suboxone together may reduce the efficacy of both medications.
  • Increased Side Effects: Combining these medications can lead to a higher risk of experiencing adverse reactions such as nausea, dizziness, or headache.
  • Individual Variability: The impact of combining Naltrexone and Suboxone can vary from person to person, making it unpredictable in certain cases.

Combination Therapy Considerations

Sequential vs. Simultaneous Treatment

Combining Naltrexone and Suboxone can be approached sequentially, where one medication is used after the other, or simultaneously, where both medications are used concurrently. Sequential treatment may be preferred for certain individuals to avoid precipitated withdrawal, while simultaneous treatment may provide immediate relief from cravings and withdrawal symptoms.

Supervised vs. Unsupervised Administration

Medical professionals may administer Naltrexone and Suboxone in supervised settings, such as clinics or treatment centers, to closely monitor patients’ progress and reactions. In contrast, unsupervised administration allows individuals to take their medications at home, which can enhance convenience and privacy but requires strict adherence to the prescribed regimen.

Long-Term Maintenance Approach

For some individuals, combining Naltrexone and Suboxone may serve as a long-term maintenance approach to manage opioid use disorder. The decision to continue this combination therapy over an extended period should be based on individual needs, treatment goals, and medical guidance.

Key Points:

  • Individualized Approach: The choice between sequential or simultaneous treatment should be based on the patient’s medical history and opioid use patterns.
  • Monitoring Compliance: In unsupervised administration, healthcare providers must regularly assess medication adherence and address any challenges that may arise.
  • Periodic Evaluation: Long-term maintenance with combined therapy requires periodic evaluation of its effectiveness and appropriateness for the individual’s ongoing recovery journey.

Patient Education and Informed Consent

Thoroughly Explaining Risks and Benefits

Before initiating combined therapy, healthcare providers must educate patients about the potential risks and benefits of taking Naltrexone and Suboxone together. This includes discussing possible side effects, drug interactions, and individualized treatment goals.

Ensuring Informed Consent

Patients should provide informed consent after fully understanding the implications of the combined therapy. Informed consent involves the patient’s acknowledgement of the potential risks and their agreement to proceed with the treatment plan.

Addressing Patient Concerns

Healthcare providers must be prepared to address any concerns or questions raised by patients regarding the combination therapy. Open communication and transparency play a crucial role in patient satisfaction and compliance.

Key Points:

  • Shared Decision-Making: Patient education and informed consent foster a collaborative approach between the healthcare provider and the patient.
  • Empowering Patients: Informed consent empowers patients to actively participate in their treatment journey and take ownership of their recovery.
  • Building Trust: Addressing patient concerns and providing comprehensive information helps build trust in the treatment process.

Consulting a Healthcare Provider

The Role of Medical Professionals

Seeking guidance from a healthcare provider is essential before considering combined therapy with Naltrexone and Suboxone. Medical professionals can conduct a thorough assessment of the patient’s medical history, substance use patterns, and overall health to determine the suitability of the treatment.

Comprehensive Medical Evaluation

Healthcare providers may conduct physical examinations and laboratory tests to ensure there are no contraindications for the combination therapy. Understanding the patient’s overall health is crucial in devising a safe and effective treatment plan.

Shared Decision-Making

The consultation process involves collaborative decision-making between the patient and the healthcare provider. Patients can openly discuss their treatment preferences and concerns, while medical professionals provide expert advice based on individual needs.

Key Points:

  • Expert Guidance: Consulting a healthcare provider with experience in addiction medicine is essential for appropriate treatment planning.
  • Identifying Risk Factors: A comprehensive evaluation helps identify any risk factors or underlying medical conditions that may influence treatment decisions.
  • Personalized Treatment: Shared decision-making allows for personalized treatment plans tailored to each patient’s unique circumstances and goals.

Tailoring Medication Dosages

Start Low, Go Slow Approach

When initiating combined therapy, healthcare providers may adopt a “start low, go slow” approach. This involves beginning with lower medication dosages and gradually increasing them as tolerated.

Minimizing Adverse Reactions

By closely monitoring patients and adjusting dosages as needed, healthcare providers can minimize the risk of adverse reactions to the combination therapy. This approach aims to strike a balance between therapeutic benefits and tolerability.

Individual Response Variability

It’s important to recognize that individuals may respond differently to medication dosages. Some patients may require higher doses, while others may achieve optimal results with lower amounts.

Key Points:

  • Safe Titration: The “start low, go slow” approach minimizes the risk of adverse effects during the initial stages of treatment.
  • Customized Treatment: Tailoring dosages to individual needs ensures that patients receive the most effective and well-tolerated treatment.
  • Monitoring Progress: Regular follow-up appointments enable healthcare providers to assess treatment efficacy and make necessary adjustments.

Managing Cravings and Withdrawal Symptoms

Addressing Opioid Cravings

Both Naltrexone and Suboxone play a role in managing opioid cravings, albeit through different mechanisms. Naltrexone blocks the opioid receptors, reducing the desire for opioids, while Suboxone’s partial agonist activity helps satisfy cravings without inducing the intense euphoria associated with full opioids.

Minimizing Withdrawal Discomfort

Naltrexone and Suboxone can help alleviate withdrawal symptoms during the recovery process. Suboxone’s partial agonist action aids in reducing the severity of withdrawal discomfort, while Naltrexone may come into play after the detoxification phase to prevent relapse.

Comprehensive Craving Management

Combining Naltrexone and Suboxone provides comprehensive craving management, targeting different aspects of opioid addiction. This approach can enhance treatment outcomes and support long-term recovery.

Key Points:

  • Dual Craving Control: The combination therapy addresses cravings from multiple angles, making it a potentially effective option for individuals struggling with intense cravings.
  • Supporting Withdrawal Phase: Suboxone’s partial agonist activity can ease the discomfort associated with opioid withdrawal, making it easier for individuals to stay committed to the recovery process.
  • Enhancing Treatment Success: Comprehensive craving management contributes to a more holistic approach to treating opioid use disorder.

Adherence to Medication Schedule

Importance of Medication Adherence

Adhering to the prescribed medication schedule is crucial for the success of combined therapy. Consistent and timely intake of Naltrexone and Suboxone ensures a steady level of these medications in the body, optimizing their effects.

Barriers to Adherence

Patients may encounter various barriers that affect their ability to adhere to the medication schedule. These barriers could include forgetfulness, transportation challenges, or fear of side effects.

Supporting Adherence

Healthcare providers can play a significant role in supporting patients’ medication adherence. They may provide reminders, offer counseling, or explore alternative solutions to overcome adherence obstacles.

Key Points:

  • Medication Consistency: Adherence to the prescribed schedule helps maintain therapeutic drug levels and increases the likelihood of successful treatment.
  • Identifying Challenges: Understanding potential adherence barriers allows healthcare providers to tailor interventions and support for each patient’s needs.
  • Collaborative Efforts: Patient-physician collaboration fosters accountability and encourages patients to take an active role in their treatment journey.

Lifestyle Modifications for Supportive Treatment

Emphasizing Healthy Habits

In addition to medication-based therapy, lifestyle modifications can significantly contribute to the success of combined Naltrexone and Suboxone treatment. Encouraging patients to adopt healthier habits, such as regular exercise, balanced nutrition, and adequate sleep, can promote overall well-being and aid in recovery.

Building a Supportive Environment

Creating a supportive and drug-free environment is crucial for individuals in recovery. Patients may benefit from connecting with support groups, engaging in positive social activities, and avoiding triggers that may lead to relapse.

Key Points:

  • Whole-Person Approach: Incorporating lifestyle modifications complements medication-based treatment by addressing the patient’s physical, emotional, and social needs.
  • Empowering Patients: Encouraging individuals to take charge of their lifestyle choices empowers them to lead healthier and more fulfilling lives.
  • Preventing Relapse: A supportive environment can significantly reduce the risk of relapse and support long-term recovery.

Considering Psychosocial Therapies

Benefits of Counseling

Psychosocial therapies, such as cognitive-behavioral therapy (CBT) and contingency management, can be valuable additions to medication-based treatment. These therapies help individuals develop coping strategies, identify triggers, and learn skills to manage stress and cravings.

Addressing Co-occurring Disorders

Many individuals with opioid use disorder may also struggle with co-occurring mental health issues. Integrating psychosocial therapies can help address these underlying conditions and improve overall treatment outcomes.

Key Points:

  • Comprehensive Treatment Approach: Psychosocial therapies complement the pharmacological aspects of treatment, addressing psychological and behavioral factors contributing to addiction.
  • Individualized Therapy: Tailoring counseling approaches to each patient’s unique needs enhances treatment efficacy.
  • Improving Coping Skills: Psychosocial therapies equip patients with valuable tools to manage cravings, stress, and emotional challenges.


Combining Naltrexone and Suboxone can be a complex but potentially effective approach to managing opioid use disorder. Understanding the interactions, risks, and benefits is essential for making informed decisions. Consulting a healthcare provider, adhering to medication schedules, and incorporating supportive therapies and lifestyle changes can contribute to successful treatment outcomes. While combined therapy offers promise, individual responses may vary, necessitating personalized treatment plans. In the journey towards recovery, comprehensive care, and ongoing support are vital for long-term success.

Frequently Asked Questions (FAQs)

1. Can I Take Naltrexone and Suboxone Together at the Same Time?

Answer: Combining Naltrexone and Suboxone simultaneously is generally not recommended due to the risk of precipitated withdrawal. It is essential to follow a specific treatment plan under the guidance of a healthcare professional to ensure safe and effective treatment.

2. What Are the Potential Side Effects of Taking Naltrexone and Suboxone Together?

Answer: The combination of Naltrexone and Suboxone may lead to an increased risk of side effects, such as nausea, dizziness, headache, or gastrointestinal discomfort. It is crucial to monitor for any adverse reactions and promptly inform your healthcare provider.

3. Can I Stop Taking Naltrexone and Suboxone Abruptly?

Answer: Abruptly discontinuing Naltrexone and Suboxone can lead to withdrawal symptoms and a potential increase in cravings. It is essential to follow your prescribed treatment plan and consult your healthcare provider before making any changes.

4. How Long Does It Take for Naltrexone and Suboxone to Start Working?

Answer: The onset of action for Naltrexone and Suboxone may vary among individuals. Suboxone’s effects typically start within a few hours, while Naltrexone may take a few days to exert its full effects. It is essential to be patient and follow the treatment plan consistently.

5. Can I Drink Alcohol While on Naltrexone and Suboxone Combination Therapy?

Answer: It is generally advisable to avoid alcohol while taking Naltrexone, as it may diminish the medication’s effectiveness. Additionally, alcohol use can be dangerous when combined with Suboxone, as it may lead to respiratory depression and other adverse effects.

6. Is Naltrexone and Suboxone Combination Therapy Suitable for Everyone with Opioid Use Disorder?

Answer: Naltrexone and Suboxone combination therapy may not be suitable for everyone. Certain medical conditions, drug interactions, or individual factors may impact the treatment’s safety and efficacy. It is essential to consult a healthcare provider for personalized treatment recommendations.

7. Can Naltrexone and Suboxone Help with Opioid Withdrawal Symptoms?

Answer: Yes, both Naltrexone and Suboxone can help alleviate opioid withdrawal symptoms. Suboxone’s partial agonist action can ease withdrawal discomfort, while Naltrexone can be beneficial after the detoxification phase to prevent relapse.

8. Will I Still Experience Cravings While on Naltrexone and Suboxone Combination Therapy?

Answer: While Naltrexone and Suboxone can help reduce cravings, some individuals may still experience occasional cravings. Comprehensive treatment that includes counseling and lifestyle modifications can further aid in managing cravings effectively.

9. Can I Drive or Operate Machinery While Taking Naltrexone and Suboxone Together?

Answer: Both Naltrexone and Suboxone may cause drowsiness and impair cognitive function in some individuals. It is crucial to assess how these medications affect you personally before engaging in activities that require alertness.

10. What Should I Do If I Miss a Dose of Naltrexone or Suboxone?

Answer: If you miss a dose, take it as soon as you remember, unless it is close to the time of your next scheduled dose. In such cases, skip the missed dose and continue with your regular dosing schedule. Avoid taking double doses to make up for missed ones.