Suboxone and Alcohol Addiction: Can Suboxone Help Treat AUD?

Suboxone is best known as a treatment for opioid addiction. You may wonder if it can also help with alcohol use disorder.

Research shows mixed results, with some studies suggesting it may reduce cravings or ease withdrawal. Others find little benefit.

Suboxone is not FDA-approved for alcohol addiction, but it may play a role in some instances under medical supervision.

You face many challenges when dealing with alcohol dependence, especially if other conditions or substances are involved. While proven medications like naltrexone, acamprosate, and disulfiram remain the standard options, Suboxone is being studied as a possible alternative for people who struggle with both alcohol and opioid use or who have not responded to traditional treatments.

Key Takeaways

• Alcohol use disorder requires careful treatment beyond willpower alone
• Suboxone may provide benefits, but it is not an approved alcohol treatment
• Safe recovery depends on medical guidance and a personalized care plan

Understanding Alcohol Use Disorder

Alcohol use disorder (AUD) affects how you think, feel, and function in everyday life. It involves patterns of alcohol use that lead to health problems, social difficulties, and an inability to control drinking despite adverse outcomes.

Defining Alcohol Use Disorder

Alcohol use disorder is a medical condition defined by impaired control over drinking. You may find yourself drinking more than planned or struggling to cut back.

AUD is diagnosed based on specific criteria. These include cravings, tolerance, withdrawal symptoms, and continued use despite harm to your health, relationships, or responsibilities.

The severity is classified as mild, moderate, or severe depending on the number of symptoms you meet. Physical signs often include needing more alcohol to feel the same effect and experiencing withdrawal when you stop.

Psychological signs include strong urges to drink and difficulty focusing on anything else. Your diagnosis can change over time.

With treatment, symptoms may lessen. Without intervention, they can progress and worsen.

Alcohol Dependence and Abuse

Alcohol dependence and alcohol abuse were once considered separate diagnoses—dependence referred to physical reliance, while abuse described harmful patterns without clear physical dependence.

Today, both are grouped under AUD. Dependence means your body adapts to alcohol, leading to tolerance and withdrawal.

You may experience shaking, sweating, or anxiety when you try to stop drinking. Abuse focuses more on the social and behavioral effects, such as missing work, neglecting family, or engaging in risky activities while drinking.

Both dependence and abuse carry serious risks. Long-term use can damage your liver, heart, and brain.

It also increases the chance of accidents, injuries, and strained relationships. Recognizing these patterns early makes it easier to seek help.

Prevalence and Impact

Alcohol use disorder is common. Research shows that millions of adults in the United States meet criteria for AUD each year.

Rates are higher among men, but women are also at risk, especially as drinking patterns shift in younger generations. The impact extends beyond health.

Excessive drinking contributes to job loss, financial problems, and broken relationships. It also increases the risk of legal issues, such as DUI charges.

Health consequences are wide-ranging. Chronic alcohol use can cause liver disease, high blood pressure, heart problems, and neurological damage.

It also raises the risk of certain cancers. AUD often co-occurs with mental health conditions like depression, anxiety, or post-traumatic stress disorder.

When both conditions exist, treatment becomes more complex and requires an integrated approach. These challenges show why alcohol addiction is not only a personal struggle but also a public health issue.

Current Treatments for Alcohol Use Disorder

Treatment for alcohol use disorder often combines medication, therapy, and structured support. You may benefit from FDA-approved medications that reduce cravings or withdrawal symptoms.

Counseling and behavioral therapies help you change habits and develop more effective coping strategies. Many people need a comprehensive plan that addresses both medical and psychological needs.

FDA-Approved Medications for AUD

The FDA approves several medications to treat alcohol use disorder. These drugs work in different ways to reduce cravings, block alcohol’s rewarding effects, or discourage drinking.

Naltrexone blocks opioid receptors in the brain, reducing the sense of pleasure from alcohol. It can be taken daily as a pill or monthly as an injection.

Acamprosate helps restore chemical balance in the brain disrupted by long-term alcohol use. It is usually prescribed after you stop drinking and is taken three times a day.

Disulfiram works differently. It causes unpleasant reactions such as nausea, flushing, and rapid heartbeat if you drink alcohol.

This effect can act as a deterrent, but it requires strong commitment and supervision. These medications are not cures, but they can improve your chances of recovery when combined with therapy and support.

Behavioral Therapies and Counseling

Behavioral therapies help you understand the thoughts and behaviors that contribute to alcohol use. They give you tools to manage cravings, avoid relapse, and build healthier routines.

Cognitive-Behavioral Therapy (CBT) is one of the most common approaches. It teaches you to recognize triggers and replace destructive patterns with healthier responses.

Motivational Interviewing focuses on strengthening your personal motivation for change. This method helps you resolve ambivalence and set practical goals for recovery.

Counseling may be one-on-one, in group sessions, or with family members. Support groups like Alcoholics Anonymous can provide peer encouragement and accountability.

These therapies are often combined with medication-assisted treatment (MAT) for better outcomes.

Comprehensive Treatment Approaches

A comprehensive treatment plan usually includes both medical and behavioral care. This approach recognizes that alcohol use disorder affects your body, mind, and social life.

Medication-assisted treatment (MAT) combines FDA-approved medications with therapy and counseling. This integration addresses both the physical dependence and the psychological aspects of addiction.

You may also receive support services, including case management, relapse prevention planning, and family involvement. Some programs include housing or employment assistance to stabilize your environment.

By combining multiple strategies, comprehensive treatment increases your chances of long-term recovery. It also helps you manage co-occurring conditions like anxiety or depression.

What Is Suboxone and How Does It Work?

Suboxone is a prescription medication that combines two active drugs to help manage opioid dependence. It works by interacting with opioid receptors in your brain to reduce cravings, limit withdrawal symptoms, and lower the risk of misuse.

Components of Suboxone: Buprenorphine and Naloxone

Suboxone contains buprenorphine and naloxone, each serving a different purpose.

• Buprenorphine is a partial opioid agonist. This means it activates opioid receptors but only to a limited degree compared to full opioids like heroin or oxycodone.
• Naloxone is an opioid antagonist. It blocks opioid receptors and prevents misuse, especially if someone tries to inject Suboxone instead of taking it under the tongue.

Together, these two drugs strike a balance between effectiveness and safety. Buprenorphine provides relief from withdrawal, while naloxone discourages abuse by counteracting opioid effects when misused.

This combination makes Suboxone different from many other medications used in addiction treatment.

Mechanism of Action: Opioid Receptors

Your brain contains opioid receptors that regulate pain, reward, and mood. When you use opioids, these receptors are fully activated, causing euphoria but also dependence.

Buprenorphine binds strongly to these receptors but stimulates them only partially. This partial agonist action reduces cravings and withdrawal symptoms while lowering the risk of overdose compared to full opioid agonists.

Naloxone works differently. As an antagonist, it blocks opioid receptors without activating them.

If Suboxone is taken as directed, naloxone has little effect. But if misused through injection, naloxone quickly blocks the receptors and can trigger withdrawal.

This dual mechanism allows Suboxone to control symptoms of opioid withdrawal while also reducing the likelihood of misuse.

Approved Uses and Off-Label Applications

The FDA approved Suboxone for treating opioid use disorder (OUD). It is not approved for treating alcohol use disorder (AUD) or alcohol withdrawal.

Doctors sometimes consider off-label use, which means prescribing a drug for a condition outside its official approval. Some research has looked at buprenorphine’s effect on alcohol cravings, but findings are mixed and not strong enough for FDA approval.

If you have both opioid and alcohol dependence, Suboxone may help with opioid withdrawal but not alcohol withdrawal. For alcohol-related symptoms, doctors usually prescribe medications like benzodiazepines, naltrexone, or acamprosate instead.

Because Suboxone is an opioid-based medication, mixing it with alcohol can be dangerous. Both substances depress the central nervous system, increasing the risk of overdose, slowed breathing, and impaired coordination.

Suboxone’s Potential Role in Treating Alcohol Addiction

Suboxone is best known for treating opioid dependence, but some studies suggest it may also have benefits for alcohol use disorder. Research points to possible effects on alcohol cravings and withdrawal, though its role differs from medications already approved for alcohol treatment.

Research on Suboxone for AUD

Suboxone contains buprenorphine and naloxone, and while it is FDA-approved for opioid use disorder, it is not approved for alcohol use disorder (AUD). Researchers have explored whether buprenorphine’s action on the brain’s opioid receptors could reduce alcohol-related symptoms.

Several small clinical trials have tested Suboxone for AUD. Results are mixed.

Some participants reported fewer cravings and lower alcohol intake, while others showed no significant changes compared to placebo. The evidence remains limited.

Most studies involve small sample sizes, short durations, or patients with both opioid and alcohol problems. Because of this, Suboxone is usually considered only when traditional AUD medications are not effective or when opioid use disorder is also present.

Effects on Alcohol Cravings and Withdrawal

Alcohol and opioids affect overlapping brain pathways, particularly those linked to reward and reinforcement. Buprenorphine, the main ingredient in Suboxone, partially activates opioid receptors, which may help reduce alcohol cravings in some people.

Some studies suggest Suboxone may ease alcohol withdrawal symptoms, such as anxiety, restlessness, or insomnia. However, the effects are not consistent across all patients.

Unlike benzodiazepines, which are often used for acute withdrawal, Suboxone is not a standard treatment for detox. A primary concern is safety.

Mixing Suboxone with alcohol can be dangerous since both depress the central nervous system. This combination increases the risk of slowed breathing, sedation, and overdose.

Because of this, Suboxone should only be considered under strict medical supervision if you have alcohol use disorder.

Comparison with Traditional AUD Medications

Three medications are FDA-approved for alcohol use disorder: naltrexone, acamprosate, and disulfiram. Each works differently:

Suboxone differs because it was designed for opioid treatment. While it may reduce cravings for some people, it lacks the extensive research and approval that these medications have.

If you have both opioid and alcohol dependence, your provider may consider Suboxone as part of a relapse prevention strategy. For alcohol-only cases, naltrexone, acamprosate, or disulfiram remain the first-line choices.

Safety Considerations and Risks of Suboxone Use

Suboxone can be an effective tool for treating opioid dependence, but it also carries significant safety concerns. The risks are highest when it is combined with alcohol, used without medical guidance, or taken without proper monitoring of your health and progress.

Mixing Suboxone and Alcohol

Combining Suboxone with alcohol is unsafe and can be life-threatening. Both substances slow down the central nervous system, which controls your breathing and heart rate.

When taken together, they increase the risk of respiratory depression, coma, or death. Even small amounts of alcohol can intensify sedation and impair judgment.

This includes not only alcoholic beverages but also medications, cough syrups, and foods that contain alcohol. If you are taking Suboxone for opioid use disorder and also struggle with alcohol addiction, you must avoid alcohol altogether.

Using both together can undo treatment progress and put you at serious medical risk.

Potential Side Effects and Risks

Like all medications, Suboxone can cause side effects. Common ones include:

• Headache
• Nausea or constipation
• Insomnia
• Sweating
• Mouth irritation from the film or tablet

More serious risks can occur with long-term use. These include liver function changes, tooth decay, and physical dependence that requires careful tapering during detoxification.

Suboxone misuse, such as injecting it, can trigger withdrawal symptoms because of the naloxone component. If you stop taking it suddenly, you may also experience withdrawal symptoms similar to opioids, such as muscle aches, anxiety, or irritability.

Medical Supervision and Monitoring

You should only take Suboxone under medical supervision. A provider will assess your complete health history, including alcohol use, mental health conditions, and other medications.

This helps reduce the chance of dangerous interactions. During treatment, your provider may order liver function tests, review any withdrawal symptoms, and adjust your dose as needed.

Regular check-ins also help track your progress and reduce the risk of relapse. If you are going through medical detox, close monitoring ensures that both opioid and alcohol withdrawal symptoms are managed safely.

Supervision also helps you stay accountable and reduces the risk of misuse or overdose.

Personalized Treatment and Co-Occurring Conditions

Effective care for alcohol use disorder often requires more than one type of support. You may need a treatment plan that considers your substance use history, co-occurring mental health conditions, and how different therapies can work together for long-term stability.

Comprehensive Substance Use Assessment

A thorough substance use assessment is the first step toward personalized treatment. This process helps addiction specialists understand your alcohol use patterns, past treatment attempts, and any history of opioid dependence or other substance use.

You may undergo a detailed review that includes:

• Medical history and physical exam
• Substance use timeline (alcohol, opioids, or other drugs)
• Mental health screening for conditions like anxiety or depression
• Social and family background

By identifying these factors, your care team can recommend the most appropriate medications, such as FDA-approved options for alcohol use disorder or, in some cases, off-label use of Suboxone. The American Society of Addiction Medicine emphasizes that individualized assessment is vital for safe and effective treatment.

This evaluation also helps determine whether outpatient care, inpatient treatment, or a combination of both will best support your recovery.

Addressing Mental Health in AUD Recovery

Many people with alcohol use disorder also experience co-occurring mental health conditions. Common examples include anxiety, depression, and post-traumatic stress disorder.

If left untreated, these conditions can increase relapse risk and make recovery more difficult. Your treatment plan should include mental health services alongside addiction care.

This may involve therapy sessions with a licensed counselor, psychiatric evaluation, or medication management for mood or anxiety disorders. Approaches such as cognitive-behavioral therapy (CBT) can help you recognize negative thought patterns that fuel both alcohol use and mental health struggles.

Peer support groups also offer a safe space for individuals to share their experiences and reduce feelings of isolation. When your mental health is addressed directly, you are more likely to maintain progress in alcohol recovery and avoid falling back into harmful patterns.

Integrated Care for Dual Diagnosis

If you live with both alcohol use disorder and another condition, such as opioid use disorder, you may need integrated care that treats both at the same time. This is often referred to as dual diagnosis treatment.

An integrated plan might combine:

• Medication-assisted treatment (naltrexone, acamprosate, or Suboxone when appropriate)
• Therapy for co-occurring mental health conditions
• Regular monitoring by addiction specialists
• Support groups focused on dual recovery

This approach reduces the risk of treating one condition while leaving the other unmanaged. For example, if opioid dependence is not addressed, alcohol treatment alone may not succeed.

Integrated treatment acknowledges that substance use and mental health challenges often overlap. Both require equal attention.

Conclusion: Suboxone’s Limited Role in Alcohol Use Disorder Treatment

Suboxone is a powerful, FDA-approved medication for opioid addiction, but its role in treating alcohol use disorder remains unproven. While some research suggests it may ease cravings or withdrawal symptoms, the evidence is mixed, and safer, approved medications like naltrexone, acamprosate, and disulfiram remain the first-line choices for alcohol recovery. The risks of mixing Suboxone with alcohol are significant and highlight the importance of professional guidance before considering any off-label use. Ultimately, effective alcohol treatment requires a comprehensive plan that integrates proven medications, counseling, and holistic support tailored to the individual’s needs. Suboxone may have a place in dual-diagnosis cases involving both alcohol and opioid dependence, but it should only be used under strict medical supervision.

If you or a loved one is struggling with alcohol or opioid addiction, Fusion Recovery provides compassionate, evidence-based care to guide you safely toward healing. Book an appointment today and take the first step toward lasting recovery.