Suboxone and alcohol do not mix safely. Both can slow your breathing, and taking them together raises the risk of an overdose, even at doses that would be safe on their own. If you are drinking alcohol, the safest step is to tell your prescriber so you can plan for it together.
At Raise the Bottom, we prescribe Suboxone with counseling and medical care at our clinics in Boise, Nampa, and Pocatello. This chapter explains why mixing Suboxone and alcohol is risky and which signs to watch for. It also covers how to talk about alcohol with your care team.
Why Mixing Suboxone and Alcohol Raises Overdose Risk
Suboxone contains buprenorphine, a partial opioid agonist used to treat opioid use disorder. It eases opioid withdrawal symptoms and cravings. Like other opioids, it can slow the part of the brain that controls breathing. Alcohol is a central nervous system (CNS) depressant, which means it slows the brain and body down too.
When the two are taken together, their effects add up. The FDA label warns that alcohol and other CNS depressants raise the risk of respiratory depression when used with buprenorphine [1]. That means breathing becomes too slow or too shallow. It can lead to coma or death.
SAMHSA notes that fatal buprenorphine overdoses often involve misuse by injection or other CNS depressants, including alcohol [2]. This makes it important to tell your prescriber about everything you take. For a closer look at the medicine’s effects, see our post on how does Suboxone work.
What Drinking Alcohol on Suboxone Can Do to Your Body
People react differently, and the effects of mixing Suboxone and alcohol depend on how much you drink and your dose. NIAAA, the federal agency that studies alcohol, lists the harms of mixing alcohol with opioid pain medicines [3]. Buprenorphine is also an opioid, so many of the same risks apply. The table below compares how each one can affect your body.
| Effect | Suboxone Alone | Alcohol Alone | Suboxone and Alcohol Together |
|---|---|---|---|
| Drowsiness | Possible, often in the first days | Common | Stronger and harder to predict |
| Breathing | Can slow breathing, sometimes seriously | Can slow at high amounts | Higher risk of dangerously slow breathing |
| Coordination | May impair coordination, especially early on | Clumsy and slow | Greater risk of falls and crashes |
| Memory and judgment | May affect alertness and thinking | Can be impaired | Greater impairment; alcohol may cause blackouts |
Even a few drinks can feel stronger than you expect while taking Suboxone. That is one reason the label also advises care with driving until you know how the medicine affects you [1]. Adding alcohol makes driving even less safe. Our guide to Suboxone induction and treatment covers other safety steps for each phase of care.
Warning Signs of an Overdose From Mixing Suboxone and Alcohol
An overdose from mixing Suboxone and alcohol can happen slowly, often while a person seems to be sleeping. Doctors call this kind of dangerous slowing CNS depression. Family and friends should know what to look for. Watch for these signs:
- Very slow, shallow, or stopped breathing
- Snoring or gurgling sounds while asleep
- Blue or gray lips and fingertips
- Being very hard to wake up, or not waking at all
- Small, pinpoint pupils
- Limp body or cold, clammy skin
If you see these signs, call 911 and give naloxone if available. Repeat it as directed on the product, and follow the dispatcher’s instructions for rescue breathing or CPR. Buprenorphine overdoses may need repeated naloxone doses. Naloxone does not reverse alcohol, so stay until emergency help arrives.
Suboxone, Alcohol, and Your Liver
Alcohol and buprenorphine are both processed by the liver. Heavy drinking, including binge drinking, can lead to liver disease over time. That can change how your body handles medicine. The FDA label advises checking liver tests before starting buprenorphine and monitoring them during treatment [1].
The label also says Suboxone is not recommended for people with severe liver problems. If you drink alcohol often, your prescriber may want to check your liver more closely. Our post on possible side effects of Suboxone lists other things to watch for while you take it.
The CDC estimated about 178,000 U.S. deaths per year from excessive alcohol use during 2020 and 2021 [4]. Reducing drinking lowers health risks. If you drink heavily or have had alcohol withdrawal, seek medical advice before stopping because withdrawal can be dangerous.
How Alcohol Consumption Can Affect Your Recovery
Alcohol can lower your guard and make opioid cravings harder to resist. Some people find that a few drinks lead to using opioids again, which raises overdose risk. Others notice that drinking makes it harder to keep up with visits, counseling, and daily doses.
If you want to cut back, your care team can help you make a plan. Counseling can help you find other ways to handle stress, sleep, and social events where people drink. This is an important part of relapse prevention, and we talk about it openly and adjust your plan as needed.
Alcohol use should prompt a safety review and added support rather than automatic withdrawal of opioid treatment. Tell your prescriber so the care plan can be adjusted. Our post on is Suboxone addictive explains why taking medication as prescribed differs from addiction.
What to Tell Your Prescriber
Your prescriber can only keep you safe if they know what you take, including alcohol consumption. Clinics may also check for alcohol at visits, and SAMHSA notes that some use a breathalyzer before a first dose [2]. It helps to share these details:
- How often you drink and how much, even if it seems small.
- Whether you have ever had a blackout or trouble stopping.
- Any sleep aids, anxiety medicines, or benzodiazepines you take.
- Any history of liver problems or hepatitis.
- Whether you want help cutting back or stopping, including care for alcohol use disorder.
If you are worried about a clinic test, our chapter on whether Suboxone shows up on a drug test explains what these tests look for. Honest answers lead to a safer plan, not a punishment.
Suboxone and Alcohol Frequently Asked Questions
Can I Have One Drink on Suboxone?
No amount of alcohol is known to be fully safe with Suboxone. Risk depends on how much you drink, other medicines, and your health. Avoid alcohol, and tell your prescriber if you drink. Do not skip or stop Suboxone to make room for drinking; ask for a plan that supports both safety and recovery.
How Long After Taking Suboxone Can I Drink?
There is no safe waiting period. Buprenorphine stays in the body a long time, with an average half-life of 24 to 42 hours. If you take it daily, it is in your system all the time. That means alcohol can interact with it no matter what time of day you drink.
Can Suboxone and Alcohol Kill You?
Yes, they can. Combining Suboxone and alcohol slows breathing and raises the risk of a fatal overdose. Many deaths involving buprenorphine also involve alcohol or other depressants. If someone on Suboxone has been drinking and is hard to wake or breathing slowly, call 911 and give naloxone if you have it.
Getting Support at Our Idaho Clinics
You do not have to manage alcohol and Suboxone on your own while you treat opioid use disorder. If you are just starting out, our chapter on how long to wait to take Suboxone after fentanyl covers the first dose. Our team talks openly about drinking and helps you build a plan that keeps you safe. Hearing the truth from you helps us more than any test result.
Our staff can also help family members learn the signs of an overdose and where to keep naloxone. Small steps like these can make a real difference for the people you live with each day. Family members are often the first ones to notice when something is wrong. When you are ready, learn more about our Suboxone program in Idaho and how we can help.
If someone may be overdosing, call 911 right away. For a mental health crisis, call or text 988.
Sources
- U.S. Food and Drug Administration. SUBOXONE (buprenorphine and naloxone) sublingual film prescribing information. Revised May 2025. https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022410s056lbl.pdf
- Substance Abuse and Mental Health Services Administration. TIP 63: Medications for Opioid Use Disorder, Part 3D: Buprenorphine. Updated 2021. https://www.ncbi.nlm.nih.gov/books/NBK574909/
- National Institute on Alcohol Abuse and Alcoholism. Harmful Interactions: Mixing Alcohol With Medicines. Revised 2014. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines
- Centers for Disease Control and Prevention. Data on Excessive Alcohol Use. Reviewed August 6, 2024. https://www.cdc.gov/alcohol/excessive-drinking-data/index.html
