Harmful Interactions National Institute on Alcohol Abuse and Alcoholism NIAAA

For more information about this drug combination, see the “Is buprenorphine used with naloxone? Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use buprenorphine only for the indication prescribed. Avoid drinking alcohol or taking illegal or recreational drugs while taking buprenorphine. Gudin, Jeffrey A; Mogali, Shanthi; Jones, Jermaine D; Comer, Sandra D. “Risks, management, and monitoring of combination opioid, benzodiazepines, and/or alcohol use.” Postgraduate Medicine, July 2014. Narcotic analgesic combinations contain a narcotic analgesic, such as hydrocodone or codeine, with one or more other analgesics, such as acetaminophen (Tylenol), aspirin, or ibuprofen (NSAIDs).

• If your doctor thinks you may have adrenal insufficiency, they’ll order blood tests to confirm the condition.
• Drinking alcohol while taking medicines can intensify these effects.
• Mixing drugs and alcohol is never a good idea because the combination can affect people in unexpected ways.
• Opioid painkillers, when mixed with alcohol can lead to life-threatening interactions, such as slowing or stopping breathing.
• Participants are reimbursed $60 for the baseline, $60 for the 30-day post-discharge assessment, and $20 for providing a urine sample at the 30-day post-discharge assessment (up to $140 total for research assessments).
• Patients are encouraged but not required to share a summary of their adherence with their buprenorphine prescriber.
• Talk with your doctor if low blood pressure is a concern for you.

Concurrent opioid and alcohol withdrawal management

Teach your family or household members about the signs of an opioid overdose and how to treat it. Do not use alcohol or medications that contain alcohol while you are receiving treatment with buprenorphine. This may increase nervous system side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur.

Treatment options

It’s used to manage cravings and withdrawal symptoms in people with opioid dependence who’ve stopped taking opioids. It’s given as part of a complete treatment program along with counseling and suggested lifestyle changes. Buprenorphine is a type of buprenorphine with alcohol opioid called a partial opioid agonist. For pain management, it works differently from full agonist opioids. (Examples of full agonist opioids include morphine and codeine.) This is because buprenorphine has a limit (ceiling) on its effects. Higher doses of this drug don’t provide greater pain relief.

Before taking this medicine

If you think you’re having a medical emergency due to low blood pressure, call 911 or your local emergency number. If you have certain lung conditions, such as COPD, buprenorphine may not be safe for you. Tell your doctor about all your health conditions before taking this drug. Serious side effects from buprenorphine can occur, but they aren’t common. If you have serious side effects from buprenorphine, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Treatment for Suboxone and Alcohol Addiction

This reimbursement for study participation is provided to both arms. Data extraction for secondary outcomes (described below) occurs up to 180 days after discharge. Mixing alcohol and medicines puts you at risk for dangerous reactions.

A study clinician/co-investigator reviews the first 10 videos with the Patient Navigator to ensure their competency in approving videos. To ensure intervention fidelity, checklists, logs, and video submissions are audited by research team members every 3 months. For this reason, FDA is recommending revisions to BTOD labeling to avoid misinterpretation of dosing information. Some medications—including many popular painkillers and cough, cold, and allergy remedies—contain more than one ingredient that can react with alcohol. Read the label on the medication bottle to find out exactly what ingredients a medicine contains. Ask your pharmacist if you have any questions about how alcohol might interact with a drug you are taking.

All videos uploaded by video DOT participants are encrypted and stored in separate site-specific HIPAA compliant web-based Scene Health entities. Only approved research staff members have access to their data. A Data and Safety Monitoring Board will review the safety of participants, collected adverse events and the validity and integrity of the data annually or after half the sample has been recruited (whichever occurs first). The study was approved by the University of Washington and the WA State IRB. Financial incentive payments are provided as cash through in-person interactions with the research staff who also function as Patient Navigator. Research staff strive to administer rewards as frequently as possible (e.g., weekly) to maximize reinforcement; however, the frequency of reward disbursement is flexible per patient preference and ability.

The sample size of 40 for the pilot randomized controlled trial was chosen as we projected we could enroll and complete the study procedures and analyses within the available funding period. Although the sample size was not selected for the purpose of providing a fully-powered study, with our sample size of 40 we are nonetheless powered at 80% to detect some effects if they are large in size. For binary outcomes, including the primary outcome measure, our pilot study will be powered to detect intervention effect sizes of RR ≥ 1.89, 2.05, 2.40, or 3.10, if linkage rates for treatment as usual are 50%, 40%, 30%, or 20%, respectively. For continuous outcomes (days of buprenorphine coverage, days of opioid or methamphetamine use), we will be powered to detect standardized effect sizes of Cohen’s d ≥ 0.91 with 40 participants. Interventions are needed to increase linkage and retention to outpatient buprenorphine among hospitalized patients with OUD, especially for people who co-use methamphetamine.

• To learn more about NOWS, see the “What should be considered before taking buprenorphine?
• MIAPP consists of a Patient Navigator with the mHealth adherence application facilitating telehealth visits, two-way chats, video-DOT, and tracking of financial incentives.
• Strategies to provide effective, simultaneous medication treatment of alcohol and opioid withdrawal while optimizing patient safety are demonstrated through 3 patient cases.
• Read the label on the medication bottle to find out exactly what ingredients a medicine contains.
• Generic drugs may have different fillers and inactive ingredients compared with their brand-name drugs.
• Contact The Recovery Village Ridgefield to speak with a representative about how professional addiction treatment can address suboxone and alcohol use or any other type of substance use disorder.

Buprenorphine belongs to a class of drugs called mixed opioid agonist-antagonists. It helps prevent withdrawal symptoms caused by stopping other opioids. It is used as part of a complete treatment program for opioid use disorder (such as compliance monitoring, counseling, behavioral contract, lifestyle changes).Ask your doctor or pharmacist if you should have naloxone available to treat opioid overdose.

A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush the unused medicine down the toilet.