Combination

Mixing Benzodiazepines (Xanax) and Buprenorphine (Suboxone)

Q: How dangerous is Benzodiazepines with Buprenorphine?

Unsafe: Risk of serious physical or psychological harm. Not recommended under any circumstances.

Q: Is it safe to mix Xanax and Suboxone?

MixSafe lists Xanax under Benzodiazepines and Suboxone under Buprenorphine. That combination is rated "Unsafe". The main cause of death in people taking buprenorphine. The ceiling does not extend to GABA-A depression. Prescribed benzodiazepines alongside buprenorphine treatment are not automatically dangerous and stopping either abruptly carries its own risk — the danger is recreational dosing on top, especially of short-acting benzodiazepines.

DepressantOpioid

Verdict

Unsafe

The main cause of death in people taking buprenorphine. Avoid recreational benzos on top, and do not stop a prescribed one abruptly.

The main cause of death in people taking buprenorphine. The ceiling does not extend to GABA-A depression. Prescribed benzodiazepines alongside buprenorphine treatment are not automatically dangerous and stopping either abruptly carries its own risk — the danger is recreational dosing on top, especially of short-acting benzodiazepines.

What “Unsafe” means

Risk / Physical

The risk here is to the body — breathing, heart, temperature or organs. Set limits before you start, because this kind of harm does not announce itself in time to react.

Headspace vs physical risk

In an emergency, call 911911 Never Use Alone Poison Control

What to do

Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.

Can you mix Benzodiazepines (Xanax) and Buprenorphine (Suboxone)?

MixSafe rates mixing Benzodiazepines and Buprenorphine as "Unsafe" — risk of serious physical or psychological harm. Not recommended under any circumstances. Source: MixSafe research. Educational information, not medical advice.

Buprenorphine: Partial agonist — displaces other opioids off the receptor

Benzodiazepines also called: benzodiazepine, benzos, benzo, xanax, alprazolam, valium
Buprenorphine also called: subutex, suboxone, bupe, bup, buprenorphine/naloxone, zubsolv

Source

Buprenorphine precipitated opioid withdrawal: Prevention and management in the ED setting. https://www.sciencedirect.com/science/article/abs/pii/S0735675722003126
Buprenorphine-Precipitated Withdrawal Among Hospitalized Patients Using Fentanyl. https://pmc.ncbi.nlm.nih.gov/articles/PMC11437388/
Practice-Based Guidelines: Buprenorphine in the Age of Fentanyl. SAEM. https://www.saem.org/education/substance-use/practice-based-guidelines-buprenorphine-in-the-age-of-fentanyl

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Checking more than two?

Combinations of three or more carry risks that no pair-by-pair chart can show. The checker rates every pair at once and flags the whole-mix ones on top.

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Related combinations

Benzodiazepines withWhat not to mix with Benzodiazepines →

Buprenorphine withWhat not to mix with Buprenorphine →

All combinations →

Rated unsafe. Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety.