Does Suboxone Help with Alcohol Withdrawal?

Reviewed by Josie Desmarais, PMHNP-BC · Board-Certified Psychiatric-Mental Health Nurse Practitioner · Last updated August 2026

No. Suboxone is not approved or effective for alcohol withdrawal, and using it as a substitute during alcohol detox is dangerous. Alcohol withdrawal is driven by the brain’s GABA system — not opioid receptors. Suboxone acts exclusively on opioid receptors and cannot prevent the serious, potentially fatal complications of alcohol withdrawal. If you or someone you know is stopping heavy alcohol use, do not attempt it without medical supervision.

The right treatment depends on the substance — our substance use disorder treatment team can guide you.

Why Suboxone Cannot Treat Alcohol Withdrawal

The mechanism explains everything.

Suboxone contains buprenorphine (a partial mu-opioid agonist) and naloxone (an opioid antagonist). Both compounds act at opioid receptor subtypes. Buprenorphine’s value in treating opioid use disorder (OUD) comes from its ability to partially substitute for opioids at those receptors — relieving withdrawal and suppressing cravings. For more on this, see our guide to whether Suboxone shows up on a drug test.

Alcohol works on a fundamentally different system. Chronic alcohol use causes the brain to downregulate GABA-A receptor sensitivity (GABA is the primary inhibitory neurotransmitter) and upregulate glutamate excitatory activity to compensate for alcohol’s constant sedating effect. When alcohol is removed abruptly, that compensatory excitatory state becomes unopposed. The result is CNS hyperexcitability: anxiety, tremors, hypertension, tachycardia — and in severe cases, seizures and delirium tremens (DTs).

Suboxone has no activity at GABA-A receptors. It cannot correct the neurological imbalance driving alcohol withdrawal. Using it during alcohol detox will not prevent seizures or DTs.

What IS Used to Treat Acute Alcohol Withdrawal

Medically supervised alcohol detoxification uses GABA-targeting medications:

Benzodiazepines (diazepam, chlordiazepoxide, lorazepam) are first-line treatment for acute alcohol withdrawal. They activate GABA-A receptors, directly counteracting the hyperexcitability that causes withdrawal seizures and DTs. The severity of alcohol withdrawal is assessed using the CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol), which guides symptom-triggered dosing — similar to how COWS guides opioid withdrawal management. We cover why Suboxone can make you tired in a separate article.

Phenobarbital is used in many clinical settings as an alternative or adjunct to benzodiazepines, particularly in patients with significant benzodiazepine tolerance or severe withdrawal requiring higher-level management.

Inpatient or medically supervised detox is appropriate for anyone with a history of withdrawal seizures, DTs, or severe alcohol dependence. Do not attempt to stop cold turkey without medical evaluation first. Alcohol withdrawal is one of the few withdrawal syndromes that can be directly fatal.

What IS Used for Long-Term Alcohol Use Disorder

After acute detoxification, FDA-approved medications for alcohol use disorder (AUD) are entirely different from Suboxone:

Naltrexone (oral or extended-release injectable Vivitrol) is the most widely used medication for AUD after detox. Naltrexone is an opioid receptor antagonist — the same drug class as the naloxone component in Suboxone, but a different molecule at a different dose. It reduces alcohol cravings and relapse rates by blocking the opioid-mediated reward signal that makes alcohol pleasurable. Monthly Vivitrol injections improve adherence. Important: naltrexone cannot be used in someone actively taking Suboxone — it will precipitate opioid withdrawal. Transition planning is required. If that applies to you, read more about how long Suboxone blocks opiates.

Acamprosate works on glutamate and GABA systems to reduce the anxiety and discomfort associated with extended alcohol abstinence. Most effective when initiated after the person has already stopped drinking.

Disulfiram (Antabuse) creates an aversive physiological reaction (flushing, nausea, palpitations, vomiting) when alcohol is consumed. It functions as a behavioral deterrent and requires strong patient motivation to be effective — it does not work if the person stops taking it. Our team also explains how to maximize Suboxone absorption in detail.

If You Have Both OUD and Alcohol Use Disorder

Co-occurring OUD and AUD is more common than most people realize. Approximately 20–40% of people with OUD have significant concurrent alcohol use.

The treatment complexity matters:

• Suboxone addresses the opioid component — it has no therapeutic effect on the alcohol component
• Alcohol use while on buprenorphine is not automatically contraindicated, but heavy alcohol use significantly amplifies CNS depression risk, which increases the danger of respiratory depression and overdose
• Naltrexone (Vivitrol) treats AUD but cannot be used while a person is actively on Suboxone without transition planning — both act on opioid receptors, and combining them as-is is incompatible
• People managing both substances need a provider capable of handling the full clinical picture, which often means sequential treatment planning or coordinated specialty care

At Trust Psychiatry & Wellness, we evaluate the full picture of substance use — not a single substance in isolation. A comprehensive psychiatric evaluation is the right starting point for anyone managing multiple substance use concerns.

This article is for educational purposes only. Suboxone (buprenorphine/naloxone) requires a prescription and ongoing medical supervision. Contact Trust Psychiatry & Wellness at (561) 849-4449 to discuss MAT treatment options.

Frequently Asked Questions

Is it dangerous to drink alcohol while on Suboxone?
Yes, potentially — especially in quantity. Both buprenorphine and alcohol are CNS depressants. Combined, they compound sedation and respiratory depression. This combination has been implicated in overdose deaths. Heavy, regular alcohol use while on Suboxone must be disclosed to your prescriber.

Can I use Suboxone to get through alcohol withdrawal on my own?
No. Suboxone will not prevent alcohol withdrawal seizures or delirium tremens. Attempting this is dangerous. Seek medical evaluation before stopping heavy, long-term alcohol use — inpatient or medical detox may be necessary depending on your history. Learn more about taking gabapentin with Suboxone here.

Is naltrexone (Vivitrol) the same as the naloxone in Suboxone?
They are related but different. Both are opioid antagonists, but naloxone (in Suboxone) is present primarily as an abuse deterrent with very poor sublingual bioavailability. Naltrexone (Vivitrol) is a standalone oral or injectable antagonist used specifically for AUD and OUD separately — at higher doses and different formulations. They are not interchangeable and should not be combined with buprenorphine without transition planning.

Can a MAT provider also treat alcohol use disorder?
Many can. A psychiatric nurse practitioner or physician with substance use disorder training often manages both OUD and AUD, either concurrently or sequentially depending on medication interactions and the patient’s clinical needs. Ask your provider directly whether they manage AUD alongside MAT.

What should I do if I’m struggling with both alcohol and opioids?
Contact a SUD specialist who can assess both conditions together. SAMHSA’s National Helpline (1-800-662-4357) is free, confidential, and available 24/7 — they can connect you with treatment programs in Florida. Trust Psychiatry offers evaluation and treatment planning for complex presentations. You may also want to understand who can prescribe Suboxone.

Dual Diagnosis SUD Care in Florida

Managing opioid use disorder and alcohol use disorder simultaneously requires a provider who understands both — and the medication interactions between them. At Trust Psychiatry & Wellness, Josie Desmarais, PMHNP-BC offers MAT for opioid use disorder and comprehensive substance use disorder treatment via telehealth across Florida, including West Palm Beach. If you’re managing more than one substance, that’s exactly who we’re here for. Call (561) 849-4449 or contact us.

Related articles: How Long Will Hydrocodone Stay in Your System? · How to Get Suboxone Same Day in 2026 · How Much Does Suboxone Cost Without Insurance in 2026?

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