Special FDA Warning about Suboxone and Methadone“…receiving MAT with benzodiazepines or other CNS depressants such as drugs to treat insomnia appears to increase the risk of death.”

~FDA Commissioner Scott Gottlieb

One of the most-effective ways to treat substance abuse disorders is with Medication-Assisted Treatment, or MAT.

Specifically in the case of an addiction to opioids such as prescription painkillers or heroin, the preferred medications are methadone and Suboxone.  These drugs are used in Opioid Replacement Therapy (ORT), and work by blocking the brain’s opioid receptors and easing both drug cravings and withdrawal symptoms.

Unfortunately, people in recovery from opioid addiction also often prescribed benzodiazepine tranquilizers for anxiety or sleeping pills for insomnia. Both conditions are among the most-frequent complaints from people who are newly-sober.

Muscle relaxants and antipsychotics are also included in the warning.

Magnifies the Effects of Respiratory Depression

In late-September 2017, the Food and Drug Administration issued a Drug Safety Communication, warning of the serious risks and possibility of death that can result from combining MAT drugs with anxiolytics or sleeping pills.

However, the FDA strongly cautioned against withholding MAT drugs from patients taking other depressants. In the midst of the ongoing and worsening opioid epidemic, taking patients off of medications that can help them recover is counterintuitive.

The FDA instead recommends that physicians carefully manage the medications. The anti-anxiety or sleeping medication should be gradually tapered, and, if possible, discontinued altogether.

Drug Combinations to Avoid

MAT/ORT medications include:

  • buprenorphine – Subutex, Probuphine
  • buprenorphine/naloxone – Suboxone, Bunavail, Zubsolv
  • methadone – Methadose, Dolophine, Diskets

Benzodiazepine medications include:

  • alprazolam – Xanax
  • chlordiazepoxide – Librium, Librax
  • clobazam – Onfi
  • clonazepam – Klonopin
  • clorazepate – Tranxene
  • diazepam – Valium, Diastat
  • estazolam – ProSom
  • flurazepam –Dalmane
  • lorazepam – Ativan
  • oxazepam
  • quazepam – Doral
  • temazepam – Restoril
  • triazolam – Halcion

Sleeping medications include:

  • butabarbital sodium – Butisol
  • eszopiclone – Lunesta
  • pentobarbital – Nembutal
  • ramelteon – Rozerem
  • secobarbital sodium – Seconal sodium
  • suvorexant – Belsomra
  • zaleplon – Sonata
  • zolpidem – Ambien, Edluar, Intermezzo, Zolpimist

Muscle relaxant medications include:

  • baclofen – Gablofen, Lioresal
  • carisoprodol – Soma, Soma Compound, Soma Compound w/ codeine
  • chlorzoxazone
  • cyclobenzaprine – Amrix
  • dantrolene – Dantrium, Revonto, Ryanodex
  • metaxalone – Skelaxin
  • methocarbamol – Robaxin, Robaxin-750
  • orphenadrine
  • tizanidine – Zanaflex

Antipsychotic medications include:

  • aripiprazole – Abilify, Abilify Maintena, Aristada
  • asenapine – Saphris
  • cariprazine – Vraylar
  • chlorpromazine
  • clozapine – Clozaril, Fazaclo ODT, Versacloz
  • fluphenazine
  • haloperidol – Haldol
  • iloperidone – Fanapt
  • loxapine – Adasuve
  • lurasidone – Latuda
  • molindone
  • olanzapine – Symbyax, Zyprexa, Zyprexa Relprevv, Zyprexa Zydis
  • paliperidone – Invega, Invega Sustenna, Invega Trinza
  • perphenazine
  • pimavanserin – Nuplazid
  • quetiapine – Seroquel, Seroquel XR
  • risperidone – Risperdal, Risperdal Consta
  • thioridazine
  • thiothixene – Navane
  • trifluoperazine
  • ziprasidone – Geodon

Keep Yourself Safe from Dangerous Drug Interactions

Always discuss with your doctor ANY drugs you are taking – even if you are taking illicit drugs. Not only can these interactions jeopardize your sobriety, they can also put your life at risk.

Lasting Recovery outpatient drug rehab in San Diego specializes in the use of MAT as an effective strategy to reduce cravings during recovery. If you would like to know more, contact Lasting Recovery today.

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