A Question:
I have been taken xanax for over half my life. initially for anxiety and insomnia. then like most was unable to function or handle the withdraw and remained on it. later because of an injury i was introduced to oxycontin. i became addicted and could not step off. one because of “real back pain” the other because of the withdrawl. i would have to go to rehab and or miss work. which is impossible for me because i am the sole provider for my children and i. also my family is very uneducated with these things and have a “zero” tolerance and would be disowned for sure. i no longer want to take opiates but i do feel i need xanax. will taking suboxone while taking xanax be fatal. or is it possible to combine the 2 until i am opiate free?
My Answer:
Thank you for writing; I feel for you, and have been there. It sounds like you recognize where things stand, which is miles ahead of many patients on Xanax who misinterpret the withdrawal as their own ‘anxiety disorder’. I would first suggest that you never give up the courage to get off of the Xanax. While it is a difficult thing to do, most people will eventually have less anxiety, less insomnia, less fatigue, and less depression if they can get away from benzos. You CANNOT simply stop the Xanax, as you probably know, as the withdrawal from that class of medication can be fatal, and includes seizures that can just occur suddenly out of nowhere… while you are driving down a highway for example.
I must be cautious to avoid giving medical advice that has the potential to be dangerous; anyone reading my posts MUST make any treatment decisions along with their own physician. But for the sake of education, yes, people have died from the combination of Suboxone and Xanax (alprazolam) and other benzos (like lorazepam, diazepam, clonazepam, etc.). But two points deserve mention. First, the deaths occur from respiratory depression when opiates and benzos are combined– the respiratory depression is ‘multiplied’, not just added together. The danger is primarily restricted to people who are not tolerant to the medications. If a person is used to both medications, the risk of having trouble is not all that significant. So in your case, I would start the Suboxone and if you feel ‘buzzed’ from it I would have you take only half of your Xanax dose until you are tolerant to the Suboxone. You could probably resume your regular Xanax dose after a couple days.
The second point is that the danger from Suboxone is much less significant than the danger of combining a full opiate agonist (like methadone, oxycodone, or hydrocodone) with a benzo. The antagonist action of buprenorphine provides a significant measure of safety that is not present with opiate agonists.
One final comment– the best way to get off the Xanax is to change to a very long acting benzo– clonazepam is usually the best choice– and then go on a slow taper. If a person is motivated to get clean, and if the taper is done very slowly (over a period of 6 months) the withdrawal is minimal and can be tolerated without the need for inpatient detox.
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