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I use Xanax for anxiety. Can I take Suboxone?

  • Asks ...

    I take Xanax for anxiety problems and I am also addicted to Vicodins. Can I use Suboxone to get off the opiates and still continue to take the Xanax?

  • Dr. David Sack Says ...
    Dr. David Sack

    At Promises, one out of four of our clients addicted to opiates (heroin, Vicodin, Percodan,oxycodone) had an anxiety disorder before they became addicted.  In many of these clients, the opiates were used in part to control their anxiety.  On the other hand most of the other clients who did NOT have anxiety problem before getting hooked on opiates also abuse anti-anxiety medicines (Xanax, Klonopin, Valium, Serax, Librium) and sleep medicines.  There are three reasons for this.  First, anxiety is a nearly universal symptom of opiate withdrawal and many addicts use anti-anxiety to blunt their withdrawal symptoms.  Second, opiates disrupt sleep and decrease the restorative quality of sleep and because anti-anxiety medications are sedating they are used to control insomnia and restless sleep. Finally, sedatives and alcohol are used with opiates to amplify the ‘high’ or to soften the crash.  Regardless of the reason, over half of all the opiate abusers we treat also need to be detoxed from anti-anxiety medications.
     
    Xanax is rarely the best long term treatment for anxiety disorders, and this is especially true for those who have opiate dependency.  There are number of other medications that can be very helpful such as Selective Serotonin Reuptake Inhibitors and Serotonin-Norepinephrine Reuptake Inhibitors, atypical antipsychotic medications such as quetiapine (Seroquel), and mood stabilizers.  All of these are non-addicting and may be helpful once someone has been detoxed.