Suboxone is not an approved or established treatment for alcohol use disorder. It is FDA-approved for opioid use disorder, and the medications with real evidence behind them for heavy drinking are naltrexone, acamprosate, and disulfiram. All three are part of alcohol use disorder treatment at Porch Light Health.
Suboxone treats opioid use disorder, not alcohol use disorder. If you are drinking heavily, the first conversation to have with a clinician is about naltrexone, acamprosate, or disulfiram. Buprenorphine only enters the picture when someone is being treated for opioid use disorder at the same time.
No. The FDA has approved Suboxone, a combination of buprenorphine and naloxone, for the treatment of opioid use disorder. Alcohol use disorder is a separate condition with its own approved medications, and Suboxone is not among them.
That distinction matters more than it might sound. Buprenorphine is a partial opioid agonist, meaning it activates opioid receptors partially rather than fully. It was developed to stabilize people whose brains have adapted to opioids.
Alcohol works differently. It acts primarily on the GABA and glutamate systems, which is why the medications that help most with drinking are built around different targets.
You may still find the question asked online, and there is a good reason for it. Naltrexone, one of the genuinely effective medication options for alcohol use disorder, also works on opioid receptors. People reasonably wonder whether other opioid-receptor medications might do the same job.
So far, they do not.
The honest summary is that the evidence is thin, indirect, and pointed in more than one direction.
The most cited human study is a 2021 analysis in JAMA Network Open by Xu and colleagues. It followed 13,335 people with opioid use disorder and found that days on buprenorphine were associated with 43% lower odds of an alcohol-related hospital event compared with days off treatment.
Read that carefully. Every person in the study had opioid use disorder and was being treated for it. The finding suggests that stabilizing someone’s opioid use may reduce alcohol-related crises as a downstream effect, which is a different claim from buprenorphine treating the drinking itself.
No large randomized trial has tested buprenorphine as a stand-alone treatment for alcohol use disorder. Until one does, there is no evidence base to build a prescription on.
A 2006 study in Biological Psychiatry by Ciccocioppo and colleagues tested buprenorphine in alcohol-preferring rats. The dose determined the direction of the effect. Low doses significantly increased alcohol consumption, and only high doses reduced it.
The researchers attributed the split to two different receptor systems responding at different thresholds. Whatever the mechanism, a medication that can increase drinking at one dose and decrease it at another is not a promising candidate without human trials to map that line.
This is preclinical work in rodents, and it should not be read as a finding about people. It does help explain the clinical caution.
Three medications carry FDA approval for alcohol use disorder, and Porch Light Health offers all three. The one most often confused with Suboxone is naltrexone therapy, because both act on opioid receptors. They work in opposite directions: naltrexone blocks those receptors, while buprenorphine partially activates them.
| Medication | How It Works | Often Suits | Practical Notes |
| Naltrexone | Blocks the opioid receptors involved in alcohol’s rewarding effects | People who want to cut back or stop, including those still drinking | Daily tablet or monthly injection; can be started while still drinking |
| Acamprosate | Acts on the glutamate system to ease the discomfort of early abstinence | People who have stopped drinking and want to stay stopped | Taken three times daily; started after withdrawal |
| Disulfiram | Causes an unpleasant physical reaction if alcohol is consumed | People who want a hard deterrent and accept supervision | Once daily; requires roughly 12 hours alcohol-free before starting |
When the approved medications do not fit, the NIAAA points to topiramate and gabapentin as second-line therapy. Both are used off-label for alcohol use disorder, and both have more supporting evidence than buprenorphine does.
Buprenorphine does not appear on that list at all.
There is one situation where buprenorphine and heavy drinking come up together legitimately, and it is common. Many people have both opioid use disorder and alcohol use disorder.
In that case, buprenorphine is prescribed for the opioid use disorder, exactly as approved. Someone might receive Suboxone therapy for opioid use disorder while a separate plan addresses the drinking, often with naltrexone or acamprosate alongside counseling. Both conditions get treated, and the buprenorphine is doing its approved job.
That distinction is worth holding onto. A person can be on Suboxone and receiving alcohol treatment at the same time without Suboxone being the alcohol treatment.
Co-occurring mental health conditions are common in this group too, so coordinating medication, psychiatry, and therapy keeps the plans from working against each other.
If you take buprenorphine, drinking is a genuine danger rather than a caution to file away.
Buprenorphine and alcohol are both central nervous system depressants. Taken together they compound each other’s effect on breathing, and the FDA carries boxed warnings about combining buprenorphine-containing medications with alcohol, benzodiazepines, and other sedatives. The risk is respiratory depression, which can be fatal.
Tell your prescriber about every substance you use, whether it is prescribed or not:
The answer is rarely to stop the buprenorphine, which carries its own risks. It is to build a plan that accounts for what you are actually taking. Our guide to drinking while taking Suboxone covers what the combination does and why it is worth raising even if you drink only occasionally.
If you carry naloxone, keep it accessible and make sure someone close to you knows how to use it.
Care starts with an evaluation covering:
That assessment shapes which medication makes sense, and whether you need support through withdrawal first.
Medication also works best paired with support around it. Porch Light Health combines medication with individual therapy, group counseling, family therapy, and case management, using motivational and cognitive-behavioral approaches. Care runs through in-person clinics, mobile medical units, and telehealth across Colorado and New Mexico.
We accept Medicaid, Medicare, and major commercial plans including Anthem Blue Cross Blue Shield, UnitedHealthcare, Humana, Cigna, and Kaiser Permanente. A sliding fee program sets fees by family size and income for eligible patients.
Coverage depends on your plan and your eligibility, so the fastest way to get a real answer is to ask us directly.
Trying naltrexone and still drinking heavily is common, and it does not mean medication failed you. It usually means the plan needs adjusting, and comparing naltrexone with acamprosate is often where that conversation starts.
A clinician will typically look at several things before changing course:
Untreated anxiety, depression, or trauma driving the drinking is another common reason a first medication underperforms, and addressing both conditions on one plan tends to work better than treating them in sequence.
Suboxone is not the next step on that list. The next step is a conversation about the options that have evidence behind them.
Ready to talk to someone? Call 866-839-8868 or contact our team to ask about alcohol use disorder treatment near you.
Can Suboxone be prescribed for alcohol use disorder?
Suboxone is FDA-approved for opioid use disorder, not alcohol use disorder, and it is not a standard treatment for drinking. A clinician may prescribe Suboxone to someone who also has opioid use disorder, but it would be treating that condition rather than the alcohol use.
Does Porch Light Health prescribe Suboxone for alcohol use disorder?
No. We prescribe buprenorphine-based medications, including Suboxone, for opioid use disorder. For alcohol use disorder we offer naltrexone, acamprosate, and disulfiram alongside therapy and case management.
What is the most effective medication for alcohol use disorder?
There is no single answer that fits everyone. Naltrexone and acamprosate have the strongest evidence, and which one suits you depends on whether you are still drinking, how your liver and kidneys are functioning, what other medications you take, and what your goal is.
Does naltrexone work the same way as Suboxone?
No. Both act on opioid receptors, but in opposite directions. Naltrexone blocks them, which reduces the reward from drinking. Buprenorphine partially activates them, which is what makes it useful for opioid withdrawal and cravings.
Is it safe to drink alcohol while taking Suboxone?
No. Buprenorphine and alcohol both depress the central nervous system, and combining them raises the risk of dangerously slowed breathing. If you are on buprenorphine and drinking, tell your prescriber so your plan can account for it safely.
Can I get alcohol use disorder treatment through telehealth?
Yes, in many cases. Porch Light Health offers virtual outpatient care across Colorado and New Mexico, and some visits and labs may still need to happen in person. What is available depends on your situation and location.
What if I have both an alcohol and an opioid problem?
Both conditions can be treated at the same time, and that is a routine part of what we do. Buprenorphine or another medication addresses the opioid use disorder while a separate medication and counseling plan addresses the drinking.
Will my insurance cover alcohol use disorder medication?
Coverage varies by plan and eligibility. Porch Light Health accepts Medicaid, Medicare, and major commercial insurers, and a sliding fee program is available for eligible patients based on family size and income. Call us and we can look at your specific plan.
You do not need to have it figured out before you call. If drinking is affecting your health, your work, or the people around you, that is reason enough to talk to someone.
Porch Light Health offers medication for alcohol use disorder, therapy, and psychiatric care at more than 60 points of care across Colorado and New Mexico, through clinics, mobile medical units, and telehealth. We accept Medicaid, Medicare, and major commercial plans, and a sliding fee program is available for eligible patients.
Call 866-839-8868 or contact us to get started. You can also find a clinic near you or ask about the sliding fee program.
