Can I Take Adderall With Suboxone?

With a doctor's supervision and monitoring, you can take Suboxone and Adderall together. But if you're misusing one or the other without a doctor’s knowledge or support, you could place your health and recovery at risk.

Can I Take Adderall With Suboxone? 

If your doctor supervises your prescriptions and recovery, you can take Adderall and Suboxone at the same time. In some cases, it's smart. 

Many people with an opioid use disorder (OUD) may also have attention deficit hyperactivity disorder (ADHD).[1] Doctors prescribing Suboxone often have patients using Adderall to treat ADHD who also have an OUD. 

An underlying mental health issue can make addressing an OUD more difficult. Uncontrolled ADHD can cause relapse. Simultaneously, untreated OUD can worsen symptoms of ADHD. Treating your ADHD and your OUD at the same time may therefore be essential. This may mean taking adderall or other stimulant medications at the same time as Suboxone. 

Comparing Suboxone & Adderall 

Suboxone and Adderall are prescription medications. They work differently on the brain:

What Is Adderall?

Adderall is a prescription stimulant medication containing dextroamphetamine and amphetamine salts.[2] The medication is structurally similar to street drugs like methamphetamine, which is another example of a potent stimulant. 

Stimulant medications like Adderall work by boosting the release of two key brain chemicals:[3] dopamine and norepinephrine. These neurotransmitters give us energy and may therefore create chemical rewards in the brain. In this way, stimulant drugs can be addictive and have potential for misuse, which is why they are tightly controlled and require a prescription.

In people with ADHD, the stimulant causes the release of neurotransmitters that can help people feel more awake and “focused” when they often otherwise feel chronically distracted. For individuals with ADHD, when taken properly as prescribed, the medication should not cause a "high". Instead, patients feel more focused and able to concentrate. 

Some people with ADHD do misuse their medications. In fact, in a study of college students, about 25% of those with ADHD admitted they took their medications in higher quantities or more frequently than prescribed. [4] 

People without ADHD may also misuse Adderall: they think it will make them smarter or more easily able to study or preform academically. Some parents may even give ADHD drugs to their healthy kids in an effort to make them smarter.[5] This can be dangerous for many reasons as stimulant medications can have dangerous or even life threatening side effects. 

What Is Suboxone?

Suboxone is a prescription medication used to treat OUD. It contains two ingredients:

• Buprenorphine: This long-acting partial opioid agonist prevents symptoms of opioid withdrawal, and eases cravings. [6]
• Naloxone: This full opioid agonist can prevent opioid overdose. When dissolved sublingually as prescribed, the Naloxone is not absorbed and is essentially inert. But if someone attempts to inject their Buprenorphine, it does enter the blood stream and become active, preventing an overdose. In this way, it is included in Suboxone strips to act as a safety mechanism/misuse deterrent. [6]

Suboxone is proven effective in people with OUD. In one study, 75% of people using buprenorphine products like Suboxone avoided relapse one year later. [6]

How Do Suboxone & Adderall Interact When Taken Together?

Suboxone and Adderall work on different parts of the brain. One is a stimulant, causing an increase in heart rate, brain activity, and more. The other (Suboxone) acts more like a depressant, causing a decrease in those same factors. 

People using both medications have a modest increase in risk of overdose, but usually only when the medications are not taken as prescribed or are misused. 

Conversely, people using Adderall to properly address their ADHD are also more likely to stay in OUD treatment. The benefits of taking both medications in individuals who have both ADHD and OUD may therefore outweigh the risks.[7]

What Are the Dangers of Mixing Suboxone & Adderall? 

While you can use Suboxone and Adderall together with your doctor's help, risks are involved. You should understand them and determine if this combination is right for you. 

The dangers include the following:

• Misuse potential: Adderall is an addictive medication, and the longer you use it, the higher the risk of dependence.
  
• Overdose: In 2014, nearly 9 in 10 deaths involving stimulants also involved opioid drugs.[8] Therefore mixing different medications does increase the risk of accidental overdose. Using stimulant medication with buprenorphine is associated with a 19% increased risk of drug-related poisoning.[10]
  
• Heart damage: Stimulants cause the release of norepinephrine and dopamine which cause the heart to beat faster and put increased oxygen demand on the tissues of the heart. Over time, this can raise the risk of heart disease.[9] Acutely, high doses can increase the risk of heart attack or arrhythmia. 

Can You Safely Mix Both Medications? 

If your doctor says you can use Adderall and Suboxone at the same time, you can take these medications together. There are of course always risks, but working with your doctor ensures you can take both medications safely and minimize any complications. Talk openly with your doctor and the rest of your treatment team about which medications, including stimulants, you are taking while on Suboxone. 

SOURCES

1. Stimulant Prescription Medications Among Persons Receiving Buprenorphine for Opioid Use Disorder with Prior Drug-Related Poisoning—Evidence of Net Sum Gain. JAMA. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096599/. May 2022. Accessed October 2022. 
2. Adderall. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf. March 2007. Accessed October 2022. 
3. Prescription Stimulants DrugFacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/prescription-stimulants. June 2018. Accessed October 2022. 
4. Prescription Stimulants in Individuals With and Without Attention Deficit Hyperactivity Disorder: Misuse, Cognitive Impact, and Adverse Effects. Brain and Behavior. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/. July 2012. Accessed October 2022.
5. Why Parents Misuse Prescription Drugs to Enhance the Cognitive Performance of Healthy Children: Influence of Peers and Social Media. Journal of Drug Issues. https://journals.sagepub.com/doi/10.1177/0022042621994547. February 2021. Accessed October 2022. 
6. Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. Spring 2018. Accessed October 2022. 
7. Analysis of Stimulant Prescriptions and Drug-Related Poisoning Risk Among Persons Receiving Buprenorphine Treatment for Opioid Use Disorder. JAMA. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2792174. May 2022. Accessed October 2022. 
8. Trends in Stimulant-Related Overdose Deaths. Massachusetts Department of Public Health. https://www.mass.gov/doc/data-brief-trends-in-stimulant-related-overdose-deaths-february-2020/download. February 2020. Accessed October 2022. 
9. Adult ADHD Medications and Their Cardiovascular Implications. Case Reports in Cardiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4992783/. August 2016. Accessed October 2022. 
10. Analysis of Stimulant Prescriptions and Drug-Related Poisoning Risk Among Persons Receiving Buprenorphine Treatment for Opioid Use Disorder. JAMA. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096599/. May 2022. Accessed October 2022.