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  • Writer's pictureDr. Harold Pierre

Should Patients With ADHD Take Adderall and Suboxone Together?

Updated: Jan 10

Should Patients with ADHD Take Adderall and Suboxone Together? Everything You Need to Know

Suboxone and Adderall are two common medications used to treat opioid addiction and ADHD, respectively. However, there are concerns about the safety of taking these two drugs together. This comprehensive discussion will provide an evidence-based overview on prescribing Adderall or other stimulant medications like Adderall to patients also using Suboxone.

What is Suboxone?

Searching for suboxone information online

Suboxone is the brand name for a medication containing buprenorphine and naloxone. It belongs to the class of drugs called partial opioid agonists and is used to treat opioid addiction.

Suboxone contains two active drugs:

  • Buprenorphine - This is the main active ingredient in Suboxone. Buprenorphine is a partial opioid agonist, meaning it activates the opioid receptors in the brain but to a lesser extent than full agonists like heroin or oxycodone.

  • Naloxone - This is added to discourage misuse of Suboxone. If Suboxone is injected, naloxone blocks the effects of buprenorphine and causes withdrawal symptoms.

  • Buprenorphine binds to the opioid receptors in the central nervous system and reduces cravings and withdrawal symptoms. This allows people dependent on opioids like heroin or painkillers to stop using these drugs and transition into addiction treatment.

  • Buprenorphine is the most common medication prescribed for medication-assisted treatment (MAT) of opioid use disorder. MAT combines behavioral therapy and medications to treat addiction.

What is Adderall?

Adderall is the brand name for a stimulant medication. It is most commonly used to treat attention deficit hyperactivity disorder (ADHD).

  • The active ingredients in Adderall are dextroamphetamine and amphetamine salts. These belong to the class of stimulants called amphetamines.

  • Adderall works by increasing the activity of norepinephrine and dopamine in the brain. This leads to increased concentration, focus, and impulse control.

  • For people with ADHD, stimulant medications can help reduce hyperactivity and improve attention span, focus, and impulse control.

  • Adderall is available in immediate-release and extended-release formulations. Extended-release versions like Adderall XR have a lower potential for misuse.

Concerns About Taking Adderall and Suboxone Together for ADHD

Medical concept of Brain made from wooden puzzle into human head. Idea of thinking, workflow, adhd and learning copy

Suboxone and Adderall work in opposite ways - the buprenorphine in Suboxone is a depressant while Adderall is a stimulant. Naturally, there are some concerns regarding safety when a stimulant medication with buprenorphine.

  • Risk of drug interaction - There is a risk that stimulants might impact the effects of Buprenorphine. This could potentially lead to a relapse or overdose in someone recovering from opioid addiction.

  • Masking withdrawal symptoms - Adderall is a stimulant. It may mask symptoms of opioid withdrawal in someone who takes Adderall and then stops buprenorphine suddenly.

  • Increased side effects - Combining both medications might also lead to more side effects like insomnia, anxiety, nausea, headache etc.

  • Risk of abuse or addiction - Buprenorphine, Adderall and other ADHD drugs have some potential for misuse on their own. Taking them together further increases this risk. Adderall abuse is real and can lead to Adderall addiction. Prescription stimulants should be carefully monitored.

However, research suggests these concerns may be overstated when the medications are taken as prescribed under medical supervision.

Does Taking Stimulants Impact Opioid Addiction Treatment?

Recent studies have analyzed the effects of taking prescription amphetamines like Adderall on treatment outcomes in people taking Suboxone for opioid use disorder. Here's what the research shows about treating the symptoms of ADHD:

  • Better retention in treatment - Patients prescribed stimulants stayed in Suboxone treatment longer compared to patients not taking stimulants. This was true regardless of whether the person had a history of stimulant abuse.

  • Lower risk of overdose - In patients taking Suboxone, periods of stimulant use did not increase the risk of emergency room visits or overdoses compared to periods of no Adderall use.

  • Helps treat co-occurring ADHD - Up to 21% of people with opioid addiction also have ADHD. Treating ADHD with stimulant medication likely improves Suboxone treatment adherence and retention.

Overall, the evidence so far does not support concerns about prescribing amphetamines like Adderall to people using Suboxone under medical supervision. In fact, it shows Adderall may help keep people in treatment longer without increasing overdose risk.

Why Might Adderall Use Help Patients Stay on Suboxone Treatment?

Single capsule of the Stimulant Adderall XR, 20 mg

There are several ways prescribing Adderall alongside Suboxone could benefit treatment outcomes:

  • Treats ADHD symptoms - ADHD may make it harder for people to stick to treatment. Adderall improves ADHD symptoms like poor focus and impulsivity. This makes it easier to comply with treatment requirements.

  • Treats narcolepsy - opioid addicts have a higher rate of narcolepsy.

  • Provides therapeutic stimulation - For some people addicted to stimulants, Adderall may substitute and reduce cravings for illicit stimulants like cocaine or methamphetamine. This therapeutic use of Adderall is carefully monitored.

  • Improves cognitive function - Chronic opioid use can impair thinking ability and memory. By improving cognition, stimulants may help patients engage better in counseling and recovery programs.

  • Boosts mood - Depression is common in people with opioid addiction. Stimulants can elevate mood and energy levels and help overcome apathy towards treatment.

  • Increases motivation - Adderall enhances motivation and drive to accomplish tasks. This can positively impact a patient's commitment to stay in treatment and avoid relapse.

However, more research is still needed to better understand the benefits of prescribing amphetamines to support Suboxone treatment in different groups of patients.

Is it Safe to Prescribe Adderall to People Using Suboxone?

Based on current evidence, it is likely safe to prescribe Suboxone and Adderall together when clinically indicated and with proper monitoring.

Here are some factors providers consider when deciding if Adderall is appropriate for an individual Suboxone patient:

  • Only prescribe Adderall if an ADHD diagnosis is made according to clinical guidelines. Don’t prescribe ADHD medications without a proper diagnostic evaluation.

  • Calculate the risk of abuse or misuse. Consider any history of stimulant or other substance abuse. Extended release Adderall has lower abuse potential.

  • Discuss any cardiovascular risks. Weigh benefits against risks if the patient has a history of heart disease.

  • Start with a low dose and monitor the response closely. Slowly increase to the most effective minimum dose.

  • Prescribe the extended release form to avoid peaks and crashes that can lead to cravings.

  • Encourage adherence to prescription instructions and regular provider follow-up. Warn against doubling up doses.

  • Track progress and monitor for signs of misuse like running out early or intoxication. Conduct random urine screens.

With structure monitoring and responsible prescribing, evidence so far suggests Adderall and Suboxone taken together do not increase overdose risk compared to Suboxone alone.

What You Should Know Before Taking Adderall and Suboxone Together

If your healthcare provider determines Adderall is appropriate for you along with Suboxone treatment, keep the following in mind:

  • Take both medications only as prescribed. Never double up doses or take more than instructed.

  • Don’t use other opioids or sedatives like benzodiazepines unless approved by your doctor. Especially avoid illicit opioids.

  • Watch for increased side effects like insomnia, anxiety, nausea, headache, and let your provider know if these become severe.

  • Store your medication securely and don’t share it with others. Selling or giving away these medications is illegal.

  • Keep all follow-up visits and comply with random urine drug screens.Your provider needs to monitor your progress.

  • Report any concerning symptoms like chest pain, hallucinations, depression or suicidal thoughts immediately.

  • Don’t stop either medication suddenly without medical supervision - this can lead to complications.

  • Reach out for support if you feel you may be misusing your medication or experience cravings to use opioids.

Following prescriber directions, monitoring side effects, and asking for help when needed can help minimize risks from Adderall and Suboxone prescribed together under medical supervision.

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Frequently Asked Questions about Taking Adderall and Suboxone

Can you take Adderall while on Suboxone?

Yes, stimulants and buprenorphine can be safely prescribed together under medical supervision in many cases. Research so far has not found an increase in overdoses when Adderall is combined with Suboxone treatment compared to Suboxone alone.

Why is Adderall prescribed to people taking Suboxone?

The stimulant effects of Adderall can help treat co-occurring ADHD, which is common in people with opioid addiction. Managing ADHD symptoms helps improve adherence and retention in Suboxone treatment programs.

Does Adderall block the effects of Suboxone?

There is no evidence so far suggesting therapeutic doses of Adderall interfere with Suboxone treatment when both are taken as directed. High non-prescribed doses of Adderall may counteract Suboxone’s effects.

Can you take Adderall and Suboxone at the same time?

Yes, Adderall and Suboxone are often prescribed together for concurrent use. Maximum benefit is seen when both are taken daily as scheduled. Your prescribing doctor will provide specific guidance for personalized treatment. Talking to your doctor is the best way learn if combining treatment is right for you.

Is taking Adderall with Suboxone dangerous?

Current research has not shown an increase in overdoses when Adderall is added to Suboxone treatment under medical supervision and when taken as prescribed. However, combining any medications does increase risks if misused.

What side effects can occur when buprenorphine and amphetamine are taken together?

Common side effects may include insomnia, headache, nausea, and anxiety. Less common effects are psychosis, mania, and heart problems. Very high non-prescribed doses further increase health risks.

Can you get high when Suboxone and Adderall interact?

Someone without ADHD taking very high recreational doses of both medications together may experience a high. Therapeutic doses prescribed for ADHD and opioid addiction do not cause a high.

Is it bad to take Adderall and Suboxone if not prescribed?

Yes, it is dangerous to take either medication without a prescription, especially in combination. Effects like oversedation, overstimulation, or overdose could occur. Only take as specifically directed by your doctor.

In summary, therapeutic use of Adderall and Suboxone under medical supervision is well tolerated by many people and offers benefits for treating co-occurring ADHD and opioid use disorder. However, nonmedical use does pose significant health risks.

The Bottom Line

  • Many individuals prescribed Suboxone for opioid addiction also have ADHD requiring treatment.

  • Current research suggests Adderall and other amphetamines may improve retention in Suboxone treatment when used responsibly under medical supervision.

  • In prescribed doses, stimulants do not appear to increase overdose risk when combined with Suboxone based on evidence so far.

  • Any use of amphetamines with Suboxone should involve a careful assessment of the risks and benefits by a healthcare provider.

  • Signs of misuse or uncontrolled side effects must be monitored closely if both medications are prescribed together.

  • More studies are needed on combining stimulants and Suboxone in different patient populations. However, current data supports this practice for those who would benefit.

  • Never take medications prescribed for someone else. Adderall and Suboxone should only be used under the management of your personal healthcare provider.

While more research is still welcome, the evidence so far suggests that prescribing amphetamines alongside buprenorphine is likely safe and beneficial for many patients when clinically warranted and properly monitored by a healthcare professional. Please talk with your healthcare provider before making any decisions about the information you've gathered from this blog post.

About the author:

Dr. Harold Pierre is a board-certified anesthesiologist and addiction medicine specialist with over 20 years of experience. He is board-certified by the American Board of Anesthesiology and the American Board of Preventive Medicine.

This website is provided for educational and informational purposes only and does not constitute providing medical advice or professional services. The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician or another qualified medical professional. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

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