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Many addicts make the mistake of believing they are addicted to one drug. Alcoholics think that if they just stop drinking, everything will be fine. Opiate addicts tend to think if they can just stop taking opiates, everything will be fine. But addiction is a tricky disease. When a person becomes addicted to any substance, they increase the likelihood that they will become addicted to other substances.

One reason for this is that addicts learn to cope with normal life problems by taking a substance. When an addict enters medication assisted treatment (MAT) like Suboxone or methadone, they no longer have their drug of choice as a way to cope with normal life problems. Medication assisted treatment on its own only treats the biological part of addiction. The addict no longer has withdrawal symptoms but they also don’t get high. Without the high, they don’t have a way to cope with their problems.

MAT, Coping Skills and Cocaine

At this point the addict needs to learn new coping skills to deal with their problems. Most medication assisted treatment programs offer counseling to help the addict learn new ways to cope with their problems. However an addict new to recovery may resist the new ways of coping. Normal coping skills need to be practiced on a regular basis. They don’t work as fast as a substance would. They take work on the part of the addict and awareness of when they need to be applied.

Addicts who are new to recovery may not be willing to put in the work or are resistant to counseling. They want the easy fix that drugs afforded them. They may be overwhelmed by normal everyday problems because they are not accustomed to dealing with them. They may be in denial about the need for coping skills. Most addicts who are new to recovery believe addiction is a physical problem. They believe that once they stop using their drug of choice, life will get better on its own. When it doesn’t, they become frustrated and look for other ways to cope.

This is where other drugs come into the picture. An addict on medication assisted treatment quickly learns their drug of choice no longer works. Suboxone and methadone block the euphoric effects of opiates. The addict looks for another drug to replace opiates. Often this is a subconscious process. They don’t even realize they are replacing one drug for another. They find that they can’t cope with life and they need something to make them feel better.

Since opiates no longer work, the addict may turn to drugs like cocaine to fill the void. For the opiate addict, drugs like cocaine are nothing new. Most addicts try a number of different drugs by the time they reach medication assisted treatment. Addiction is a gradually process that takes years to develop. For someone who has never used drugs, cocaine seems like a dangerous drug. However over time, addicts lose their fear of taking substances. They block the dangers of these drugs from their mind.

Side Effects of Cocaine

Cocaine has many side effects on its own and when combined with powerful opioids like Suboxone or methadone, it becomes even more dangerous. Cocaine is a central nervous system stimulant that increases the levels of the neurotransmitter dopamine in the brain. Dopamine is a part of the brain’s natural reward system. When the brain releases dopamine, it makes us feel good. This is where the euphoric effects of cocaine come from. However, cocaine keeps the brain from recycling dopamine back into the cells. This excess of dopamine can cause some of the serious side effects of cocaine.1

What are the physical side effects of Cocaine?

  • Constricts blood vessels
  • Dilates pupils
  • Increases body temperature
  • Increases blood pressure
  • Causes headaches
  • Abdominal pain
  • Nausea
  • Decreased appetite (which can lead to malnutrition)

What are the psychological side effects of Cocaine use?

  • Irritability
  • Anxiety
  • Restlessness
  • Paranoia
  • Psychosis
  • Hallucinations

What are the dangers of Cocaine use?

Some of the side effects of cocaine use can lead to serious health problems. The body is not designed to function with such high levels of dopamine.  Cocaine use can cause:

  • Heart attack
  • Stroke
  • Death

In addition to the risk of heart attack, stroke and death, cocaine users are at risk for other health problems depending on how they use the drug. Intravenous (IV) cocaine users are at increased risk of HIV and Hepatitis from sharing needles. Cocaine users who snort the drug can lose their sense of smell; have chronic runny noses, hoarseness, nosebleeds and trouble swallowing.

4 Reasons to Avoid Cocaine + Methadone/Suboxone

In addition to all the side effects and health problems caused by cocaine alone, cocaine can be more dangerous when combined with other substances like Suboxone and methadone. When cocaine is combined with opioids like Suboxone and methadone, the opposing stimulant effect of cocaine and the sedating effect of opioids combine to create what addicts call a “speedball.”

What are the dangers of taking Cocaine with Suboxone or methadone?

  1. Poly-addiction (addiction to more than one substance)
  2. Withdrawal symptoms (from Suboxone or methadone)
  3. Defeats the purpose of treatment
  4. Increased risk of overdose 


The addict who takes cocaine while on Suboxone or methadone is at risk for poly-addiction. Poly-addiction is addiction to more than one substance. Poly-addiction while in Suboxone or methadone treatment works like this. The addict seeks treatment for their opiate addiction but does not learn or use new coping skills. They begin to look for other ways to cope with problems. They begin abusing cocaine. They develop a tolerance to cocaine. As tolerance develops, they need more and more cocaine to get high. The more cocaine they use, the more they become addicted. The addict is now addicted to opiates and cocaine.

Reduced Effectiveness of Suboxone or Methadone

In addition, cocaine has also been shown to reduce the levels of buprenorphine in the blood of someone on Suboxone. Buprenorphine is the main ingredient in Suboxone. This means that cocaine can cause someone on Suboxone to experience withdrawal symptoms. cocaine has the same effect when taken with methadone. It reduces the levels of methadone in the addict’s body which in turn causes them to experience withdrawal symptoms. Addicts in Suboxone or methadone treatment need a consistent level of Suboxone or methadone in their system to prevent withdrawal symptoms. Withdrawal from Suboxone or methadone includes symptoms like agitation, restlessness, sweating, nausea, vomiting and diarrhea.2

Drug Seeking Lifestyle

The purpose of taking Suboxone or methadone is to get treatment for an addiction to opiates. Suboxone or methadone keeps the addict from experiencing withdrawal symptoms. Without withdrawal, the addict no longer needs to take illegal, street drugs. However, a person taking cocaine on Suboxone or methadone is already taking street drugs and has withdrawal symptoms. It completely defeats the purpose of treatment.

Increased Risks of Overdose

Cocaine use while on Suboxone or methadone also increases the risk of overdose. Because Suboxone and methadone are depressants, they can reduce some of the side effects of cocaine when taken together. The reduction of side effects like anxiety and increased heart rate may give the addict the false sense that they can take more cocaine. The more drugs the addict takes, the higher their risk is for overdose. Addicts often believe they are not at risk for overdose unless they feel high. However, the combination of stimulants and depressants can still cause overdose before the addict reaches the level of intoxication they desire.

Cocaine on its own is a powerful drug which is dangerous to take in any amount. When taken in combination with Suboxone or methadone, there is increased risk of the dangerous side effects of cocaine use. The combination of drugs increases the likelihood that the addict could have a heart attack or stroke which could cause death. In addition, addicts risk becoming addicted to more than one substance, have withdrawal from Suboxone or methadone which defeats the purpose of treatment and are at higher risk of overdose. 

  • 2. McCance-Katz, EF, P. Jatlow, and PM Rainey. "Result Filters." National Center for Biotechnology Information. U.S. National Library of Medicine, Jan.-Feb. 2010. Web. 29 Dec. 2013.
About the author Anna Deeds:
I am a recovering addict and a Licensed Professional Counselor. I have over 7 years clean from all substances and more than 10 years from illicit drugs. I work as an addiction counselor and have more than 5 years experience counseling addicts.
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Page last updated 20/11/2015

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