Can you use weed while on Suboxone®?

As more states legalize recreational weed and medical marijuana, many people in treatment for opioid use disorder (OUD) wonder: Can I use weed while taking Suboxone®? Will it help with cravings or withdrawal? Could it interfere with my medication?

Some people believe marijuana can help with anxiety, pain, and opioid withdrawal, while others worry it could increase relapse risk or interfere with Suboxone’s effects. So, what does the research say? Let’s break it down.

How do marijuana (weed) and Suboxone interact?

Both marijuana and Suboxone affect your body’s systems in different ways. When used together, they can interact in complex ways that might impact your recovery. Let’s look at how they affect specific body systems.

The respiratory system

Smoking marijuana can irritate your lungs and airways, potentially causing symptoms like chronic bronchitis or inflammation. According to the American Lung Association, smoking marijuana damages the lungs’ first line of defense against infection by killing cells that help remove dust and germs. When combined with Suboxone, using marijuana might put additional stress on your respiratory system and increase the risk of respiratory complications, slowing down breathing to dangerously low levels. So, adding another respiratory irritant like marijuana might not be ideal for your overall health.

The nervous system

Both Suboxone and THC (the psychoactive compound in marijuana) affect your central nervous system (CNS). Suboxone works by binding to opioid receptors in the brain to reduce cravings and withdrawal symptoms. THC works through the endocannabinoid system, which also has widespread effects throughout the CNS. When two substances that both influence the nervous system are used together, they can amplify certain effects. That may include increased sedation, risk of respiratory depression, slowed reaction time, and difficulty concentrating.

The cardiovascular system

Marijuana temporarily increases heart rate in the period right after use, sometimes significantly. Suboxone itself is generally safe for heart health when used as prescribed, but combining it with THC may still cause uncomfortable effects like heart palpitations, dizziness, or changes in blood pressure, particularly in people who already have heart concerns. If you have a history of heart issues, it’s definitely worth mentioning to your doctor to make sure you’re keeping an eye on things. Research also suggests that regular marijuana use may be linked to a higher long-term risk of certain cardiovascular events.

The brain

This is where things get particularly important for people in recovery. THC activates the brain’s reward system by releasing dopamine, the same system that opioid use affects. For someone working to rebalance their brain chemistry through MAT, introducing THC can interfere with that process. It may also worsen symptoms of anxiety, depression, or other mental health conditions that sometimes accompany OUD. Over time, heavy marijuana use has been linked to changes in memory, motivation, and emotional regulation, areas that are already often affected during OUD recovery.

The liver

Both marijuana compounds (THC and CBD) and Suboxone are processed through your liver’s cytochrome P450 enzyme system. Studies have shown that CBD can inhibit certain liver enzymes that metabolize medications. For people who take Suboxone, this can potentially affect medication levels and how the body processes them. This could lead to stronger medication effects or increased side effects. Regular marijuana use could affect how consistently your Suboxone works, making it important to discuss any cannabis use with your healthcare provider.

What happens if you smoke marijuana while on Suboxone?

Marijuana contains THC, the psychoactive compound responsible for producing a high. While some states allow medical marijuana use for pain, PTSD, and other conditions, its effects on patients taking Suboxone are more complex.

Risks of using marijuana while on Suboxone

For people currently in recovery from OUD, the risks of marijuana use outweigh the potential benefits. Here’s why:

• THC may trigger cravings or relapse: THC activates the brain’s same reward system as opioids, triggering dopamine and feelings of euphoria. Over time, this may increase cravings and the temptation to return to opioid use. 
• May interact with Suboxone: Combining THC and Suboxone can depress the central nervous system, potentially leading to increased drowsiness. Both THC and Suboxone depress the central nervous system, potentially leading to increased drowsiness, dizziness, cognitive impairment, or respiratory depression.
• Legal and employment concerns: Even in states where medical marijuana is legal, some workplaces prohibit THC use. It typically shows up on standard drug tests, which could affect employment or treatment program requirements.

What does the research say about cannabis for opioid use disorder?

A 2022 review by the Canadian Agency for Drugs and Technologies in Health (CADTH) examined whether cannabis could help treat opioid use disorder (OUD) by reducing cravings, improving treatment retention, or lowering opioid use.

Key takeaways from the study

• No strong evidence supports cannabis as an effective treatment for OUD.
• Studies showed mixed results—some found cannabis helped, others found no effect, and some suggested it could worsen treatment outcomes.
• Cannabis had no proven impact on relapse rates, hospitalizations, overdoses, or overall quality of life for people in addiction treatment.
• A Canadian clinical guideline strongly advises against using cannabis for OUD due to a lack of conclusive evidence.
  

Why this matters

Despite growing interest in cannabis as a possible tool for recovery, this review found no clear benefit. Experts recommend sticking with proven treatments like Suboxone (buprenorphine) and methadone until more high-quality research is available. Your care team at QuickMD will always keep you updated as new research emerges.

Get expert guidance on Suboxone and recovery with QuickMD

You already took one of the most important steps by starting MAT. Along the way, new questions are going to come up, and that’s completely normal. Whether you’re wondering about a supplement, a medication interaction, or something you read online, you don’t have to figure it out alone.

Your QuickMD care team is here for exactly these moments. From the comfort and privacy of your own home, you can connect with your doctor whenever you need to, with same-day appointments 24/7, even on holidays. You can rely on them to take your questions seriously and help you stay informed without judgment, no matter what you’re going through.