At Fight Addiction Now, we’ve written quite a bit about recovering from heroin and Suboxone, but there are still several frequently asked questions about both substances that we’d like to address.
In specific, we would like to address questions people have about detoxing from heroin and Suboxone (which usually happens separately, of course). Get answers to all of the pressing heroin and Suboxone detox FAQs here.
What Are the Similarities Between Heroin and Suboxone?
Heroin and Suboxone (generic name buprenorphine) both come from the opioid family of drugs, and you could argue that both are rather exclusive. Heroin is exclusive in the sense that it is illegal. You can’t just go to the doctor and get a prescription for it; you have to know where to look and whom to ask (not that we recommend you do).
So even though heroin is exclusive in this sense, hundreds of thousands of Americans have figured out how to get their hands on it. The drug causes 10,000 or more overdose deaths each year (at least since 2014), ruins the lives of countless others, and sends tens of thousands to rehab every year.
Suboxone is exclusive because it’s a prescription drug that’s usually only prescribed for a very specific reason: detox from other opioids. Even though this drug is supposed to help cease your addition to opioids, some patients end up being dependent on it.
Thus, heroin and Suboxone both carry addiction risks (and overdose risks, as well). Both also create feelings of euphoria when taken. However, the way each reacts in the brain is quite distinct.
What Are the Differences Between Heroin and Suboxone?
People use heroin not only to numb pain, especially when their prescription for a legal opioid has run out, but also to experience feelings of pleasure and euphoria. Higher doses of this illegal drug can induce a floating, dream-like state.
Suboxone does has some pain-relieving properties, but not as strong as heroin does. People with low opioid tolerances may experience some euphoria when taking Suboxone, but it’s not one of the drug’s primary characteristics. Instead, as previously mentioned, Suboxone’s main intent is to help people overcome their physical dependence on other opioids, such as heroin.
The main difference between these two drugs in question is that heroin is a full agonist, while buprenorphine is a partial agonist. Full agonists such as heroin, morphine and oxycodone activate the opioid receptors in the brain and release the full opioid effect. Partial agonist activates the same receptors, but to a much lesser extent.
Suboxone also has antagonist properties, meaning it blocks the effects of other opioids. This is thanks to the substance naloxone that is present in Suboxone. Classifying buprenorphine solely as an opioid blocker would be misleading, however. It’s in its own category and is not a replacement or substitution for any other opioid.
Are There Similar Withdrawal Symptoms Between Heroin and Suboxone?
Heroin and Suboxone certainly share some of the some withdrawal symptoms. But instead of only listing the common symptoms between the two, we will give the full lists of withdrawal symptoms for each, with the similar ones in bold.
Potential withdrawal symptoms of heroin include:
- Elevated heart rate
- Diarrhea and vomiting
- Irritability and/or aggression
- Excessive sweating
- Muscles spasms and aches
- Difficulty concentrating
- Anxiety attacks
- Abdominal pain
- Tremors and convulsions
Potential Suboxone/buprenorphine withdrawal symptoms include:
- Nausea and vomiting
- Muscle aches
- Insomnia or drowsiness
- Difficulty concentrating
- Digestive issues (indigestion)
- Fever or chills
- Anxiety and/or depression
- Drug cravings
As you can see, there is great overlap between the two forms of withdrawal. The primary difference is that the more extreme symptoms of heroin withdrawal (hallucinations, seizures, convulsions, etc.) aren’t typically seen in Suboxone withdrawal.
What Is the Heroin Withdrawal Timeline Like?
The heroin withdrawal timeline will differ according to the severity of the addiction, but here is the average timeline to expect in detox:
- 6 to 24 hours after the last dose: Acute withdrawal begins.
- 2 to 3 days in: Symptoms peak.
- 5 to 10 days in: Heroin completely leaves the system, and acute withdrawal concludes.
After acute withdrawal, you still have to watch for recurring symptoms, known as post-acute withdrawal syndrome, which can last months or years.
We’ve written an entire article if you would like to know more about what to expect in heroin withdrawal:
How Long Is the Suboxone Withdrawal Timeline?
The withdrawal timeline of Suboxone is similar to that of heroin, but Suboxone has slightly more noticeable mental health effects after the acute withdrawal period. Much of this is because buprenorphine has quite a long half-time, meaning it stays in the system longer.
The Suboxone withdrawal timeline will vary for each user, but the average timeline looks like:
- First 24 hours after the last dose: Acute withdrawal will begin at some point during day one.
- 3 days in: Symptoms reach their highest intensity.
- 1 week in: Acute withdrawal begins to subside, but body aches, mood swings and insomnia linger.
- 2 weeks in: Physical symptoms subside as depression begins to take over.
- 1 month in: Depression may persist, and drug cravings start to return.
Since Suboxone withdrawal tends to drag out before finally going away, it’s best to seek professional detox and long-term care to overcome this addiction. It’s especially crucial since the cravings for Suboxone are a threat to return after the traditional 30-day treatment period.
Will I Be Given Suboxone to Detox from Suboxone?
Many detox programs will try to find natural ways to help you overcome Suboxone withdrawal. However, the medical professionals may deem that the best way to get you off Suboxone is with a tapered Suboxone regimen, ironically.
That’s why it’s best to look for a certified medication-assisted treatment (MAT) program to help you get off Suboxone. Such a program will start you with a manageable dose of Suboxone and then strategically wean you off the drug for good, in a way that minimizes the withdrawal symptoms.
What Is Suboxone Detox Tapering Like?
If you enter a MAT-certified drug rehab center where you’re planning to stay from detox to inpatient and even to the outpatient stage, the staff can taper you off Suboxone more slowly. For example, the medical providers might taper your dose down by 25 percent every 10 days.
But if you enter a standalone detox facility and need to be off Suboxone before you move on to the next stage of recovery, the detox team may deploy an emergency buprenorphine taper. This means they will wait until the onset of withdrawal, and then administer small doses of buprenorphine (e.g. 1 milligram or smaller) every hour until withdrawal is tolerable. Withdrawal still won’t be easy, but you will be stable and ready to come off Suboxone by the time you leave the facility.
For long-term buprenorphine tapering, it’s best to take your full dose at the beginning of the day and not spread it out over every few hours. This way, there is no need to think about it for the rest of the day, and you won’t be sitting around waiting anxiously for the next dose. This protocol is also beneficial because it will be harder to adjust to eventually taking Suboxone zero times per day when you were used to taking it two to four times each day.
Can I Use Kratom Instead of Suboxone to Detox from Opioids?
Kratom is an herbal substance that has some pain-relieving, stimulant and psychotropic (mind-altering) properties. This substance has been banned in a handful of states and certain counties within states, but it is legal in a majority of the U.S.
We’ve heard stories of people turning to kratom instead of Suboxone to help them beat opioid addiction, including from our own readers. There has even been some talk about using kratom as a supplement to Suboxone.
It’s hard for us to attest to the effectiveness of using kratom during opioid detox, as the evidence is all anecdotal at this point, and kratom is not federally approved for detox treatment. All we can say is that if you want to read more about the kratom vs. Suboxone conversation, you can go here:
Can I Detox from Either Heroin or Suboxone at Home?
If you’ve only been on small doses of heroin or Suboxone for a short time, that’s one thing. But if you have a full-blown addiction to either one of these drugs, definitely do not try to detox at home. Why?
- Heroin withdrawal can be fatal. If you’re at the point of withdrawal where you start experiencing seizures, death is a legitimate risk if you’re not under medical supervision.
- Suboxone detox is tricky and should be handled by professionals. Although Suboxone withdrawal is rarely deadly, relapse is a big risk because the drug takes a long time to get out of your system, and the symptoms linger for months. This makes people want to stop the withdrawal symptoms by taking more buprenorphine.
If you need help for yourself or a loved one in finding Suboxone or heroin treatment, Fight Addiction Now can help guide your search for the right program. Click on “Start Chat Now” or use our contact form to get in touch with an expert.