Virtually all heroin detox centers use Suboxone. The difference is that they use it in gradually reducing doses to wean you off the heroin, while doctors who are authorized to prescribe Suboxone generally do so for the long term. These doctors can also wean you off Suboxone, but typically they have regular repeat patients month after month. All licensed physicians can prescribe buprenorphine, the narcotic component in Suboxone, for pain. However, in most states, doctors cannot prescribe the drug for opioid maintenance without a special permit to do so. They must follow strict guidelines. Their patient caseload is limited to a certain number, too.
The Risks Of Heroin
If you have decided to stop using heroin, you should be proud of that decision. If you’ve ever tried to stop before and have experienced heroin’s withdrawal symptoms, then you already know what you’re up against. Suboxone may be able to help you stay clean from heroin permanently. You will no longer risk death and serious health problems from using the drug. After all, there is no such thing as pharmaceutical heroin in the United States. It’s a Schedule I controlled substance, meaning that it’s not only in the most restricted drug category there is, but also that is has no accepted medical use. If you inject heroin, you are at special risk for a heart valve infection known as endocarditis. You could also easily overdose.
The heroin available on the streets of the United States is produced in clandestine laboratories under questionable conditions. It’s safe to assume that there is little regard for cleanliness or quality control. It’s all about the money. If someone dies from a batch that is contaminated or too strong, do you think anyone involved really cares?
Heroin Cut With Fentanyl
Much of the heroin sold in the US is also cut with fentanyl. Fentanyl is about 50 times stronger than heroin. It’s not hard to see how an overdose could easily occur. Many fentanyl overdose addicts have been discovered with a needle still in their arms. They didn’t even stay alive long enough to remove it.
A heroin detox center will most likely want to wean you off all opioids, including the Suboxone they will use to treat your heroin withdrawal symptoms. They will do this gradually. Although you may face some limited withdrawal symptoms towards the end of your detox, you should not be in pain or great discomfort during this time. If you can’t at least eat, drink water and otherwise function, then something is wrong. Be sure to speak up. Your dose may be too low. Other meds may help.
It’s true that not everyone is helped by Suboxone. If your heroin use was extreme, you may fall into this category. Some people just don’t get good results from Suboxone. Not everyone is the same. There are very few drugs that work for everyone who takes them.
You must decide if you want to be completely drug-free or not. If you think you can’t handle a drug-free life, then perhaps you should see a physician or facility authorized to prescribe Suboxone on a regular monthly basis. It’s better than using heroin.
Suboxone or Methadone?
Your other option is methadone detox or methadone maintenance, or MMT. First of all, there is an important chemical difference between Suboxone and methadone. Suboxone and methadone are both synthetic opioids, but only methadone is a full agonist, or full narcotic. Suboxone is only a partial agonist. This basically means that they act upon the brain’s opioid receptors in different ways. Both drugs can occupy and activate the opioid receptors, but only methadone has a full effect. Suboxone’s effect is more of a partial one. That’s why is produces little euphoria. It’s also why it has what is called a ceiling effect. This last term means that once a certain amount of Suboxone has been ingested, it will have no further pain or withdrawal relief effects.
Here are some facts:
- Overdose from methadone is more likely than overdose from Suboxone
- Methadone can safely be taken during pregnancy
- Methadone requires daily trips to a clinic
- Suboxone can be filled at any pharmacy and taken in the privacy of your home
- Suboxone may be of limited use for some people
- Methadone, given in sufficient doses, will relieve opioid withdrawal symptoms in virtually everyone
Both Suboxone and methadone have a long half-life. This means that they are long-acting in the body. Both need be taken only once a day. Both will block the brain’s opioid receptors for time period of up to several days from a single dose. This blockage will prevent any kind of effects from other opioids taken while the blockage is active.
Suboxone does have an important disadvantage: the client must be in full withdrawal from their drug of choice when the Suboxone is administered. This means that the client must suffer through withdrawal for at least 48 hours before they can get relief. This is asking a lot. Because Suboxone is only a partial agonist, it can cause precipitated withdrawal if taken too early in the withdrawal process. Precipitated withdrawal means that the drug will actually make the client’s withdrawal symptoms worse.
Worse than that, the drug will block the brain’s opioid receptors for at least a couple days. During this time, no relief from other opioids will be possible. Never take Suboxone unless and until your body is ready for it. Never lie to rehab or detox staff about the last time you used.
In contrast, methadone, a full narcotic agonist, can be taken at any stage of withdrawal. It will provide complete relief from symptoms. Some people don’t get enough withdrawal symptom relief from Suboxone. These people will probably need to use methadone. Methadone does have one major disadvantage: you will be required to attend a clinic daily to get your dose. This can be disruptive to your life and work routine, especially if there is no methadone clinic near you. Some clinics do allow limited take-home doses after you have complied with their program requirements for a certain period of time. Others never allow this practice.
If you need help deciding on if you should go to detox or rehab, we are here to help. Call us 24 hours a day at 866-802-6848. A trained counselor will be able to help you make the right treatment decision for you. We look forward to speaking with you.