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Can Suboxone help with heroin dependence?

Yes, buprenorphine/naloxone (Suboxone) is approved for treating heroin dependence as part of a Medication for Addiction Treatment (MAT) plan. 

What is heroin? 

Heroin is an opioid drug made from morphine, a naturally occurring substance found in poppy plants. Heroin has been classified as an illegal drug since 1924 within the United States. 

Heroin can have various appearances and is frequently sold as a white or brown powder or a black sticky substance known as “black tar.” 

The drug is most commonly injected but may be smoked or snorted. Heroin can cause significant physical dependence since it is immediately absorbed, causing a “rush” of intense pleasure and wakefulness. 

As a result, many people who use heroin experience opioid use disorder (OUD). Over time, people become tolerant of heroin, requiring more of the substance to achieve the same pleasurable feeling and cause overdose or withdrawal if heroin is discontinued. 

Long-term heroin use can cause significant health problems such as: 

  • Chronic constipation
  • Depression 
  • Heart valve or lining infections 
  • Infertility 
  • Liver and kidney disease 
  • Lung diseases
  • Mental health disorders
  • Severe itching 
  • Skin infections
  • Trouble sleeping  
  • Vomiting 

People using heroin also may struggle with meeting personal obligations, mood swings, self-isolation, and denial about their heroin dependence. 

How does Suboxone help with heroin dependence? 

Buprenorphine/naloxone (Suboxone) is a combination of an opioid agonist/antagonist that binds to the same opioid receptors as heroin. 

Suboxone can help prevent withdrawal symptoms when a person stops taking heroin and reduce their cravings. It also is used as a maintenance medication to assist with recovery from OUD. 

Also, since Suboxone is a long-acting drug and has a much higher attractivity to the opioid receptors in the body, a person will not experience the pleasurable effects of heroin while using Suboxone. 

However, a person could still overdose from combining Suboxone with heroin or other drugs such as alcohol, benzodiazepines, illegal drugs, sedatives, or other medications that depress the central nervous system. 

When taken by itself, Suboxone has a very low risk of overdose due to its “ceiling effect” (the effects of Suboxone reach a maximum), but overdose is still possible, so it is important to use Suboxone only as directed by your MAT provider. 

Talk to an MAT provider if you need help with heroin dependence. More information regarding the treatment of heroin dependence can be found here.

Brittany Hoffmann-Eubanks, PharmD, MBA

Brittany Hoffmann-Eubanks, PharmD, MBA, received her Doctor of Pharmacy and Master of Business Administration degrees from Drake University College of Pharmacy and Health Sciences and completed her community pharmacy residency with Midwestern University and a local community pharmacy.

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