Is There Really a Difference Between Heroin and Suboxone?

Suboxone is given to hundreds of thousands of people in America as a treatment for addiction to opioids. Suboxone is promoted as a real “solution” to addiction but most people choosing this solution are never told the whole story of what they are in for. We’ll give you some of this untold story and compare the effects of Suboxone to those of heroin and let you make up your mind about the advisability of this solution.

First, we’ll cover a few definitions.

Heroin paraphernalia

Heroin: An illicit drug refined from the sap of the opium poppy. Its potency can vary wildly from weak to nearly pure, meaning that it is very difficult for an addicted person to control their dosage. Therefore, it is all too easy to overdose.

Opioids: A category of drugs that includes most painkillers, heroin and other illicit drugs that are chemically similar.

OxyContin – a painkiller.

Painkillers: Of course, a painkiller is any drug that interrupts the transmission of pain in the body. Most painkillers that people become addicted to are synthetic or semi-synthetic opioids.

Suboxone: This is a relatively new formula containing buprenorphine, an opioid painkiller, and naloxone, a drug that reverses the effects of opioid drugs. Naloxone is included in this formula to make it harder for the patient to get high from an opioid he wants to abuse while he's taking Suboxone. This formula is marketed for the treatment of addiction.

No Withdrawal – But the Individual is Still Addicted to Opioids

Those taking Suboxone for addiction to heroin or painkillers can then stop taking heroin or other opioids without going through the usual tortuous withdrawal sickness. But the reason there’s no withdrawal is because Suboxone itself contains an addictive opioid drug. The individual is still addicted to an opioid for the duration of the treatment. Some doctors use Suboxone as a temporary bridge to a sober life and others plan on keeping their patients on this drug for the rest of their lives.

Advocates for the use of Suboxone/buprenorphine claim that users don’t get high on this replacement drug, they stay on their treatment programs and they live healthier lives. Are these claims true?

There’s some truth. But as we said, there’s more to the story. First, let’s look at the effects of Suboxone. Then we’ll compare them with the effects of heroin.

The Effects of Suboxone

Here are some of the effects of using Suboxone.

A sleepy man with a headache
  • Respiratory suppression
  • Sleepiness
  • Dizziness
  • Problems with coordination
  • Low blood pressure
  • Blurred vision
  • Constipation
  • Headache
  • Intoxication
  • Impaired ability to drive a car or operate machinery
  • Slow reflexes
  • Reduction of immunity to illness or infection
  • Sleeping problems
  • Cold or flu symptoms
  • Nausea
  • Emotional highs and lows

One doctor administering Suboxone stated that “A lesser dose of Suboxone (2 mg a day) will block an estimated 80 percent of a person’s feelings, while higher doses can make a patient practically numb.” This doctor also describe the effect of long-term use of Suboxone: “Loss of interest in sex, hair loss and abnormalities in how the body deals with emotions and stress.”

The effects of Suboxone do not include quenching a person’s cravings to get high. And treatment with Suboxone does nothing to get to the root of a person’s problems that led them to drug abuse in the first place.

Can a Person Get High on this Drug?

The more a person is unused to opioids, the more likely it is that they can get quite high. Those addicted to opioids may abuse Suboxone for the high they can get or they may save it for a day they can’t get their hands on their preferred opioids, perhaps heroin or OxyContin or Opana. Or they may sell this drug on the street.

Suboxone is widely abused inside and outside of jails. The website describes the effect of Suboxone as a “mild euphoria that can last for around eight hours.”

Suboxone is touted as an excellent solution for opioid addiction but those who are prescribed this drug tell a different story. 

Effects of Heroin

Compare that list of Suboxone effects to this list of heroin effects.

  • Respiratory suppression and slowed breathing
  • Unclear thinking
  • Memory loss
  • Itching
  • Nausea
  • Euphoria
  • Dry mouth
  • Flushed skin
  • Constricted pupils
  • Sleepiness, grogginess
  • Lowered immunity
  • Constipation

Does Suboxone Really Help?

According to SAMHSA, Suboxone is supposed to be offered as part of a well-rounded recovery program. Per their website: “buprenorphine is prescribed as part of a comprehensive treatment plan that includes counseling and participation in social support programs.” However, most doctors and other practitioners who are qualified to prescribe this drug are not trained in addiction recovery. Many simply prescribe this medication and have no resource for offering the re-education, counseling or life skills training that are needed for a person to create a new, sober life for himself (or herself).

Without real help to change one’s approach to living, a person may continue to crave the escape from reality that opioids has been offering. A Maryland recovery center outlined the problem for those who do not get this vital help to change their thinking and way of life:

A woman still craving drugs.
Taking Suboxone does not eliminate cravings for the effects of drugs.

“Often they replace opiate use with increased problem drinking or the use of other illicit drugs like cocaine or benzodiazepines like Xanax . Many still suffer from underlying emotional or traumatic issues that are never addressed. And when these people finally realize that their ‘solution’ of Suboxone has become a problem and actually want to get off the crutch, they find it harder to do than the opiate they were originally trying to get off of in the first place.”

Also, a person may not suffer withdrawals from opioids while on Suboxone but he may still crave the high and use illicit or prescription opioids to try to get that high anyway. Adding heroin or painkillers on top of Suboxone can result in respiratory distress, coma, or even death.

As the New York Times reported, the use of Suboxone has triggers the growth of “a volatile subculture” that traffics in this drug for purposes that are not therapeutic. There are cash-only buprenorphine clinics for the addicted who can’t get heroin or pills or who want to abuse it recreationally. It’s also a popular drug of abuse inside prisons.

And Finally – Withdrawal

If a person taking either drug wants to stop taking it, what is the withdrawal like?

For heroin, the symptoms of withdrawal peak after about 72 intensely uncomfortable hours. Withdrawal will last four to ten days.

The withdrawal from Suboxone can last much longer. One rehab center described the withdrawal process like this:

  • 72 hours: Physical symptoms at their worst
  • 1 week: Bodily aches and pains, insomnia, and mood swings
  • 2 weeks: Depression
  • 1 month: Cravings and depression

Is There a Better Way?

A doctor or other practitioner who’s been sold on the use of Suboxone as treatment for heroin or other opioid addiction may not consider the downsides of this drug. However, many people want to break free from all addictive substances and forge a new, healthy lifestyle for themselves. With the right kind of support, rehab can result in an abstinent life that can truly be enjoyed.

Every family or addicted individual facing a decision about rehab and recovery would be wise to educate themselves on all the effects and outcomes of Suboxone treatment for addiction. As a short-term bridge, it may help some people ease out of addiction, as long as they quickly receive the other help they need to recover fully from the harmful physical, mental and spiritual effects of their past drug abuse.


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.