Is Suboxone the Answer to Heroin Addiction?


Suboxone is currently the most popular opiate replacement drug. It has become big business for one simple reason; people who decide to stop using opiates learn from the recovery and treatment community that they are too weak to go through detox without a replacement drug regimen. That lie is bad enough, (millions go through opiate withdrawal with no treatment whatsoever successfully each year) but suboxone supporters then magnify the untruth by saying that not only is suboxone needed in the detox process, but after the individual is detoxed they will also need to be on suboxone for life.

Just like methadone maintenance used to be, suboxone maintenance is the new opiate cure-all. So, rather than spend a few days detoxing from opiates and moving on as free individuals, they learn that they need to take a drug that mimics heroin or other opiates for the rest of their lives or risk a lapse back into uncontrolled heroin use. This lifelong suboxone regimen supposedly gives them a way to avoid those few days of potential discomfort in the detox process and also stay off opiates for the rest of their lives, but at what price? Are you really free if you believe you need suboxone because you are too weak to stay away from opiates? It comes right back to the power of drugs myth doesn’t it!

The lifelong replacement therapy theory is rooted in the myth that no one can be emotionally strong enough to withstand a few days of detox discomfort – that if they are faced with the possibility of withdrawal, they will avoid detoxification altogether and instead remain an active opiate user. And, if that user is somehow successfully detoxed, the newly sober individual will always need their suboxone crutch or face inevitable relapse – because again, they have an inherent weakness.

If you learn that you are weak, (and this is a learned concept!) that opiates are more powerful then you are, and that you NEED a substitute that shields you from heroin, then it is fairly easy to sign up for suboxone treatments and never wander far from your local drug store or doctor. This is all part of the recovery movement our culture advances daily. We once again see that decisions are made based on beliefs in weakness, not in the facts of natural human resiliency that we see the world over. The fact is this: people get over opiate use (and all other substance use) by the millions every year with no crutches and they have done so with opiates for centuries. They become free based on the choice to detox their bodies and then move on. They reject recovery (and remember, replacement “therapy” is just another tool of the recovery movement) and choose freedom instead.

Suboxone does have some value in the actual temporary detox process, where it can be administered to curb the potential discomfort of opiate withdrawal. We don’t deny this. However, suboxone has withdrawal potential of its own, so it must be very carefully limited and monitored with the goal of being tapered completely just like the opiates themselves. Used in this manner, it is a tool that has a very limited scope in its benefits, but those benefits exist.

However, that is not where the suboxone story ends. The replacement drug therapy lie is that you will NEED a continued regimen for life or you are certain to return to problematic opiate use.  As is the case with all the recovery society half-truths they miss the all-important point with the replacement drug model, and that is why the person likes to get high in the first place! Because this portion of the issue is ignored completely and goes unanswered, the person eventually stops their suboxone treatments (because suboxone doesn’t get you as high as heroin in comparable respective dosages) and returns to opiate use and is seen by recovery society members as a recovery failure. As a whole, suboxone replacement therapy it is a remarkably ineffective and damaging method to deal with problematic opiate use because the reasons for one’s use are never addressed in this model.

If we want to actually help people create an abstinent lifestyle or one of reduced use, the answer lies not in fear tactics, but in addressing why someone makes the decision to continue their use. This is the source of all use – one’s desires and motives for a brief moment of satisfaction, relief and happiness. By sidestepping the actual reasons people create to continue their use while convincing that individual that they can’t stop or reduce without suboxone’s magic, we are continuing the false belief in the “power of heroin.” It’s time to let go of drug mythology and address people where they are and why they make the choices to use or not to use. Because in the end, no one, not even the hardened and tired “addict” does anything they don’t want to do.

  • Paul

    But the things stated in this article about “what suboxone-supporters say” are… bizarre and simply untrue.

    Where do these claims come from? I have never seen anyone except this piece’s author making the arguments he asserts are coming from the side he is arguing against.

    Fighting against a straw-man, much?

    • Mark Scheeren

      I realize that your
      experience may be exactly as you state, and I respect that perspective. I have
      been helping people with substance use issues for more than 26 years, and in
      this capacity I have daily access to people who struggle with heroin and other
      opiates, as well as access to many in the medical community who advocate
      heavily for daily suboxone maintenance. Try to remember, suboxone is promoted
      as a replacement drug therapy, and as such it replaces heroin or opiates in
      daily long term users. While this approach sounds like an improvement (taking
      suboxone instead of heroin or painkillers), why not simply stop using
      altogether since that is the purpose of detox to begin with – at least it used
      to be before methadone and suboxone et al. Today I meet people nearly daily who
      have been convinced by the medical community (in this case suboxone certified
      doctors) that they must remain on suboxone long term or deal with increased
      risk of relapse. This trend makes little sense when the individuals I am describing
      are detoxing to be free from opiates and not to be living with a
      “need” for suboxone for the rest of their days.

      • Paul

        Well while your 26 years might have seniority over me, the fact is that suboxone only became available as a treatment option for opioid addiction in 2002.

        Being that you write (and I presume, work) for an institution that avoids any new treatment options, I do question where you have come across people taking the position you write so vociferously against in your normal routine.

        I’m going to preface what I am about to say with a disclaimer that I only bring it up as a point of reference for the tone in which you raise your opponents arguments. That said, it reminds me of a young earth creationist railing against what they’ve been taught is “evolutionists” arguments–flimsy, brazen, and illogical–wholly dissimilar to anything you might hear from an actual proponent to the position they are fighting.

        I would be flabbergasted if there exists any physicians out there who, upon reflection as to why they prescribe a patient suboxone, that it involves in any way, shape, or form a derogatory summation of that patient’s personal character. Certainly not in the reason behind their writing of a suboxone prescription.

        The way this article is written sounds like a physician who despises suboxone as much as you do, yet for some reason prescribes it anyway. If such doctors do exist out there, they ought to find another line of work.

        • Babe

          The prescribing doctors don’t “despise” suboxone, they advocate for it. What better job security than to have every new patient in “need” of a lifelong replacement therapy. The second sentence in this article states; “it has become big business for one reason…” In my humble opinion, from the medical “professional” standpoint, as with many other medical treatments, it is all about money to the prescriber, not about the best option for a successful and happy life for the patient. Doctors don’t do much of their own research before prescribing a medicine. They might, but they don’t have to. They are recruited by the pharmaceutical companies that manufacture and distribute the drug through pharmaceutical representatives, then should the doctor have interest in prescribing the medication to his/her patients they attend informational seminars again put on by the pharmaceutical companies per FDA requirements. Of course, they are “informed” of the negative side effects and possible drug interactions, its all on the pamphlet you get when you pick up any prescription, again, courtesy of the pharmaceutical manufacturer and FDA approval. Between the pharmaceutical manufacturer, the FDA, and the medical provider, do you really think that any of these organizations truly has the best interest of a struggling addict desperate for a substance-free life at heart? I HIGHLY doubt it. In fact, why would they develop a drug that is a partial opioid agonist, partial antagonist as a opiate maintenance regimen when there is already a highly successful regimen developed that is 100% long term opioid antagonist? Because, money. That is the only thing they care about. What about someone who clearly advocates for life long sobriety free from the need for maintenance programs and in favor of non-profit effective rehabilitation and alternative methods outside of the outrageously ineffective common 12-step process, do you think he has the best interest of the addict at heart? More likely than the profiting agencies. SO, what are YOU advocating?

          I do not know the author of this article, I don’t know what his credentials are, and I am not a professional. I am an addict and I have been thorough in my research about these “recovery assistant drug therapies.” It is OKAY to be a skeptic. It is amazing to me that my personal opinion of Suboxone maintenance programs matches the attitude expressed in this article 100% prior to reading it. Again, I am a 100% unbiased perspective. Have a good day, and don’t be such a dick to someone who is trying to do some good in the world.