Heroin and Suboxone | MyStreetHealth

Heroin

A short-acting opioid with intense withdrawal.

Heroin is an illicit opioid derived from morphine. It is a short-acting full opioid agonist — effects typically last 3 to 5 hours, which means withdrawal begins quickly after the last dose and can be severe.

Heroin use disorder is associated with increased overdose risk, rapid physical dependence, and withdrawal symptoms that are difficult to manage without medical support. Buprenorphine is one of the most effective treatments available.

Transition to buprenorphine

Heroin clears quickly — induction timing is often straightforward.

Because heroin is short-acting, it clears the body faster than many other opioids. Most patients can begin buprenorphine 6 to 12 hours after their last use, once mild to moderate withdrawal symptoms are present.

This makes induction generally more predictable than with longer-acting opioids. Your physician will assess your withdrawal status during your first visit and guide you through exactly when and how to take your first dose.

If you have been using street heroin, there is a significant chance it contains fentanyl. Fentanyl stays in the body longer than heroin and can affect induction timing. Your physician will discuss this with you.

Fentanyl in the heroin supply

Most street heroin now contains fentanyl.

Illicitly manufactured fentanyl has largely displaced heroin in the US drug supply in many regions. Many patients presenting for treatment have been using what they believed was heroin but was primarily or entirely fentanyl.

Fentanyl is highly lipophilic — it accumulates in body tissues and releases slowly over time. This means withdrawal may be more prolonged than expected, and induction timing may need to be adjusted. Your physician will assess this at your first visit.

See our fentanyl treatment page for more on how fentanyl affects buprenorphine initiation.

What treatment looks like

Simple to start. Continuous from there.

1

Call or text

Same-day visits often available. No referral needed. (888) 835-9995.

2

Meet your physician

Video visit from your phone or computer — no travel, no waiting room.

3

Prescription sent to your pharmacy

If appropriate, sent electronically the same day.

4

Ongoing care

Same physician every visit. Monthly appointments once stable.

Where we practice

Virginia · Maryland · Washington DC · West Virginia · Ohio

Heroin and Suboxone.