suboxone

I am prescriber suboxone but have not been taking it and doing heroin. I want to get back on my suboxone but last time i tried i was still sick as a dog after i took 2 8 mg. tablets. How long should i wait in terms of hours between my last use of heroin and my first taking of my suboxone

[J T Junig, MD PhD]

It depends on the tolerance you have established to the heroin.  If your tolerance is very high, you want to be off heroin (and all opiates) for a long enough time for your tolerance to drop, so that the Suboxone doesn't 'yank' it down and make you sick.

In general, if you are off all opiates for a good 48 hours you should be OK-- unless you were on methadone, in which case I'd double that, at least.  But even if you DO get precipitated withdrawal, all is not lost-- just keep taking the Suboxone each morning, 16 mg, (more won't make it any better), and within 3 days you will be almost completely free of withdrawal.  Precipitated withdrawal is miserable, but it does not last long, as long as you don't take any agonists.  Just stick with the Suboxone, no matter what, and you will be much better after a few days.