Can the suboxone doctor be able to tell if i don't stay away from herion for 48 hours?

If you aren't in: withdrawal, he may not want to treat you. If you have heroin on board when you take your first dose of buprenorphine, it is very likely to throw you into withdrawal, which can be severe. Doctors are trained to make sure that people who start on suboxone/subutex have not recently used other opioids and are at least in mild withdrawal. If you just used, your pupils will be pinpoint as well.

See below: The need to wait is based on the risk of induced withdrawal which is only seen when patients are on morphine equivalent of 200 mg or more. This is less than half of active users. If you don't mind this potential reaction, there is no need to wait. Very few of my patients wait that long