Last published: November 23, 2023
What is buprenorphine?
Buprenorphine (pronounced 'bew-pre-nor-feen') is a prescription drug.
It is taken as a replacement in the treatment of heroin and methadone dependence. Replacing a prescribed drug to treat a drug of dependence in this way is known as pharmacotherapy. As well as improving wellbeing by preventing physical withdrawal, pharmacotherapy helps to stabilise the lives of people who are dependent on heroin and other opioids, and to reduce the harms related to drug use.
Buprenorphine pharmacotherapy can be used to:
- help people to withdraw from heroin and methadone
- reduce the need to use heroin – this is known as buprenorphine maintenance
- treat severe pain.1
There are four formulations of buprenorphine available for people on pharmacotherapy treatment in Australia:
- Suboxone Sublingual Film® – A combination of buprenorphine and naloxone (also known as Narcan®). This is the most widely used form.
- Subutex Sublingual Tablets® – Contains only buprenorphine.
- Buvidal® is a modified release formulation of buprenorphine for administration by subcutaneous (SC) injection once a week (Buvidal® Weekly) or once a month (Buvidal® Monthly).
- Sublocade® is an extended-release formulation of BPN, administered monthly by SC injection.2-4
Bup, B, subs, bupe, orange
Other types of opioids
How is it used?
Suboxone Sublingual Film® is a lime-flavoured, rectangular, orange film, which is placed under the tongue to dissolve. The film will not work properly if it is chewed or swallowed.3
Subutex Sublingual Tablets® are also placed under the tongue to dissolve and will not work properly if chewed or swallowed.4
How effective is it?
Buprenorphine treatment is more likely to be successful if it is part of a comprehensive treatment program, which addresses the body, mind and environment in which opioids have been used.
For example, treatment may include a combination of buprenorphine, counselling, alternative therapies and the development of a positive support network of peers, friends and a support group. 1
Buprenorphine maintenance may not work for everyone, so it is important to work with a doctor or drug counsellor to find the best approach.
Advantages of buprenorphine maintenance over heroin use
- Using buprenorphine on its own is unlikely to result in an overdose.
- Buprenorphine maintenance keeps the person stable while they make positive changes in their lives.
- Health problems are reduced or avoided, especially those related to injecting, such as HIV, hepatitis B and hepatitis C viruses, skin infections and vein problems.
- Doses are required only once a day, sometimes even less often, because buprenorphine’s effects are long lasting
- Buprenorphine is much cheaper than heroin.5
Effects of buprenorphine
There is no safe level of drug use. Use of any drug always carries some risk. Even medications can produce unwanted side effects. It’s important to be careful when taking any type of drug.
Buprenorphine affects everyone differently, based on:
- size, weight and health
- whether the person is used to taking it
- whether other drugs are taken around the same time
- the amount taken.
The most common side effects of buprenorphine are:
- increased sweating
- tiredness or drowsiness (especially after a dose)
- loss of appetite, nausea and vomiting
- abdominal pain
- skin rashes, itching or hives
- tooth decay
- changes to periods (menstruation)
- lowered sex drive (males and females)
- weight gain (particularly for females).1, 6
Mixing buprenorphine with other drugs
Mixing buprenorphine with other drugs can have unpredictable effects and increase the risk of harm.
Buprenorphine and benzodiazepines: increases the risk of overdose, passing out, difficulty breathing, memory loss, and possible death.
Buprenorphine and alcohol: increases the risk of overdose, impaired coordination, passing out, memory loss, nausea, vomiting, and possible death.8,9,10
There are ways in which you can reduce the risks associated with using buprenorphine:
- Use only the recommended dose.
- Avoid driving or operating machinery. · Do not mix with other depressant drugs such as benzodiazepines, alcohol or other opioids.8,9,10
If your use of buprenorphine is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find help and support.
Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs
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Using buprenorphine without a prescription from a doctor, or selling or giving it to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain buprenorphine or a prescription for it.11
See also, drugs and the law.
Pharmacotherapy drugs (methadone, buprenorphine and naloxone)
On a snapshot day in 2021, 47,563 clients received pharmacotherapy treatment for their opioid dependence across Australia (excluding data for Queensland). There were 2,485 dosing points and 2,673 authorised prescribers of opioid pharmacotherapy drugs nationally.12
- NSW Health. Depot buprenorphine 2020 [25.08.2020].
- NSW Users and AIDS Association. Depot Buprenorphine: Frequently asked questions n.d. [25.08.2020].
- Victorian State Government. Brief clinical guidelines for use of depot buprenorphine (Buvidal® and Sublocade®) in the treatment of opioid dependence2020 [25.08.2020].
- Indivior Pty Ltd. Once monthly Sublocade (burprenorphine extended-release) Injection for subcutaneous use 2020 [25.08.2020].
- Camurus Pty Ltd. Buvidal Weekly 2019 [25.08.2020].
- Indivior Pty Ltd. Sublocade® 2020 [25.08.2020].
- Gowing L, Ali R, Dunlop A, Farrell M, Lintzeris N. National Guidelines for Medication-Assisted Treatment of Opioid Dependence. Department of Health 2014 [25.08.2020].
- Psychonaut Wiki. Buprenorphine 2022 [cited: 20.05.2022].
- Australian Prescriber. Buprenorphine 2001 [cited: 20.06.2023].
- Harm Reduction Victoria. Opioids n.d. [cited: 20.06.2023].
- DRUGS, POISONS AND CONTROLLED SUBSTANCES ACT 1981 - SECT 36B, (n.d.).
- Australian Institute of Health and Welfare. National Opioid Pharmacotherapy Statistics Annual Data collection. AIHW; 2022.