Buprenorphine facts

What is buprenorphine?

How effective is buprenorphine?

Side effects of buprenorphine

Withdrawal

Getting help

Australia's national drug policy

Please note: The information given on this page is not medical advice and should not be relied upon in this way. The information is correct at the time of publication. People wanting medical advice on this issue should consult a health professional.

What is buprenorphine? 

Buprenorphine (pronounced bew-pre-nor-feen) is available by prescription, under the name of Subutex^®, as a treatment for heroin dependence.

It has been found to be effective in reducing the need to continue using heroin (buprenorphine maintenance) and also in helping people to withdraw from heroin and methadone. Buprenorphine is also prescribed to treat severe pain.

Other names 

bup, B

What does it look like?

Subutex^® comes in tablet form.

How is it used?

Subutex^® tablets are taken sublingually (placed under the tongue to dissolve). Chewing or swallowing the tablet will make it ineffective.

How effective is buprenorphine? 

Treatment, including for heroin or other opioid dependency, is more likely to be successful if it is part of a comprehensive treatment program.

Often a range of factors contribute to an individual’s use of drugs. Thus, it is strongly recommended that those wanting to remain free of heroin engage in a treatment program that addresses the physical (the body), psychological (the mind) and environmental issues relating to the person’s drug use. This may involve combining several treatment approaches, such as buprenorphine maintenance, counselling, alternative or holistic therapies (such as massage and naturopathic treatment), and developing a positive support network including peers, family, friends and support groups.

As with any type of treatment or approach to heroin dependency, buprenorphine maintenance may be effective for some people but will not suit everyone. A doctor or drug counsellor who spends time assessing the person’s specific situation and explaining different options will recommend an approach that is appropriate for that individual.

Buprenorphine is one of a number of maintenance treatments for heroin dependence. Others include:

• methadone (if using buprenorphine, the transfer to methadone can occur rapidly)

• naltrexone (if using buprenorphine, the transfer to naltrexone can take place within 3–5 days).

Read more about treatment

Advantages of buprenorphine maintenance treatment 

There are many benefits of being on buprenorphine maintenance, when compared with continuing the use of heroin:

• Maintenance treatment holds the person stable while they readjust their lives.
• Using buprenorphine on its own is unlikely to result in an overdose.
• 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.

There is no safe level of drug use. Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.

What are the side effects? 

Similar to other opioids, the most common side effects are:

• constipation
• headache
• 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
• weight gain (particularly for women).

Other effects of buprenorphine use

Taking buprenorphine with other drugs

The effects of mixing buprenorphine with other drugs, including alcohol, prescription medications and over-the-counter medicines, are often unpredictable.

Mixing buprenorphine with other depressant drugs (such as alcohol or benzodiazepines) increases the depressive effects and can result in an increased risk of respiratory depression, coma and death.

Pregnancy and breastfeeding

Read about the effects of taking drugs during pregnancy or breastfeeding.

Driving 

It is dangerous to drive during the early stages of buprenorphine treatment or when the dose has been increased. The effects of buprenorphine, such as drowsiness and reduced reaction times, can affect driving ability. The symptoms of coming down and withdrawal can also affect a person’s ability to drive safely.

Read more about the effects of drugs on driving.

Buprenorphine use in the workplace

Under occupational health and safety legislation, all employees have a responsibility to make sure they look after their own and their co-workers’ safety. The effects of buprenorphine drowsiness and reduced reaction times can affect a person’s ability to work safely and effectively.

Preventing and reducing harms

Injecting Subutex is dangerous, and can lead to severe vein damage, blood clots and other health complications.

Withdrawal 

Withdrawal from long-term use of buprenorphine may produce symptoms similar to those experienced from heroin withdrawal. However, withdrawal symptoms tend to be milder with buprenorphine than those from methadone and other opioids.

Withdrawal symptoms vary from person to person, but may include: 

These effects usually peak in the first 2 to 5 days. Some mild effects may last a number of weeks.

Getting help

Treatment

In Australia, there are many different types of treatments for drug problems. Some aim to help a person to stop using a drug, while others aim to reduce the risks and harm related to their drug use. Find out more about treatment.

What to do if you are concerned about someone’s illicit use of buprenorphine

If you are concerned about someone’s drug use, there is help available. Contact the alcohol and drug information service in your state or territory.

What to do in a crisis

Always call triple zero (000) if a drug overdose is known or suspected—and remember that paramedics are not obliged to involve the police.

If someone overdoses or has an adverse reaction while using buprenorphine, it is very important that they receive professional help as soon as possible. A quick response can save their life.

Visit the Better Health Channel to read St John Ambulance’s advice on drug overdose.

Australia's national drug policy

Australia’s national drug policy is based on harm minimisation. Strategies to minimise harm include encouraging people to avoid using a drug through to helping people to reduce the risk of harm if they do use a drug. It aims to reduce all types of drug-related harm to both the individual and the community.

Last updated:  13 December 2011