What Is Buprenorphine?

Buprenorphine is a prescription opioid used for pain relief and as part of treatment for opioid dependence. It can help reduce cravings and withdrawal symptoms, making it easier for someone to stop using heroin or other opioids under medical supervision.

The medicine works differently from full opioid agonists such as heroin and methadone. It attaches strongly to opioid receptors but produces a more limited opioid effect. This makes it useful in opioid dependence treatment, although it can still cause physical dependence and other side effects.

This guide explains what buprenorphine is, what it is used for, how it works, its effects and side effects, and how it is used in addiction treatment.

What Is Buprenorphine?

Buprenorphine is an opioid medicine that acts on the same receptors in the brain affected by other opioids. It is classed as a partial opioid agonist, meaning it activates these receptors but produces a smaller opioid effect than full opioid agonists.

Buprenorphine has a strong attraction to opioid receptors. In opioid dependence treatment, this allows it to reduce withdrawal symptoms and cravings while helping the person remain stable without relying on heroin or other non-prescribed opioids.

It is a prescription medicine and should only be taken as directed by a healthcare professional. The form and treatment plan depend on why buprenorphine is being prescribed.

What Is Buprenorphine Used For?

Buprenorphine has two main medical uses. It can be prescribed for moderate to severe pain, with certain forms designed for pain relief, and it can be used as part of treatment for opioid dependence. The formulation and dose depend on the reason for treatment.

For opioid dependence, buprenorphine helps control withdrawal symptoms and cravings. This can reduce the need to use heroin or other non-prescribed opioids and allow the person to take part in wider addiction treatment and recovery support. UK guidance recognises buprenorphine as one of the medicines that can be used for opioid dependence.

Buprenorphine does not treat every part of addiction on its own. Treatment can also include psychological support, recovery planning and help with other problems that may affect substance use.

Types of Buprenorphine and How It Is Taken

Buprenorphine comes in several forms, and the way it is taken depends on the formulation and the reason it has been prescribed.  The dose, timing and length of treatment are decided by a healthcare professional based on the person’s needs.

1) Sublingual Tablets

Sublingual buprenorphine tablets are placed under the tongue and allowed to dissolve. The medicine is absorbed through the tissues in the mouth instead of being swallowed like an ordinary tablet. This allows buprenorphine to enter the bloodstream without being broken down in the digestive system first.

Sublingual tablets are commonly used as part of treatment for opioid dependence. They can reduce withdrawal symptoms and opioid cravings, helping someone remain stable while they receive further addiction treatment and support.

The tablet should be used exactly as prescribed. It should not be chewed or swallowed unless the prescribing instructions specifically say otherwise. Some opioid dependence medicines combine buprenorphine with naloxone in the same tablet.

2) Buccal Films

Buprenorphine is also available as a buccal film, which is placed inside the mouth against the cheek. The film sticks to the inside of the cheek and gradually dissolves, allowing the medicine to pass through the lining of the mouth.

The film should be left in place until it has dissolved. It should not normally be chewed or swallowed whole because this can affect how the medicine is absorbed.

Buccal buprenorphine can be prescribed for certain types of pain and, depending on the specific medicine, may also be used in opioid dependence treatment. The instructions can differ between products, so the person should follow the directions given by their prescriber or pharmacist.

3) Transdermal Patches

Transdermal buprenorphine is delivered through a skin patch. The patch slowly releases buprenorphine into the body over a set period, providing continuous pain relief instead of requiring repeated doses throughout the day.

These patches are mainly prescribed for ongoing pain. The patch is applied to the skin in the area recommended by the healthcare professional and is replaced according to the prescribed schedule.

The patch should not be cut, damaged or used more often than prescribed. Heat can also affect how some medicines are absorbed through the skin, so people using a buprenorphine patch should follow the product instructions about heat sources and other precautions.

4) Long-Acting Buprenorphine Injections

Long-acting buprenorphine injections are given by a healthcare professional and are designed to release buprenorphine gradually over a longer period. They can be used in opioid dependence treatment for people who are suitable for this type of treatment.

Unlike tablets or films that may need to be taken regularly, an injection can provide a longer-lasting dose. This can make it easier for some people to follow their treatment plan and reduces the need to take medication at home every day.

The timing of injections depends on the specific medicine and treatment plan. They should only be given according to the prescribing schedule and by an appropriately trained healthcare professional.

5) Buprenorphine and Naloxone

Some medicines used for opioid dependence contain both buprenorphine and naloxone. They are available in forms such as sublingual tablets or films, depending on the specific product.

Buprenorphine helps reduce opioid cravings and withdrawal symptoms, while naloxone is included to reduce the potential for misuse of the medicine by injection. When taken as directed, buprenorphine is the main component responsible for the treatment effect.

The medicine should be taken exactly as prescribed. A healthcare professional will explain how and when to take it, particularly when starting treatment after using heroin or another opioid. Starting buprenorphine too soon after another opioid can cause sudden withdrawal symptoms, so the timing of treatment needs to be medically supervised.

How Does Buprenorphine Work?

Buprenorphine attaches strongly to opioid receptors in the brain. It activates these receptors enough to reduce opioid withdrawal symptoms and cravings, but its effects are more limited than those produced by full opioid agonists.

Its strong attachment to the receptors also means it can block or reduce the effects of other opioids. This is useful in treatment, but it also means the timing of the first dose matters.

Someone who is physically dependent on opioids can experience precipitated withdrawal if buprenorphine is taken too soon after another opioid. The medicine can displace the other opioid from the receptors and cause withdrawal to begin suddenly. A healthcare professional should decide when treatment should start based on the person’s opioid use and withdrawal symptoms.

What Does Buprenorphine Feel Like?

When taken as prescribed for opioid dependence, buprenorphine is intended to reduce withdrawal symptoms and cravings and help the person feel more stable. It can cause opioid effects, but these are generally more limited than those produced by full opioid agonists.

Some people may feel sleepy, dizzy, tired or sick, particularly when they first start taking it. These effects can become less noticeable as the body adjusts to the medicine. (NHS)

Taking more than prescribed or combining buprenorphine with alcohol, sedatives or other medicines that slow breathing can increase the risk of serious harm.

What Are the Effects and Side Effects of Buprenorphine?

Buprenorphine can help reduce opioid withdrawal and cravings, but it can also cause side effects. The effects vary between people and can depend on the formulation and other medicines being taken.

Can You Become Addicted to Buprenorphine?

Yes, physical dependence can develop with regular buprenorphine use. Buprenorphine is an opioid, so the body can become used to having it, which can cause withdrawal if treatment is stopped suddenly.

Physical dependence is not the same as addiction. Someone taking prescribed buprenorphine as part of opioid dependence treatment may become physically dependent without misusing the medicine. The treatment should be monitored by a healthcare professional, and any decision to reduce or stop it should be made with their guidance.

How Can AnorMed Help With Opioid Addiction Treatment?

AnorMed is an independent addiction treatment referral service, not a medical clinic or rehab provider. Our advisors can help you understand the treatment options available for opioid addiction and connect you with suitable rehabilitation providers across the UK and Europe.

Treatment can involve medically supervised detox, opioid substitution treatment, residential rehab, outpatient care and psychological support. The right approach depends on the person’s substance use, physical health, mental health and treatment needs.

If you are already taking buprenorphine and want to reduce or stop it, speak to your prescriber or another qualified healthcare professional first. AnorMed can help you explore addiction treatment options, but medication decisions need to be made by a medical professional.

FAQs

Is buprenorphine the same as methadone?

No. Both medicines can be used to treat opioid dependence, but buprenorphine is a partial opioid agonist while methadone is a full opioid agonist. A healthcare professional can advise which treatment is suitable.

How long does buprenorphine stay in your system?

Buprenorphine can remain in the body for several days because it has a long half-life. How long it can be detected depends on factors such as the dose, frequency of use and type of drug test.

Can you drink alcohol while taking buprenorphine?

Alcohol can increase the sedating effects of buprenorphine and raise the risk of serious breathing problems. Speak to your prescriber about alcohol use while taking the medicine.

Can you drive while taking buprenorphine?

Buprenorphine can cause sleepiness, dizziness and reduced concentration. Do not drive if you are affected by these symptoms, and follow your doctor’s advice about driving while taking the medicine.

Is buprenorphine used during opioid detox?

Yes. Buprenorphine can be used to manage withdrawal and as longer-term opioid substitution treatment. The treatment plan depends on the person’s opioid use and clinical needs.