Buprenorphine

What is Buprenorphine?

Buprenorphine is a semi-synthetic opioid medication used primarily in the treatment of opioid use disorder (OUD). It works as a partial opioid agonist, meaning it activates opioid receptors enough to prevent withdrawal and reduce cravings but not enough to produce the intense euphoria associated with full opioids like heroin or oxycodone. This unique pharmacology allows buprenorphine to stabilize individuals in recovery and reduce the risk of overdose. Medically, it is prescribed in formulations such as Suboxone® (buprenorphine/naloxone), Subutex® (buprenorphine alone), Bunavail®, and Sublocade® (a long-acting injectable). These come as sublingual tablets, films, or monthly injections.

Illicit or non-prescribed buprenorphine can also appear on the street, typically as diverted prescription tablets or films. Recreational misuse is less common than with other opioids due to buprenorphine’s “ceiling effect,” which limits the level of euphoria it can produce. However, some individuals misuse buprenorphine to self-treat withdrawal, maintain opioid dependence without medical supervision, or combine it with other substances. Because of its role in treatment programs, monitoring appropriate use vs. misuse is often necessary.

Effects:

• Reduced opioid cravings and withdrawal symptoms

• Mild euphoria at low doses (less than full opioids)

• Sedation or drowsiness

• Constipation

• Headache and nausea

• Sweating or flushed skin

• Reduced respiratory depression compared to full opioids

• Potential for dependence if misused

• Precipitated withdrawal if taken too soon after other opioids

• Impaired coordination or slowed reaction time