What is buprenorphine?
Buprenorphine is a prescription opioid with different formulations to treat opioid dependence and chronic pain. For the treatment of opioid dependence, it is taken as a regular dose to remove the need for illicit (such as heroin) or other opioids.
When used for opioid dependence, buprenorphine is often referred to as opioid agonist treatment (OAT) or opioid substitution treatment (OST). When used as OAT, it is prescribed as a sub-lingual film that is placed under the tongue to dissolve, or as a long-acting depot injection.
Those participating in a buprenorphine treatment program with are generally receive a daily dose of the drug, although for people who have been stable in treatment for a long time there is the option to collect medication weekly or even monthly.
Buprenorphine is prescribed by a doctor and the size of the dose is determined according to the characteristics of the individual.
New buprenorphine formulations
In sub-lingual form, buprenorphine is formulated with naloxone. If the contents of the film are injected, the naloxone activates and triggers acute opioid withdrawal.
Depot buprenorphine is a new long-acting formulation that has recently became available. One injection lasts for anywhere between one week to one month depending on which injection is used. There are two depot buprenorphine products at this time: Buvidal® and Sublocade®. Both are available on the Pharmaceutical Benefits Scheme (PBS) under a S100 opioid dependence listing (NSW Health, 2021).
What are the effects?
People in opioid agonist treatment with buprenorphine are less likely
to use additional or illicit opioids, have reduced infections, better health and are less likely to become involved in the criminal activities often associated with illicit drug use.
The side effects of buprenorphine may include:
- 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 (males and females)
When taken as prescribed as part of a treatment program, buprenorphine generally has no severe long-term effects on health.
What are the risks?
Toxicity and overdose
As with other prescription opioids, buprenorphine can suppress respiration resulting in fatal
overdoses, however, buprenorphine is known to have less effect on respiration compared
with other opioids. Buprenorphine can also cause sedation, although this is thought to be
less than other opioids such as methadone.
Dependence and withdrawal
Withdrawal from long-term use of buprenorphine may produce some symptoms similar to those experienced through withdrawal from other opioids, such as heroin or morphine.
It is recommended that withdrawal from buprenorphine is achieved gradually under medical supervision to prevent discomfort and unpleasant effects for the person. Withdrawal symptoms vary from person to person, but may include:
- Cold or flu-like symptoms
- Headache
- Sweating
- Aches and pains
- Difficulty sleeping
- Nausea
- Mood swings
- Loss of appetite
These effects usually peak in the first two to five days. Some mild effects may last a number of weeks (ADF, 2020).
How many people use buprenorphine?
According to the Australian Institute of Health and Welfare, on a snapshot day in June 2019, 50,945 people in Australia were on a course of pharmacotherapy treatment for opioid dependence.
From 2010 to 2019, treatment with:
- Buprenorphine rose slightly (from 14 percent to 17 percent of clients)
- Buprenorphine-naloxone increased (from 17 percent to 23 percent of clients) (AIHW, 2020)
Emergency info
If you, or someone around you, is experiencing undesired or distressing psychological or physical symptoms from the intake of alcohol or other drugs please seek immediate medical attention.
If you need urgent help from ambulance services call Triple Zero (000). If a person has been mixing drugs with alcohol or other drugs, tell the paramedic exactly what has been taken.
Services
For free and confidential advice about alcohol and other drugs, call the National Alcohol and Other Drug hotline on 1800 250 015.
The hotline will automatically direct you to the Alcohol and Drug Information Service in your state or territory.
More resources
The Illicit Drug Reporting System is an Australian monitoring system that identifies emerging trends of local and national interest in illicit drug markets.
The Ecstasy and Related Drugs Reporting System is an Australian monitoring system for ecstasy and related drugs that identifies emerging trends of local and national interest.
The Clinician’s Guide to Illicit Drugs and Health examines the health effects of each of the major illicit drugs.
The Australian Institute of Health and Welfare collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia.
The Australian Bureau of Statistics is Australia’s national statistical agency, providing official statistics on a range of economic, social, population and environmental matters of importance to Australia.
Sources
Alcohol and Drug Foundation (2019). Buprenorphine. Retrieved from https://adf.org.au/drug-facts/buprenorphine/
Australian Institute of Health and Welfare (2020). National Opioid Pharmacotherapy Statistics Annual Data collection 2019. Retrieved from https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics-2019
Darke, S., Lappin, J., & Farrell, M. (2019). The Clinician’s Guide to Illicit Drugs and Health, Great Britain: Silverback Publishing.