Buprenorphine

Buprenorphine is a medication approved by the Food and Drug Administration (FDA) to treat Opioid Use Disorder (OUD).

What is Buprenorphine?

Buprenorphine is a medication approved by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD) as a medication-assisted treatment (MAT). As with all medications used in MAT, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to provide patients with a whole-person approach.

Buprenorphine is the first medication to treat OUD that can be prescribed or dispensed in physician offices, significantly increasing access to treatment. The Drug Addiction Treatment Act of 2000 (DATA 2000), the Comprehensive Addiction and Recovery Act (CARA) and the Substance Use-Disorder Prevention Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act allows qualified practitioners to dispense or prescribe buprenorphine for the treatment of opioid use disorders (OUD) in settings other than opioid treatment programs (OTP), upon completion of specialized training.

Learn more about SAMHSA’s buprenorphine waiver certification or find buprenorphine waivered practitioners in your local area.

In addition, buprenorphine is also administered at SAMHSA-certified opioid treatment programs (OTPs). Learn more about certified/accredited OTPs or find a SAMHSA-certified OTP in your local area.

Several federal laws and regulations permit physicians and other medical personal to administer medications approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorders (OUD) under special circumstances without a buprenorphine waiver. Learn about these special circumstances.

How Buprenorphine Works

Buprenorphine is an opioid partial agonist. It produces effects such as euphoria or respiratory depression at low to moderate doses. With buprenorphine, however, these effects are weaker than full opioid agonists such as methadone and heroin.

When taken as prescribed, buprenorphine is safe and effective. Buprenorphine has unique pharmacological properties that help:

  • Diminish the effects of physical dependency to opioids, such as withdrawal symptoms and cravings
  • Increase safety in cases of overdose
  • Lower the potential for misuse

INDICATION

SUBOXONE® (buprenorphine and naloxone) Sublingual Film (CIII) is a prescription medicine used to treat adults who are addicted to (dependent on) opioid drugs (either prescription or illegal) as part of a complete treatment program that also includes counseling and behavioral therapy.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about SUBOXONE Film?

Keep SUBOXONE Film in a secure place out of sight and reach of children, and in a location not accessible by others, including visitors to the home. Accidental use by a child is a medical emergency and can result in death. If a child accidently uses SUBOXONE Film, get emergency help right away.

SUBOXONE Film can cause serious and life‐threatening breathing problems. Call your healthcare provider right away or get emergency help if:

  • You feel faint, dizzy or confused
  • Your breathing gets much slower than is normal for you

These can be signs of an overdose or other serious problems.

Do not switch from SUBOXONE Film to other medicines that contain buprenorphine without talking with your healthcare provider. The amount of buprenorphine in a dose of SUBOXONE Film is not the same as the amount of buprenorphine in other medicines that contain buprenorphine. Your healthcare provider will prescribe a starting dose of SUBOXONE Film that may be different than other buprenorphine containing medicines you may have been taking.

SUBOXONE sublingual film contains an opioid that can cause physical dependence with chronic use.

  • Do not stop taking SUBOXONE sublingual film without talking to your healthcare provider. You could become sick with uncomfortable withdrawal signs and symptoms because your body has become used to this medicine.
  • Physical dependence is not the same as drug addiction. Your healthcare provider can tell you more about the differences between physical dependence and drug addiction.
  • SUBOXONE Film is not for occasional or “as needed” use.

What is heroin?

Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants grown in Southeast and Southwest Asia, Mexico, and Colombia. Heroin can be a white or brown powder, or a black sticky substance known as black tar heroin. Other common names for heroin include big H, horse, hell dust, and smack.

How do people use heroin?

People inject, sniff, snort, or smoke heroin. Some people mix heroin with crack cocaine, a practice called speedballing.

What are the effects of heroin?

Heroin enters the brain rapidly and binds to opioid receptors on cells located in many areas, especially those involved in feelings of pain and pleasure and in controlling heart rate, sleeping, and breathing.

Prescription Opioids and Heroin

Prescription opioid pain medicines such as OxyContin® and Vicodin® have effects similar to heroin. Research suggests that misuse of these drugs may open the door to heroin use. Data from 2011 showed that an estimated 4 to 6 percent who misuse prescription opioids switch to heroin and about 80 percent of people who used heroin first misused prescription opioids. More recent data suggest that heroin is frequently the first opioid people use. In a study of those entering treatment for opioid use disorder, approximately one-third reported heroin as the first opioid they used regularly to get high.

This suggests that prescription opioid misuse is just one factor leading to heroin use. Read more about this intertwined problem in our Prescription Opioids and Heroin Research Report.

Short-Term Effects

People who use heroin report feeling a “rush” (a surge of pleasure, or euphoria). However, there are other common effects, including:

  • dry mouth
  • warm flushing of the skin
  • heavy feeling in the arms and legs
  • nausea and vomiting
  • severe itching
  • clouded mental functioning
  • going “on the nod,” a back-and-forth state of being conscious and semiconscious

Long-Term Effects

People who use heroin over the long term may develop:

  • insomnia
  • collapsed veins for people who inject the drug
  • damaged tissue inside the nose for people who sniff or snort it
  • infection of the heart lining and valves
  • abscesses (swollen tissue filled with pus)
  • constipation and stomach cramping
  • liver and kidney disease
  • lung complications, including pneumonia
  • mental disorders such as depression and antisocial personality disorder
  • sexual dysfunction for men
  • irregular menstrual cycles for women