Buprenorphine is a medicine used to treat opioid use disorder. It belongs to the opioid class of medicines, but it works differently from opioids such as morphine, oxycodone, or heroin. It is considered a first-line, evidence-based treatment that significantly reduces overdose risk, improves functioning, and supports recovery.
Sublingual buprenorphine is taken by placing a film or tablet under the tongue (or between the cheek and gum) and allowing it to dissolve. It must not be swallowed — absorption through the gut is very poor.
Most people are prescribed Suboxone, which contains buprenorphine and naloxone together. The naloxone component is included to deter misuse: if the film is dissolved as directed under the tongue, naloxone has almost no effect. However, if the product is injected, the naloxone is absorbed and can trigger sudden opioid withdrawal.
Buprenorphine is a partial opioid agonist. This means it activates opioid receptors in the brain, which:
Because it binds tightly to opioid receptors (high receptor affinity), it can actually precipitate withdrawal if taken too soon after a full opioid agonist. Your doctor will advise you on timing.
You will usually be asked to be in mild-to-moderate opioid withdrawal before your first dose (typically a score of ≥8 on the Clinical Opiate Withdrawal Scale). This is to reduce the risk of precipitated withdrawal. Your doctor will guide you through this process and discuss the timing carefully.
There are also low-dose or "microdose" starting protocols available for people who cannot easily stop their current opioid before starting — your doctor can explain whether this is an option for you.
Many side effects settle within the first few weeks. Tell your doctor if they persist or are troublesome.
There is no fixed duration. Many people benefit from taking buprenorphine for an extended period — months to years — and this is associated with better outcomes. Stopping prematurely greatly increases the risk of relapse and overdose. Any decisions about reducing or stopping should be made with your psychiatrist.
Your prescription is managed carefully through a specialised dispensing program. Initially, dispensing may be daily or near-daily (supervised consumption) — and as stability is demonstrated, take-away doses may be arranged.
Please bring any questions to your next appointment. You can also contact the rooms on 03 9834 3600. In an emergency or crisis, call 000 or go to your nearest hospital emergency department.
Clinical content informed by: the RACGP National Guidelines for Medication-Assisted Treatment of Opioid Dependence (MATOD); and the Therapeutic Goods Administration (TGA) approved product information for Suboxone® (Indivior). These sources are publicly available at racgp.org.au and tga.gov.au.