the facts about
 

BUPRENORPHINE
 

for Treatment of
 

Opioid Addiction
 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Substance Abuse and Mental Health Services Administration 

Center for Substance Abuse Treatment 

www.samhsa.gov 

i 
 

 

 

 

“I’d been shot on the streets, I’d been in

detox. It was jails, institutions.... Death,

I knew, was imminent for me...so I started 

my recovery process.... It’s been 15 years

since, and my life has never been better.” 

Walston B. 

How do you escape from the misery and risks of drug 

addiction? Most people cannot do it on their own. They need 

help to return to normal, healthy living. One important form 

of help is called medication-assisted treatment. 

There are three, equally important parts to this form of 

treatment: 

•	Medication 

•	Counseling 

•	Support from family and friends. 

Buprenorphine is one type of medication used for treatment 

of opioid addiction. Perhaps your doctor or substance abuse 

treatment provider has recommended it for you, or perhaps you 

already take it. This booklet gives you the facts you need to know. 

NOTE: Important words often used in treatment are 

introduced in this booklet in bold type.

ii 
Opioid addiction is a disease. 

Opioids are drugs that slow down the actions of the body, such as 

breathing and heartbeat. Opioids also affect the brain to increase 

pleasant feelings. They get their name from opium, a drug made 

from the poppy plant. 

	 	

Opioid medications are prescribed to treat pain and sometimes 

for other health problems such as severe coughing. Heroin is an 

illegal opioid that is smoked, snorted, or injected to get a good 

feeling, often called a “rush” or “high.” People also sometimes 

seek this feeling by taking large doses of prescription opioids. 

If you take opioids, you can become tolerant to them. This 

means that more of the drug is needed to obtain its effects. It 

is also possible to become dependent on opioids. This means 

that if you stop taking them, you will feel sick. This sickness is 

called withdrawal. Dependence is not the same as addiction, 

but sometimes dependence leads to addiction. The signs of 

addiction are: 

•	Craving—The mind develops an overwhelming desire for 

the drug. 

•	Loss of control—It becomes harder to say no to using the 

drug. Use is compulsive and continues even though the drug 

causes harm. 

Tolerance and dependence are common side effects of 

prescribed opioid medication that can be managed under a 

doctor’s care. Tolerance and dependence also are side effects 

from misuse of opioids. Addiction is not likely to develop in a 

person using medication properly, but this sometimes happens. 

Addiction usually occurs through misuse. Some people are at 

higher risk of addiction because of their genes, temperament, 

or personal situation. 

1 

1
Not everyone who uses opioids gets addicted. But it is difficult to 

stop using opioids after you have become addicted, because the 

cravings are so strong and the fear of withdrawal is so great. 

Opioid addiction can be treated. 

Opioid addiction is a chronic disease, like heart disease or dia

betes. A chronic disease is a medical condition for life. It cannot 

be cured, but it can be managed. A person with addiction can 

regain a healthy, productive life. 

­

But if you are like most people, you cannot walk away from 

addiction on your own. Treatment—the care of medical professionals and substance abuse treatment providers—can help. 

Treatment helps you give up the problem drug. It helps you get 

through withdrawal and cope with cravings. Treatment also 

helps you change addictive thinking into nonaddictive, healthful patterns. It can help you move away from other harmful 

behaviors, too, such as drinking alcohol or abusing other drugs 

besides the problem opioid. 

Just as important, treatment helps you address life issues you 

might have that are tied to the addiction, such as feelings of 

low self-worth, a bad situation at work or home, or spending 

time with people who use drugs. In short, treatment helps you 

move into a healthy, addiction-free lifestyle—into a way of living 

referred to as recovery. 

Treatment may include medication. 

Medication-assisted treatment is treatment for addiction 

that includes the use of medication along with counseling and 

other support. Treatment that includes medication is often the 

best choice for opioid addiction. 

2 
 

 

 

If you are addicted, medication allows you to regain a normal 

state of mind, free of drug-induced highs and lows. It frees you 

from thinking all the time about the drug. It can reduce problems of withdrawal and craving. These changes can give you the 

chance you need to focus on the lifestyle changes that lead back 

to healthy living. 

Taking medication for opioid addiction is like taking medication to 

control heart disease or diabetes. It is NOT the same as substi

tuting one addictive drug for another. Used properly, the medica

tion does NOT create a new addiction. It helps you manage your 

addiction so that the benefits of recovery can be maintained. 

Buprenorphine is a medication used 

to treat opioid addiction. 

Buprenorphine is one of three medications commonly used to 

treat opioid addiction. The other two are methadone and naltrexone. Cost varies for the different medications. You may need 

to take this into account when considering your treatment options. 

The person who takes buprenorphine feels normal, not high. 

However, the brain thinks it is receiving the problem opioid, so 

­

­

withdrawal symptoms stay away. Buprenorphine also reduces 

cravings. If cravings continue to be a problem, your doctor will adjust your medication or help you find other ways to reduce them. 

3 
You take buprenorphine as a pill that dissolves under the 

tongue. You do NOT chew or swallow it. There are two forms. 

Suboxone® contains buprenorphine plus another medication 

called naloxone. The naloxone is added to prevent abuse—it 

brings on withdrawal in people who abuse buprenorphine by 

injecting it. Subutex® contains only buprenorphine. This form 

is prescribed if you should not take naloxone for any reason, 

such as if you are allergic to it or are pregnant. 

The pill is taken once a day. Over time, the dose interval may 

stay at once a day or change to every other day. 

The main advantages of buprenorphine are: 

•	You are unlikely to overdose on buprenorphine if you take it 

properly. 

•	Buprenorphine is long acting. This means that after an initial 

period, your doctor may have you take the pill every other 

day rather than once a day. 

•	Doctors can prescribe buprenorphine so that you can take doses 

at home. Important: Not all doctors have approval to prescribe 

this medication, and not all doctors provide counseling for addic

tion. Also, daily check-in at a treatment center can be helpful to 

recovery. Therefore, for some people, a treatment center is the 

best place to receive medication for opioid addiction. 

Buprenorphine may be prescribed if 

it is the right choice for you. 

Before you are given the first dose of any medication for opioid 

addiction, your doctor will ask you questions about your addiction, 

health, and other problems. You will get a drug test—usually a 

check of urine or saliva. You also will have a physical exam and 

tests for diseases that are common to people who have been 

­

44 
 

 

abusing drugs. Your liver will be checked to make sure the 

medication can be safely taken. If buprenorphine is safe and 

appropriate for you, your doctor may recommend it. 

You and your doctor or substance abuse treatment provider 

decide together on a treatment plan. The plan describes the 

medication routine, the counseling and other services that will 

be provided, and the rules that must be followed. These rules 

will be explained to you and you will get them in writing. 

Buprenorphine must be used carefully. 

Your doctor will prescribe a low dose to start taking after with

drawal symptoms begin. Dose levels may be adjusted up as 

needed. Always take doses exactly as prescribed by your doctor. 

Buprenorphine can make you feel drowsy at first. You should not 

drive or perform other high-risk tasks until you know how this 

­

medication affects you. If drowsiness continues to be a problem, 

your doctor may adjust dose levels. 

You may take buprenorphine for days, months, or years—as 

long as it is needed to prevent relapse. However, you should be 

checked often by a doctor if you have liver disease. 

If you are stable in recovery and want to stop taking buprenorphine, 

you must do it slowly, over time. This is called tapering. Tapering 

works best with the help of your doctor or substance abuse treatment provider, after progress has been made in treatment. 

5
Buprenorphine has side effects in 

some people. 

Side effects are feelings of discomfort or sickness that come 

with taking medicine. Buprenorphine has a few mild side effects. 

Usually these go away after the medication is taken for a while. 

If you have side effects, you should NOT stop taking the medica

tion. Instead, talk with your doctor or substance abuse treatment 

provider. An adjustment in dosage or a change in medication may 

help. There are some simple things you can do to reduce side 

effects, too. 

Warnings

•	While taking this medication, you should NOT take other

medications without consulting your doctor first. 

•	While taking this medication, you should NOT use illegal

drugs, drink alcohol, or take sedatives, tranquilizers, or other 

drugs that slow breathing. Taking any of these substances 

in large amounts along with buprenorphine can lead to 

overdose or death. 

•	Buprenorphine kept at home must be locked in a safe place 

to prevent accidental use by others, especially children. 

•	If you are a woman and are pregnant or breast-feeding,

methadone is safer than buprenorphine for mother and 

child. In special circumstances, doctors may recommend the 

naloxone-free form of buprenorphine instead of methadone. 

Ask your doctor for more information. 

•	Liver problems are rare but can occur. If you have a 

pre-existing liver condition, your doctor should conduct 

regular tests on your liver. 

­

6 
7 

CoMMon SIde	effeCTS 

and SIMpLe WayS	To ReduCe TheM

Body aches, headaches, and cold- or flu-like symptoms— 

Check with your doctor about over-the-counter 

medicines you may take. 

dizziness—Stand up slowly. Call your doctor if problems 

persist. 

Constipation—Drink more water and juice. Eat food with 

fiber. Exercise more. 

Sweating—Shower often. Dress in layers. 

Sleep problems, including tiredness—Take the pill in the 

morning. Avoid naps. Go to bed at the same time every 

night. Exercise. Do not drink caffeine after lunchtime. 

upset stomach or vomiting—Take the pill after you have 

eaten. Take an antacid product as directed by your doctor. 

Mood swings—Exercise more. Do fun things that do not 

involve the old drug lifestyle. Relax. Talk to your substance 

abuse treatment provider. 

Serious side effects—For extreme stomach pain, vomiting, 

or diarrhea, contact your doctor right away. Also seek 

help if the following side effects appear, because they may 

indicate serious liver problems: 

•	 Dark or tea-colored urine

•	 Bad stomachache

•	 Light-colored bowel movements

•	 Yellowing in the whites of the eyes 

•	 Yellow skin. 
Counseling can help. 

Medication is one part of treatment for opioid addiction. 

For many people, another important part is counseling: the 

opportunity to talk with a professional either one-on-one or 

in a group with others in treatment. 

Through counseling, you learn about the motivations and 

behaviors that led to your opioid addiction. You learn how to 

commit to a more healthful lifestyle. You gain support and skills 

while working with others to manage your recovery long term. 

Counseling can provide you with encouragement and with 

motivation to stick to treatment. It can help you learn how to 

make healthy decisions, handle setbacks and stress, and move 

forward with your life. 

In group counseling, you connect with others in treatment 

and make new friends who don’t use drugs. You can get these 

benefits from support groups, too. These are informal 

meetings of people facing similar challenges. 

88 
Family and friends are important, too. 

It is very hard to go through recovery alone. Support from 

family and friends is very important. Love and encouragement 

can help you make the decision to enter treatment and stick 

with it. 

Some treatment programs offer counseling for your loved ones. 

They do this because your addiction may have caused pain and 

anger or feelings of shame and hopelessness. 

Counseling is a useful way for family and friends to learn more 

about your situation, how to help, and how to handle the 

problems your addiction has caused them. It is a safe place for 

them to express feelings and to find out what help is available 

for everyone affected. 

There are support groups for family and friends, too. These 

are safe places to share information and encourage others who 

have loved ones who are dealing with addiction. 

Many people with an opioid addiction regain normal, healthy 

lives. One way they do this is with medication-assisted treatment. Medication, counseling, and support: together they can 

help you, your loved ones, and your friends. 

“The treatment center that I was at had 

a lot of education about addiction. They

talked about it as a disease and not a 

moral failing.... I had a medical condition....

And that was a big relief for me to hear

that and to be able to realize that recovery

was possible.” 

Tom C. 

9 

9
		

	 	 	

	 	 	 	 	 	 	

	 	

	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	

	 	

acts 	 f The

addICTIon

WhaT’S	TRue and	WhaT’S	noT

addiction is a disease. It cannot be cured, but it can 

be treated with medication, counseling, and support 

from family and friends. Addiction is NOT a sign of 

weakness. It is NOT TRUE that all you need to kick 

addiction is to “be strong.” 

The goal of medication-assisted treatment is to

recover from addiction. It does NOT replace one 

addictive drug with another. It provides a safe, controlled level of medication to overcome the use of a 

problem opioid. 

a	substance abuse treatment provider must

obtain your informed consent (agreement in

writing) before sharing information about you

with others. There are two exceptions to this 

privacy rule: (1) if it appears that you may harm 

yourself or others and (2) if you have been ordered 

into treatment by the courts. To learn more about 

your privacy rights, talk to your substance abuse 

treatment provider. 

Recovery is possible. But it takes work. After treatment is finished, everything is NOT automatically fine 

again. Recovery takes commitment every day, through 

treatment and beyond. 

10 
		

	 	 	 	 	 		

	 	 	 	 	

	 	 	 	

	 	 	 	 	 	 	

	 	

BupRenoRphIne

WhaT’S	TRue and	WhaT’S	noT

Buprenorphine helps you think and function

normally. It is legal and taken under a doctor’s care. 

It is NOT just another drug to abuse. 

Buprenorphine is produced under safe conditions and sold legally. There is no risk of getting 

tainted doses, which can happen with street drugs. 

Also, risk of overdose on this medication is very small. 

you can stop taking buprenorphine when you

are ready. You can become dependent on buprenorphine, as with many medications taken over time. For 

this reason, if you wish to stop taking buprenorphine, 

you should work with a substance abuse treatment 

provider to taper off. This prevents withdrawal 

symptoms from appearing. 

11 

The	f acts
	 	 		

	 	

Support groups and information 

•	This is not a complete list. Listing here does not mean that 

the Substance Abuse and Mental Health Services Administra

tion (SAMHSA) endorses any of the organizations. 

•	Some support groups have abstinence-only policies and do 

not look favorably on medication-assisted treatment. The 

programs listed here do not have such policies, but individual 

group meetings vary. You may need to try several support 

groups to find the right one. 

•	Some support programs are just for people with a substance 

use disorder, and others allow families and friends to attend 

meetings or have separate meetings for them. Check with 

each organization for details. 

•	An Internet-based support group may be your best option 

if no groups meet in your community. Another option is to 

contact Alcoholics Anonymous (AA, http://www.aa.org) to 

find out whether AA meetings in your community are open 

to people in recovery from other substances besides alcohol. 

­

dual Recovery anonymous

http://www.draonline.org or 913-991-2702 

LifeRing

http://www.unhooked.com or 800-811-4142 

national alliance of advocates for Buprenorphine

Treatment

http://www.naabt.org 

Rational Recovery

http://www.rational.org or 530-621-4374 

Secular organizations for Sobriety

http://www.cfiwest.org/sos/index.htm or 323-666-4295 

1212 
SMaRT Recovery

http://www.smartrecovery.org or 866-951-5357 

Women for Sobriety, Inc.

http://www.womenforsobriety.org or 215-536-8026 

Buprenorphine physicians and 

treatment program locator 

800-662-HELP (4357) (English and Español) 

800-487-4889 TDD (for hearing impaired) 

http://buprenorphine.samhsa.gov/bwns_locator/index.html 

Free booklets 

•	The Facts About Naltrexone for Treatment of Opioid 

Addiction (SMA) 09-4444 (also in Spanish) 

•	Medication-Assisted Treatment for Opioid Addiction: Facts 

for Families and Friends (SMA) 09-4443 

•	Introduction to Methadone (SMA) 06-4123 

•	Faces of Change: An Illustrated Booklet for Consumers 

(SMA) 08-4174 

•	What Is Substance Abuse Treatment? A Booklet for Families 

(SMA) 08-4126 (also in Spanish: (SMA) 08-4098) 

•	Motivación para el Cambio (Spanish only) PHD1133 

How to get free copies 

1. Ask your substance abuse treatment provider. 

 

 

2. Contact SAMHSA’s Health Information Network (SHIN) at 

877-SAMHSA-7 (877-726-4727) (English and Español). 

3. Order from SHIN’s Web site at http://www.samhsa.gov/shin. 

4. Download the products from http://www.kap.samhsa.gov. 

13 
“What I’ve found in my life is that 

the more people I know that I tell that 

I’m a person in recovery..., then the 

more people will be able to carry that 

message to their friends and family 

and say, ‘Hey, I know somebody who 

doesn’t use drugs anymore who used 

to, and his life has gotten better. 

Maybe you can give this a try.’”—

Dan P.

aCknoWLedgMenTS

This booklet was produced by JBS International, Inc., under Contract No. 270-04-7049 

with the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental 

Health Services Administration (SAMHSA), U.S. Department of Health and Human 

Services (HHS). 

All material appearing in this booklet is in the public domain and may be reproduced 

or copied without permission from SAMHSA. Citation of the source is appreciated. 

However, this publication may not be reproduced or distributed for a fee without 

specific written authorization from the Office of Communications, SAMHSA, HHS. 

This publication may be downloaded or ordered at http://www.samhsa.gov/shin. Or, 

please call SAMHSA’s Health Information Network at 877-SAMHSA-7 (877-726-4727) 

(English or Español).

HHS Publication No. (SMA) 09-4442 

Printed 2009