Buprenorphine for opiate addiction
How buprenorphine works, the forms it comes in, how the first dose goes and who can prescribe it.
Find treatment near youUpdated October 2026. Sources are linked on this page.
The short answer
- What it is
- A prescription medicine that quiets opioid withdrawal and cravings, taken under the tongue or given as a shot.
- How long
- As long as it helps. Many people take it for years, and there is no required end date.
- What it costs
- Covered by every state Medicaid program and most insurance. Ask which form your plan prefers.
How buprenorphine works
Buprenorphine attaches to the same receptors in the brain that heroin, fentanyl and pain pills do. It switches them on only partway. That is enough to stop withdrawal and settle cravings, but its effects are weaker than those of full opioids.
It also holds on to those receptors firmly. While it is there, other opioids have less effect. Taken as prescribed, it lets most people feel normal instead of high or sick.
This page goes deep on one medicine. To see how it compares with methadone and naltrexone, read our overview of medication treatment.
The forms it comes in
Film or tablet
The most common form is a small film or tablet that dissolves under your tongue or inside your cheek. You take it at home, usually once a day. Most of these products also contain naloxone, which is added to make the medicine less likely to be misused.
Long-acting injection
Buprenorphine also comes as a shot given under the skin by a nurse or doctor, once a week or once a month depending on the product. There is nothing to take each day and nothing to store at home. Some people start on film or tablets and move to the shot once their dose is settled.
Your prescriber can tell you which forms your insurance covers and which fit your routine.
How you start
You need to be in early withdrawal before your first dose. SAMHSA says that means at least 12 to 24 hours since your last opioid, with symptoms already under way. Your prescriber will tell you how long to wait, because it depends on what you have been using.
The wait matters. If you take buprenorphine while other opioids are still active in your body, it can push them off the receptors and bring on sudden, harsh withdrawal. Waiting is uncomfortable. It is also what makes the first dose bring relief.
The first dose can happen in a clinic or at home with instructions. Over the next days your prescriber adjusts the amount until withdrawal and cravings stay quiet. If you want to know what those waiting hours feel like, see the withdrawal timeline.
Who can prescribe buprenorphine now
Until recently, a prescriber needed a special federal permission, known as the X-waiver, and could treat only a limited number of patients. Congress removed that requirement in a law signed at the end of December 2022, so it has not applied since 2023.
Now any practitioner with a standard DEA registration to prescribe controlled medicines can prescribe buprenorphine for opioid use disorder, as long as state law allows it. That includes many family doctors, nurse practitioners and physician assistants. The federal patient limits are gone too.
In practice, not every office offers it yet. You can ask your own doctor, look for a clinic that lists medication treatment, or start by video. Our page on telehealth treatment explains how remote prescribing works, and you can find treatment in your state in our directory.
Side effects in plain words
Most side effects are mild and ease as your body adjusts. The common ones are:
- constipation
- headache
- nausea
- sweating
- feeling drowsy or dizzy
- trouble sleeping
- dry mouth
The FDA has warned that forms dissolved in the mouth can cause tooth decay and other dental problems. Ask your prescriber and dentist how to protect your teeth.
The serious risk is slowed breathing. It is much more likely if buprenorphine is mixed with alcohol, benzodiazepines or other sedating drugs. Tell your prescriber about everything you take.
Store it locked and out of reach. A dose meant for an adult can be very dangerous for a child. Call 911 if someone is not breathing or cannot be woken.
Worries people bring to the first visit
“I will just be dependent on something else.” Your body does get used to buprenorphine, and stopping suddenly causes withdrawal. That is physical dependence. It is different from addiction, where use is out of control and harming your life.
“I will have to stop after a few months.” SAMHSA says the length of treatment is fitted to each person and can be open-ended. Any change to your dose is a decision to make with your prescriber.
“I am pregnant.” Buprenorphine and methadone are the recommended treatments in pregnancy. See pregnancy and treatment for more.
What buprenorphine costs
With Medicaid
Every state Medicaid program must cover medications for opioid use disorder. That includes buprenorphine.
See your options: With MedicaidWith private insurance
Marketplace plans must cover substance use treatment. Ask about the copay for film, tablets and injections.
See your options: With private insuranceWith no insurance
Ask the clinic about a sliding scale and ask the pharmacy for the generic price.
See your options: With no insuranceFind buprenorphine in your state
Real, licensed facilities from public records. No paid placements.
Questions people ask us
Is buprenorphine the same as Suboxone?
Suboxone is one brand of buprenorphine combined with naloxone, sold as a film. Buprenorphine is the active medicine. It also comes as generic films and tablets, with or without naloxone, and as long-acting injections. They all treat opioid use disorder in the same basic way.
Why does buprenorphine have naloxone in it?
Naloxone is added to make the medicine less likely to be misused, according to SAMHSA. When you take the film or tablet as directed, under the tongue or inside the cheek, the buprenorphine does the work. The naloxone is not there to treat you.
What happens if I take buprenorphine too soon?
If other opioids are still active in your body, buprenorphine can knock them off the receptors and cause sudden, intense withdrawal. This is why prescribers ask you to wait until withdrawal has clearly started. If it happens to you, contact your prescriber. It passes, and it does not mean the medicine will not work for you.
Can my regular doctor prescribe buprenorphine?
Possibly. Since 2023, any practitioner with a standard DEA registration that covers controlled medicines can prescribe it for opioid use disorder where state law allows. Not every office has started doing so. Ask, and if the answer is no, ask for a referral or look up programs in your state.
Sources
- SAMHSA: Buprenorphine
- SAMHSA: Waiver elimination (MAT Act)
- MedlinePlus: Buprenorphine sublingual and buccal (opioid dependence)
- FDA: Information about medications for opioid use disorder
- NIDA: Medications for opioid use disorder
This page is general information, not medical advice. Talk with a clinician about your own situation.