The Dangers of Buprenorphine
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • Buprenorphine is an FDA-approved medication used to treat opioid addiction and overdose.
  • Buprenorphine also plays a role in stabilizing the lives of people dependent on opioids more quickly while reducing the harms related to drug use.
  • Despite the many benefits, buprenorphine is very much capable of causing its side effects.
Reading time: 9 min

Buprenorphine is an FDA-approved medication used to treat opioid addiction and overdose. With a similar mechanism of action in the brain and a relatively weaker abuse potential than methadone and heroin, this medication has helped millions of people safely get off their opioid dependence without much discomfort and uncomfortable withdrawal symptoms. Buprenorphine also plays a role in stabilizing the lives of people dependent on opioids more quickly while reducing the harms related to drug use.

Despite the many benefits, buprenorphine is very much capable of causing its side effects. These side effects may range from mild to moderate in severity and can affect different people in different ways. It is imperative to familiarize yourself with the standard and serious buprenorphine side effects so they can be well-managed without posing any severe health threats.

Buprenorphine belongs to the class of opioids that is commonly used as a part of medication-assisted treatment to overcome different types of opioid addiction. Because it shares a similar mechanism of action as heroin, methadone, and other dangerous opioids, buprenorphine reaches the brain and activates the same receptors, allowing the body to feel comparable effects while minimizing the risk of abuse.

To begin treatment with buprenorphine, a patient must abstain from using opioids for at least 24 hours and be in the initial stages of withdrawal. At this point, their body starts craving the abused opioid and develops various withdrawal symptoms, including drug cravings. At this point, experts start therapy with buprenorphine to provide the brain with a steady supply of a similar drug to stabilize them physically. Over time, these experts start reducing the daily dose of buprenorphine till the point that the patients become drug-free.

The time a patient needs buprenorphine varies depending on their needs. Some people may need it for a few weeks or months, while treatment may continue indefinitely for others. To minimize the risk of relapse, some addiction specialists re-engage their patients in ongoing treatment with buprenorphine.

At present, the FDA has approved the following types of buprenorphine for the treatment of opioid use disorder:

  • Generic Buprenorphine sublingual tablets
  • Buprenorphine sublingual tablets (Subutex)
  • Buprenorphine extended-release injection (Sublocade)
  • Buprenorphinesublingual tablets (Zubsolv)
  • Buprenorphine sublingual films (Suboxone)
  • Buprenorphine implants (Probuphine)
  • Buprenorphine buccal film (Bunavail)

Despite the multiple benefits of buprenorphine in opioid addiction and withdrawal management, the drug is capable of causing side effects. These side effects can be short-term or long-term and may vary from one person to another. Some common short-term buprenorphine side effects include:

  • Headache
  • Dry mouth
  • Nausea
  • Back pain
  • Constipation
  • Difficulty falling asleep
  • Stomach pain
  • Mouth numbness
  • Blurred vision

In addition to the short-term side effects mentioned above, some people may acquire other long-term adverse effects, especially if they have been using this drug for anextended time. These include:

Liver Damage

Prolonged misuse of buprenorphine can trigger liver damage in various users. This includes acute liver injury and chronic liver failure. Due to this potential, medical healthcare specialists recommend all people using buprenorphine get regularly checked for liver function tests.

Blood Pressure Fluctuations

Some people who have been using buprenorphine for a long time to overcome opioid addiction may develop fluctuations in their blood pressure. Most of them frequently experience low blood pressure, which may indicate an allergic reaction or an underlying adrenal insufficiency.

Insomnia

Buprenorphine is capable of inducing short-term sleep disturbances in people who are taking it. In the long run, these minor sleep-related inconveniences may become chronic, perpetuating insomnia.

Adrenal Insufficiency

Many cases of adrenal insufficiency have been reported in people using buprenorphine to overcome opioid use disorder. This side effect typically appears after more than one month of using buprenorphine and may trigger a host of symptoms like weakness, fatigue, anorexia, vomiting, nausea, low blood pressure, and dizziness. People diagnosed with adrenal insufficiency secondary to buprenorphine immediately need to withdraw from this drug and commence treatment with high-dose steroids to recover the normal functions of the adrenal glands.

Reduced Fertility

Chronic use of opioids, including buprenorphine, can potentially reduce fertility in both males and females with reproductive potential. Experts are not sure whether this side effect is reversible or not.

Status Epilepticus

In some people, withdrawal of buprenorphine, especially after long-term use, can precipitate status epilepticus, a life-threatening condition that causes seizures.

Contrary to other opioids, like morphine and heroin, the effects of buprenorphine are mild. It also has a slower onset, and the effects of this drug last for a longer duration of time. All these properties collectively make it much less addictive than its stronger counterparts which is why doctors usually include it in medication-assisted treatment. Nevertheless, as an opioid, buprenorphine carries a small risk of causing dependence and addiction in a handful of people using it to withdraw from other opioid use disorders. Although rare, the possibility of developing a compulsion for this drug does exist as it triggers pleasurable feelings in the brain. Some people have also started using one of the buprenorphine forms called suboxone to prolong their heroin use.

People who develop buprenorphine addiction find it much harder to get off this drug at the end of the treatment and may develop withdrawal symptoms. Some common buprenorphine withdrawal symptoms include:

  • Nausea and vomiting
  • Headaches
  • Headache
  • Muscle aches
  • Lethargy
  • Insomnia
  • Digestive distress
  • Anxiety
  • Indigestion
  • Depression
  • Drug cravings
  • Irritability
  • Fever and chills
  • Sweating
  • Poor concentration

For some people, these withdrawal symptoms may diminish within a week, while others may continue to experience them for over a month after buprenorphine cessation.

In an attempt to overcome opioid use disorder using buprenorphine, many people become dependent on this drug. Such people may develop withdrawal symptoms and other side effects during treatment which can be highly comfortable but manageable. Try the following tips to minimize the buprenorphine side effects and continue working towards recovery.

Try psychotherapy

Psychotheray is an important component of an addiction management plan, but it can also help individuals overcome any mental side effects secondary to medication-assisted treatment. Research shows that people undergoing the process of discontinuing an opioid are less likely to experience a relapse or suffer from side effects if they try psychotherapy.

Keep in touch with a healthcare provider

Throughout the entire length of treatment with buprenorphine, it is crucial for every individual to follow their doctor’s advice for tapering it down. Keep in touch regularly and update them about any new concerns or symptoms so that you can stay the course and successfully discontinue using the drug at the end of the process. If buprenorphine is causing serious side effects, a doctor may recommend alternative medication or add certain treatments to dampen them until the body stabilizes.

Life a healthy lifestyle

As you continue the medication-assisted therapy with buprenorphine, make sure to build your daily schedule around regular breaks for food and exercise. Plan out your meals in advance and keep looking for exercise options that allow you to spend time outdoors to get fresh air and sunlight. Taking care of the body while stabilizing itself can help minimize the buprenorphine side effects as you taper it down slowly.

Safety Precautions for Using Buprenorphine

If your addiction specialist has prescribed buprenorphine to manage an underlying opioid use disorder, consider following the precautions mentioned below to minimize its side effects:

  • Do not combine buprenorphine with any other medications without consulting a doctor first
  • Make sure that your doctor is monitoring your health status and checking you for any liver-related issue that you may have
  • Do not use any recreational drugs, sedatives, alcohol, tranquilizers, or any other medication that slows down your breathing with buprenorphine. Mixing these medicines with buprenorphine can potentially lead to overdose and even death
  • Inform your doctor if you become pregnant or are planning to conceive
  • Keep buprenorphine away from pets and children to avoid accidental ingestion
  • Dispose of any unused buprenorphine safely. For more guidance, talk to your MAT practitioner
  • Do not share your medication with anyone even if they have similar addiction issues or other symptoms

FAQs

How does buprenorphine work?

Buprenorphine is a partial opioid agonist which combines with certain opioid receptors in the brain to produce effects such as respiratory depression or euphoria at low to moderate doses. These effects are comparatively weaker than the ones produced by full opioid agonist, such as heroin and methadone. As a result, buprenorphine is a safe and effective drug as long as it is taken as prescribed and carries unique properties that lower the potential for misuse, increase safety in the case of overdose, and reduce the effects of opioid dependency.

What is buprenorphine used for?
Buprenorphine is an opioid-based drug that the FDA has approved for the treatment of opioid addiction, dependence, and withdrawal. It can reduce cravings for opioids, reduce the discomfort associated with its withdrawal, manage opioid dependence, and provide pain relief to users. The use of buprenorphine for alcohol withdrawal is also one of the lesser-known benefits of this drug.
How long does bupropion stay in your system?

The amount of time buprenorphine stays in the system varies, primarily depending on the time it takes for the body to metabolize it fully. The liver is the chief organ responsible for breaking it down and metabolizing it once buprenorphine enters the bloodstream. In people with compromised liver function, it may take much longer to process buprenorphine and get it out of the system fully. For this reason, experts advise taking regular blood tests to keep an eye on the liver function tests and ensure that an individual is able to keep using buprenorphine without risking themselves for an overdose. Similarly, kidney disease also affects how fast your body can process buprenorphine. Other factors include age, gender, using other medications, and alcohol consumption.

When should I contact a doctor about my buprenorphine side effects?
Just like other prescription drugs, buprenorphine is capable of causing serious side effects in specific individuals. If you or someone around you who has been using buprenorphine develops the following side effects, get urgent medical help right away:
skin rashes
hives on the skin
swelling
vomiting
very slow breathing
hallucinations
difficulty breathing or swallowing
unusual bleeding or bruising
light-colored stools
dark-colored urine
extreme tiredness
yellowing of the skin or eyes
other symptoms of opioid withdrawal such as tremors, fever, diarrhea, and muscle pain
 
Remember not to exceed your prescribed dose for buprenorphine and avoid taking multiple doses too close to each other, as these practices significantly increase the risk of an overdose. A buprenorphine overdose can be hazardous and potentially lethal if no medical help is available.

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