Alcohol & Drugs
A picture of Methadone/BUP

What’s the deal with methadone/BUP?

Buprenorphine (say it with me: bew-pre-nor-feen) is a prescription drug.

It is taken as a replacement for heroin in the treatment of heroin dependence. Replacing a prescribed drug to treat a drug of dependence in this way is known as pharmacotherapy. As well as improving wellbeing by preventing physical withdrawal, pharmacotherapy helps to stabilise the lives of people who are dependent on heroin and other opioids, and to reduce the harms related to drug use.

Buprenorphine pharmacotherapy can be used to:

  • Help people to withdraw from heroin and methadone
  • Reduce the need to use heroin – this is known as ‘buprenorphine maintenance’
  • Treat severe pain

Pharmaceutical name

There are two formulations of buprenorphine available for people on pharmacotherapy treatment in Victoria:

  • Suboxone Sublingual Film® – A combination of buprenorphine and naloxone (also known as Narcan®). This is the most widely used form.
  • Subutex Sublingual Tablets® – Contains only buprenorphine

How does it work?

Suboxone Sublingual Film® is a lime-flavoured, rectangular, orange film, which is placed under the tongue to dissolve. The film will not work properly if it is chewed or swallowed.3

Subutex Sublingual Tablets® are also placed under the tongue to dissolve and will not work properly if chewed or swallowed.

Effects

There is no such thing as a SAFE level of drug use. Substance use carries risk. Buprenorphine may affect people differently based on:

  • A person’s body weight
  • General state of health
  • Regular use of substance
  • If taken in combination with other drugs including prescription medication
  • The amount that is consumed

Short Term Effects

The most common side effects of buprenorphine are:

  • Constipation
  • Headache
  • Increased sweating
  • Tiredness or drowsiness (especially after a dose)
  • Loss of appetite, nausea and vomiting
  • Abdominal pain
  • Skin rashes, itching or hives
  • Tooth decay
  • Changes to periods (menstruation)
  • Lowered sex drive (males and females)
  • Weight gain (particularly for females)

Treatment

Buprenorphine is in itself a treatment for opiate addiction. It is taken as a replacement for heroin in the treatment of heroin dependence. 

How effective is it? 

Buprenorphine treatment is more likely to be successful if it is part of a comprehensive treatment program, which addresses the body, mind and environment in which heroin has been used.

For example, treatment may include a combination of buprenorphine, counselling, alternative therapies and the development of a positive support network of peers, friends and a support group.1

Buprenorphine maintenance

Buprenorphine maintenance may not work for everyone, so it is important to work with a doctor or drug counsellor to find the best approach.

Counselling & Support

This is the most common kind of treatment, and there are a number of different approaches that might be taken. These might involve talking through your problems, learning to change the way you think, or thinking about how you might deal with difficult situations.

Counselling can be provided individually or in a group situation, and is available both to people who use AOD, and to their family members or support people. A support service can offer counselling or direct you to a service appropriate for you. Speak to your doctor, AOD treatment service or local community health service.

Find help and support services.

Rehabilitation

Rehabilitation programs take a long term approach to treatment to help you achieve an AOD-free lifestyle.

Residential programs can last from a few weeks to a number of years. No withdrawal medication is provided in the centres, so it is very important that you have already successfully completed your withdrawal treatment.

Residential withdrawal is also available from some treatment services.

Find out more about withdrawal.

Complementary therapies

These include treatments such as massage and relaxation therapies, which can be useful to help you manage withdrawal symptoms. Some herbal or natural remedies can also help, but you should first seek advice from your doctor or treatment service because withdrawing from alcohol and some drugs can be life-threatening.

Peer support 

These programs are provided both for people who use AOD, and their family members or support person. They are usually established by people who have had personal experience with AOD, and are often based on the Twelve-step Program model. Alcoholics Anonymous and Narcotics Anonymous are two examples of these.

- See more at: http://www.druginfo.adf.org.au/treatment-options/treatment#sthash.780SjKel.dpuf

Pharmacotherapy

Substitution pharmacotherapy is the use of medication to replace a harmful drug. This is given as a legal, measured, prescribed dose of a drug, and helps take away cravings so that you can work on other issues that will help you to recover.

Pharmacotherapy is only available for withdrawal from some drugs. For example, buprenorphine, methadone and naltrexone are used in the treatment of opioid dependence.

Your doctor or treatment service can give you more information about what is available to help you.

Withdrawal & Rehab

Withdrawal from long-term use of buprenorphine may produce some symptoms similar to those experienced through heroin withdrawal. However, symptoms tend to be milder than for heroin or other opioids such as methadone withdrawal. Withdrawal symptoms vary from person to person, but may include:

  • Cold or flu-like symptoms
  • Headache
  • Sweating
  • Aches and pains
  • Difficulty sleeping
  • Nausea
  • Mood swings
  • Loss of appetite4
Important notice

Please note: The information given on this page is not medical advice and should not be relied upon in that way. Individuals wanting medical advice about Methadone/BUP should consult a health professional.