Buprenorphine Vs. Heroin | How Buprenorphine Is Different Than Heroin

Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on December 11, 2022

Buprenorphine is a medication that can help treat opioid addiction. Although it’s an opioid itself, it’s much weaker than commonly abused opioids like heroin and oxycodone. That’s why it can ease opioid cravings and withdrawal symptoms without making you feel high.

Thousands of Ohio residents live with opioid addiction (also called opioid use disorder). One of the most effective treatments for this disease is a medication called buprenorphine. 

Because buprenorphine is an opioid itself, some people hesitate to take it. However, it differs from highly addictive opioids like heroin in important ways. 

Buprenorphine Vs. Heroin & Other Opioids

Opioids work by activating opioid receptors. Opioid receptors are proteins found on nerve cells throughout your body. 

Most opioids (including heroin, oxycodone, and morphine) are full opioid agonists. That means they fully activate your body’s opioid receptors. Buprenorphine, however, is a partial opioid agonist. That means it only partially activates opioid receptors. 

As a result, buprenorphine does not make you feel relaxed and happy (or “high”) the way opioids like heroin does. This is especially true if you have already developed a tolerance to opioids. 

Tolerance means that over time, you need increasingly stronger or more frequent doses of opioids to feel the desired effects. It’s often a sign of opioid addiction. 

Buprenorphine & Opioid Addiction Treatment

Although buprenorphine won’t get you high if you have opioid addiction, it can ease your opioid withdrawal symptoms and cravings. This can make your recovery much easier. 

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), buprenorphine has many valuable treatment outcomes, including:

  • increased retention in treatment
  • reduced risk of relapse
  • reduced risk of infectious diseases like HIV and hepatitis C, which are common among people with opioid use disorders (especially heroin use disorder)

There are multiple formulations of buprenorphine. One of the most popular is a sublingual tablet that dissolves under your tongue. It’s often sold under the brand name Subutex. There’s also a buprenorphine implant (brand name Probuphine) and a buprenorphine injection (brand name Sublocade).

Buprenorphine & Naloxone Formulations

Some clinicians also prescribe medications that contain both buprenorphine and naloxone. Naloxone is an opioid antagonist, which means it blocks the effects of opioids. It’s meant to make buprenorphine treatment even safer. 

Buprenorphine/naloxone products come in the following formulations:

  • a sublingual film (brand name Suboxone), which dissolves under your tongue 
  • a sublingual tablet (Zubsolv), which dissolves under your tongue
  • a buccal film (Bunavail), which dissolves in your cheek

Buprenorphine is not the only medication approved to help treat opioid addiction. Other options include naltrexone, which is an opioid antagonist, and methadone, which is a full opioid agonist that activates opioid receptors much more slowly than other full agonists.

Is Buprenorphine Dangerous?

When used as prescribed for the treatment of opioid dependence, buprenorphine is generally safe. Because it’s a partial agonist, it poses a very low risk of addiction and overdose compared to other opioids. 

However, like most prescription drugs, it can have side effects. According to the National Institutes of Health (NIH), the most common side effects of buprenorphine include:

  • drowsiness
  • dizziness
  • headache
  • muscle aches
  • blurry vision
  • dry mouth
  • constipation
  • nausea and vomiting
  • sweating
  • shaking
  • fever
  • trouble sleeping

Buprenorphine Abuse

In addition, some people abuse buprenorphine. That means they use the drug in a manner not prescribed by their healthcare provider. Buprenorphine abuse poses serious health risks. 

For instance, if you mix buprenorphine with other drugs that slow down your breathing, such as alcohol or benzodiazepines, you may experience sedation and respiratory depression (a life-threatening breathing disorder). 

Also, taking extremely high doses of buprenorphine can lead to overdose and addiction.

Buprenorphine Overdose

An overdose may occur if you take more buprenorphine than prescribed. Common symptoms of  overdose include:

  • extreme drowsiness
  • slurred speech
  • confusion
  • nausea and vomiting
  • smaller pupils
  • pale, clammy, or bluish skin
  • bluish lips and/or fingernails
  • slowed breathing
  • slowed heartbeat
  • low blood pressure
  • seizures
  • loss of consciousness

If you or someone you know experiences these symptoms, call 911 right away. When left untreated, a buprenorphine overdose may be life-threatening. 

Buprenorphine Addiction

Buprenorphine addiction is a disease that makes you feel unable to control your use of buprenorphine. Common signs include:

  • frequent cravings for buprenorphine
  • loss of motivation
  • loss of interest in activities once enjoyed
  • avoidance of family members and friends
  • tolerance (needing increasingly higher or more frequent doses of buprenorphine to feel the desired effects)
  • physical dependence (experiencing withdrawal symptoms like anxiety and nausea when you don’t use buprenorphine) 

Like other substance use disorders, buprenorphine addiction requires treatment. According to the National Institute on Drug Abuse (NIDA), the most effective treatments for buprenorphine addiction include medical detoxification, behavioral counseling, and support groups. 

To learn more about drug addiction treatment options, please reach out to Ohio Recovery Center. Our substance abuse treatment programs offer personalized, evidence-based interventions to help you or your loved one recover from drug use.

  1. National Institute on Drug Abuse — Effective Treatments for Opioid Addiction https://nida.nih.gov/publications/effective-treatments-opioid-addiction
  2. National Institute on Drug Abuse — How do medications to treat opioid use disorder work? https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work
  3. National Institutes of Health — Buprenorphine Sublingual and Buccal (opioid dependence) https://medlineplus.gov/druginfo/meds/a605002.html
  4. Substance Abuse and Mental Health Services Administration — MAT Medications, Counseling, and Related Conditions https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions#opioid-dependency-medications
  5. Substance Abuse and Mental Health Services Administration — What is Buprenorphine? https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine

Written by Ohio Recovery Center Editorial Team

© 2024 Ohio Recovery Center | All Rights Reserved

* This page does not provide medical advice.

Prefer Texting?
We've got you covered.

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.

Sign up for text support

Receive 24/7 text support right away.
There is no obligation and you can opt out at any time.
Let us walk you through the treatment process. We're here to help.
For 24/7 Treatment Help:
100% Free & Confidential. Call (419) 904-4158