In sublingual film, buprenorphine is co-formulated with naloxone. If the contents of the film are injected, the naloxone is activated and triggers acute opioid withdrawal.

Depot buprenorphine is a new long-acting formulation that has recently become available. One injection lasts for anywhere between one week to one month depending on which injection is used. There are two depot buprenorphine products currently available in Australia: Buvidal® and Sublocade®. Both are available on the Pharmaceutical Benefits Scheme (PBS) under a S100 opioid dependence listing.

As with other prescription opioids, buprenorphine can suppress respiration and potentially result in fatal overdose; however, buprenorphine is known to have less effect on respiration compared with other opioids. Buprenorphine can also cause sedation, although this effect is also thought to be weaker than that seen with other opioids such as methadone.

Withdrawal from long-term use of buprenorphine may produce some symptoms similar to those experienced through withdrawal from other opioids, such as heroin or morphine.

It is recommended that withdrawal from buprenorphine is achieved gradually under medical supervision to prevent discomfort and unpleasant effects for the person.

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 appetite.

These effects usually peak within two to five days but some may last anumber of weeks.

According to the Australian Institute of Health and Welfare’s National Opioid Pharmacotherapy Statistics Annual Data, approximately 53,300 people were receiving pharmacotherapy treatment on any given day across the country in 2023.

The median age of clients prescribed medicines such as buprenorphine in 2023 was 45 years (up from 38 years in 2011). This is consistent with the trend of an emergence of an ageing cohort of people who use drugs observed in drug treatment services and consequently, an ageing cohort in opioid pharmacotherapy treatment.

Non-medical use of buprenorphine was at its lowest point in 2022-23, according to the National Drug Strategy Household Survey, which recorded less than 10,000 people using it in this setting.

The Illicit Drug Reporting System (IDRS) is an Australian monitoring system run by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney that identifies emerging trends of local and national concern in illicit drug markets.

The Ecstasy and Related Drugs Reporting System (EDRS) is an Australian monitoring system run by NDARC that identifies emerging trends of local and national interest in ecstasy and related drug use, markets and harms.

The Pocket Guide to Drugs and Health is a publication authored by experts from NDARC that provides information for health professionals on the impact of drug use.

The Australian Institute of Health and Welfare collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia.

The Australian Bureau of Statistics is Australia’s national statistical agency, providing official statistics on a range of economic, social, population and environmental matters of importance to Australia.

Alcohol and Drug Foundation (2024). Buprenorphine. Retrieved from: adf.org.au/drug-facts/buprenorphine/

Australian Institute of Health and Welfare (2024). National Opioid Pharmacotherapy Statistics Annual Data collection. AIHW, Australian Government. Retrieved from: aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics/contents/about

Australian Institute of Health and Welfare (2024). Low prevalence illicit drugs in the NDSHS, AIHW, Australian Government. Retrieved from: aihw.gov.au/reports/illicit-use-of-drugs/low-prevalence-illicit-drugs-ndshs#Non-medical-use

Darke, S., Lappin, J., & Farrell, M. (2024). The Clinician’s Guide to Illicit Drugs and Health (Revised Edition); London: Silverback Publishing.