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Psychedex
Facts label

Buprenorphine Facts

Opioid; Depressant; Substituted morphinan; Mu-opioid receptor partial agonist

Dose and durationby route · individual sensitivity varies

Sublingual(mg)
Threshold< 0.3 mgLight0.5 – 2 mgCommon2 – 8 mgStrong8 – 24 mgHeavy24+ mg

Starts in 30 – 60 minLasts 18 – 24 hoursAfter-effects 24 – 72 hours

Also recorded: Insufflated. See full page: psychedex.org/substances/buprenorphine

Body and dependence

Acute toxicity
Low
Chronic toxicity
Low
Physical dependence
Moderate
Psychological dependence
Moderate
Withdrawal
Moderate
Compulsive redosing
Low

Tolerance

Builds
Moderate
Fully resets after
10 days
Carries over to
opioids

Effectslikely at a common dose

Perception
none likely · 2 possible
Body
Pain suppression; Constipation; Pupil constriction; Body high; +19 possible, including Nausea, Dizziness, Excessive sweating
Thinking
none likely · 11 possible, including Cognitive impairment, Analysis suppression, Decision impairment
Feeling
none likely · 4 possible, including Empathy suppression
Self
none likely · 3 possible, including Communication suppression

Who shouldn't take it

Absolute
Recent full agonist opioid use
Relative
Acute severe respiratory compromise; Severe hepatic impairment; Pregnancy; Concurrent benzodiazepine use; Concurrent MAO inhibitor use

Combinations65 recorded

Lethal (5)
Alcohol; GBL; GHB; Ketamine; Tramadol
Dangerous (13)
Anticholinergics; Atypical antipsychotics; Benzodiazepines, Barbiturates; Gabapentin, Pregabalin; GHB, Baclofen; Ketamine, DXM, PCP; Opioids; Antipsychotics; GHB, GBL; Ibogaine; MAOIs; SNRIs; SSRIs
Caution (33)
See full page: psychedex.org/substances/buprenorphine
Not graded (14)
Not listed never means safe.

Seek help immediately if

  • Unresponsive / can't be woken, even to a firm sternal rub
  • Slow, shallow, or stopped breathing
  • Pinpoint pupils
  • Blue/grey lips, fingertips, or skin (cyanosis)
  • Limp body; pale, clammy skin
  • Choking or gurgling sounds ("death rattle")
  • Slow, erratic, or absent pulse

What to do

  1. Try to wake them — shout their name, firm sternal rub
  2. Call emergency services immediately
  3. Administer naloxone if available
  4. Give rescue breaths (or CPR if there is no pulse)
  5. Place them in the recovery position
  6. Stay with them; re-dose naloxone every 2–3 minutes if there is no response
Reversal agent
Naloxone (Narcan) — opioid antagonist. May require repeated doses; its effect can wear off before the opioid does.

With prompt naloxone and rescue breathing, reversal is usually rapid. Because naloxone can wear off before the opioid — especially with long-acting opioids (methadone) or high-potency ones (fentanyl) — a period of monitoring is needed even after the person revives.

988 Suicide & Crisis LifelineFireside Project: 62-FIRESIDE

psychedex.org/substances/buprenorphine · Version r1 · Not medical adviceValues as of
On the printout