Buprenorphine is often used as part of a medically assisted treatment (MAT) program to treat opioid addiction to substances, including heroin and other opiates. When used alongside therapy and counseling, clients also receive physical and psychological treatment that helps overcome their opioid use disorder by targeting the root cause.

How Long Does Buprenorphine Stay In Your System?

Overcoming an opioid addiction is a difficult, sometimes confusing journey. Understanding how treatments such as buprenorphine work can help empower you to feel more in control throughout the process.

One of the biggest concerns people have about using buprenorphine is how long it stays in their system. Compared to opiates like heroin, buprenorphine stays in your system for longer. Understanding the half-life and clearance rate of buprenorphine can help you better manage and understand your potential withdrawal symptoms and side effects, as well as understand how it may affect drug tests.[1] It also allows your care provider to determine dose frequency.

The Half-Life of Buprenorphine

Studies show that the half-life of buprenorphine is 24 – 42 hours, with an average of 38 hours.[1] However, this will depend on two crucial factors: the type of administration and whether you have liver disease.

For people with liver disease, the half-life of buprenorphine can be up to 57% longer than a healthy individual. Similarly, someone who uses transdermal patches may experience a lower buprenorphine half-life (26 hours) than sublingual treatments (31 – 35 hours).

The Clearance Rate of Buprenorphine

On average, it takes about five half-lives for a drug to leave your system fully.[1] In the case of buprenorphine, it takes approximately 5-7 days for people without liver disease or 7-12 days for people with liver disease.

As mentioned, the method by which buprenorphine is administered will alter how long it takes for buprenorphine to leave the body. [1]

• Transdermal patches: 5-6 days
• Sublingual film/tablets: 6-8 days
• Extended-release injections: 10 months

Factors that affect half-life and clearance rates of buprenorphine

As always, the actual time it takes for buprenorphine to leave your system will depend largely on individual factors. For example, one study detected buprenorphine up to 38 months after the last injection.

Key factors that affect how long it takes for buprenorphine to leave the system include:[2]

• Presence of liver disease
• Your metabolism
• Age
• Drug interactions
• Genetics

Your care provider will work with you to find the best treatment plan, tailored to your unique interactions with your medication.

How Does Buprenorphine Leave Your System?

Buprenorphine is metabolized primarily in the liver, filtering and removing the drugs from your blood system, then metabolizing them into metabolites that can be excreted.[3] That’s why those with liver disease tend to have a longer half-life and clearance rate than healthy individuals.

Due to this process, buprenorphine exits the body primarily through feces, with a smaller amount leaving the body through urine (10 – 30%).[3]

The majority of norbuprenorphine (the metabolized version of buprenorphine) is excreted with bile from the liver, through the intestines, and leaves the body through feces.

A smaller amount of the metabolite will travel to the kidneys where it will leave the body through your urine.

This process highlights why those with liver disease may experience a longer half-life and clearance rate.

How Does Buprenorphine Work?

Buprenorphine is a drug known as an “opioid agonist”.[4] It works by attaching to opioid receptors in the brain where opiates such as heroin would have attached.

Specifically, buprenorphine is a partial opioid agonist. This means that while it still attaches to opioid receptors and activates them, it activates the receptors to a lesser degree, reducing the effect. Even at higher doses, buprenorphine has a ceiling effect, as the effects on the receptors level off, reducing the risk of an overdose.

Unlike heroin, which attaches quickly and stays in the body for a short length of time, buprenorphine works more slowly and stays longer. This means the “high” felt by the fast-paced heroin and other opiates is reduced and managed better. And thanks to the partial agonist nature of buprenorphine, it also helps in reducing cravings and withdrawal symptoms.

How is Buprenorphine Administered?

There are multiple ways buprenorphine is administered.[5]

• Sublingual films or tablets: Tablets or films are placed under the tongue, allowing for quick absorption
• Transdermal patches: The medication is absorbed through the skin for slow, continuous release
• Injection: A modified-release injection like Sublocade might be used weekly or monthly under the skin to help keep sustained levels of buprenorphine. It’s important to note that Suboxone should not be injected as it can cause adverse effects.

Your care provider will determine the treatment type provided based on your preferences, medical history, severity of addiction, and treatment plan.

What is the Difference Between Suboxone and Buprenorphine?

Buprenorphine is one of the leading medications to treat opioid use disorder. For many years, it was sold primarily under the brand name Subutex. In fact, until 2011, Subutex and Suboxone were the two most commonly used medications to treat substance abuse caused by opioid addiction. However, in 2011, the company behind Subutex decided to discontinue it in the U.S. in favor of treatments with a lower likelihood of being abused by those struggling with substance use.[6]

Nowadays, buprenorphine-only medication is sold under different names, such as Cizdol and Brixadi. But what is the difference between buprenorphine-only medications and Suboxone?

Suboxone vs. Buprenorphine-only Medications

Both types of medication work by attaching to opioid receptors in the brain, reducing cravings and withdrawal symptoms while also decreasing the risk of an overdose.[7]

The key difference between the two medication types is that Suboxone is combined with naloxone.

When dealing with addiction, the physical reaction to a drug alone is not the only problem. There are a lot of psychological triggers, like social cues or environmental factors, that induce addictive behaviors, too. So, while these partial opioid agonists tackle the physical aspects of opioid addiction, they can still be abused. Some people might attempt to inject it or abuse buprenorphine in an attempt to experience the high they used to feel with opioids.

By adding naloxone, Suboxone deters people from injecting or taking too much medication as it works as an opioid antagonist, blocking receptors and reducing the “high” effects of opioids. If injected, it blocks buprenorphine from working properly and can cause uncomfortable withdrawal symptoms. Because it causes discomfort to inject or take too much of, the naloxone in Suboxone helps prevent the injection or misuse of buprenorphine, in turn, helping deal with the trigger causes of opioid addiction.

Both medications are approved by the FDA for use to treat opioid addiction. For both Suboxone and buprenorphine-only treatments, close medical supervision is required to ensure that the correct dose is being administered and the treatment is working as intended.

How Addictive is Suboxone?

One worry about using buprenorphine in treatment plans is that people can still become addicted to these alternative treatments. However, it’s important to note that Suboxone was created specifically to be less addictive.

Thanks to the naloxone combined with buprenorphine, it is harder to abuse Suboxone as it will cause discomfort if you take too much, as it blocks the buprenorphine from working properly.

Of course, to help cope with the potentially addictive properties of opioid use disorder treatments, medication should always be paired with counseling and therapy and be continuously monitored by your care provider.

What is the Three-Day Rule for Buprenorphine?

To make addiction treatment more accessible for those who need it most, the “three-day rule” was introduced, initially for emergency treatment of opioid use disorder.[8]

Following this ruling, emergency physicians were granted permission to dispense up to three days of medication to one person to initiate opioid addiction treatment.

As of August 2023, the Maintaining Addiction Treatment Act was passed, allowing all qualified healthcare providers to dispense up to three days of essential addiction-treatment medication at a time. This means that people no longer need to access emergency services to start treatment straight away, it can be administered in non-emergency settings as a means to initiating opioid use disorder treatment.

The three-day rule marks a big step forward in addiction treatment, as having a few days of medication stops factors such as transportation limitations from limiting people’s access to much-needed medication.

Of course, the three-day rule is meant as a way to start the addiction treatment process, and it’s important to establish a treatment plan with your care provider to set the path to successfully overcoming addiction.

Seek Help for Opioid Addiction with Confidence

Opioid addiction can feel lonely, affecting your mental health, but you don’t have to go through it alone. Reaching out and asking for help is the best first step you can take.

At Engage Wellness, our specialized team can help you find the right treatment to overcome your addiction.

Reach out to our caring team and start the road to recovery. Whether you’re ready to start treatment or need help finding a facility for an initial detox period, we have the resources to get you started.

Your journey to recovery begins now.

Frequently Asked Questions