How to Start Buprenorphine Outside of a Clinic

This information has been provided to us by California Bridge.

Buprenorphine is a safe and effective treatment for substance use disorder. It is taken as a substitute for drugs like heroin to reduce withdrawal symptoms and stabilize the lives of people transitioning away from opioid use. Buprenorphine, or simply bup, is most successful when it is part of a comprehensive treatment program, usually including counseling and developing a peer support network.

To start buprenorphine treatment outside of a clinical setting:

  1. Plan to take a day off and have a place to rest.
  2. Stop using and wait until you feel very sick from withdrawals. At least 12 hours is ideal but it might take a few days depending on the drug.
  3. Place one or two 8mg tablets or strips under your tongue for your first dose (8-16mg total).
  4. Repeat dosage after one hour to feel well.
  5. The next day, take 16-32mg (2-4 tablets or strips) at one time.

If you have a care provider, they can help you with dosage. Otherwise, start with a lower dose if you have a light habit (e.g. 5 “Norco 10’s” a day) and a higher dose if you have a heavy habit (e.g. injecting 2g heroin a day).

Some additional tips:

  • Talk to your care provider if you find yourself struggling. They can help you find ways to make the process easier, such as adjusting your dosage.
  • Give yourself time and a place to rest. Let your support network know you’re taking the day off. Don’t drive or do anything strenuous.
  • Using other drugs, like cocaine or pills, makes starting bup harder. Mixing alcohol or benzos with bup can be dangerous.

You are not alone. Help is out there. Find an emergency department offering medication-assisted treatment on California Bridge’s website.

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