Buprenorphine is a partial opioid agonist at the m receptor and is used as a daily-dose sublingual tablet or filmstrip for managing opioid addiction. In the United States, the Drug Addiction Treatment Act of 2000 made buprenorphine the only opioid medication for opioid addiction that can be prescribed in an office-based setting. Due to its high affinity for the μ receptor, buprenorphine inhibits the reinforcing effect of exogenous opioids. The ceiling on μ agonist activity of buprenorphine reduces potential for overdose and confers low toxicity even at high doses. Buprenorphine pharmacotherapy has proven to be a treatment approach that supports recovery from addiction while reducing or curtailing use of opioids. This review examines buprenorphine pharmacotherapy for opioid addiction, focusing on the situation in the United States, and is based on a review of pertinent literature and on the authors’ research and clinical experience. The references in this paper were chosen according to the authors judgment of quality and relevance, and with respect to their familiarity and involvement in related research.