Abuse of prescription opioids is becoming increasingly widespread. This study compared the social, health and treatment-related factors associated with buprenorphine and amphetamine abuse in Finland. Structured clinical interviews were conducted with clients seeking treatment for buprenorphine (n= 670) or amphetamine (n= 557) abuse in Helsinki from January 2001 to August 2008. Unadjusted and adjusted odds ratios (ORs) with 95 confidence intervals (CIs) were computed for factors associated with buprenorphine compared to amphetamine abuse. In multivariate analyses, buprenorphine abuse was associated with male gender (OR 1.57, 95 CI 1.17-2.09), daily abuse (OR 5.45, 95 CI 4.14-7.18), no drug free months during the last year (OR 1.68, 95 CI 1.23-2.29), and inversely associated with increasing age (OR 0.95, 95 CI 0.93-0.97 per year) and psychotic symptoms (OR 0.33, 95 CI 0.24-0.45). Despite more intense abuse patterns, clients seeking treatment for buprenorphine abuse shared similar characteristics to amphetamine clients. These characteristics were different to characteristics of those who abuse prescription opioids in North America. This is important for developing and targeting intervention programs.