Buprenorphine Info

Buprenorphine Pharmacotherapy in the Treatment of Opioid Dependence
Summary by the CSAM Committee on the Treatment of Opioid Dependence (November 2006)

The Physician Clinical Support System

SAMHSA, in collaboration with the American Society of Addiction Medicine (ASAM) created the Physician Clinical Support System - Buprenorphine (PCSS-B) to assist physicians in the appropriate use of buprenorphine, and to promote improved patient care, research and education. The PCSS supports primary care physicians, pain specialists, psychiatrists and other non-addiction medical practitioners, and is designed to significantly increase access to buprenorphine treatment among the millions of untreated opioid dependent patients. To find a PCSS clinician in your locale or region, to become a PCSS mentor, or for more information about the project, click here.

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction: A Treatment Improvement Protocol (TIP 40)

Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction was developed by SAMHSA and a team of independent substance abuse treatment professionals, in consultation with the National Institute on Drug Abuse, the Drug Enforcement Administration (DEA), and FDA. The purpose of this TIP is to provide physicians with science-based clinical practice guidelines on the use of buprenorphine in the treatment of opioidaddiction. The primary audience of this TIP is physicians who are interested in providing buprenorphine for the treatment of opioid addiction.

• Click here to access this Clinical Guideline

CLINICAL TOOLS (updated 6/2004)

Information for Patients and Family Members

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• Information for patients who are considering treatment with buprenorphine
• Information for families of patients who are in treatment with buprenorphine

Information for the Physician and the Physician's Office Staff

Initial patient contact

• Checklist for personnel who answer initial inquiries about buprenorphine
• Form for personnel who answer initial inquiries
• DSM IV criteria for diagnosis of opiate dependence
  
  • DSM IV worksheet
• Clinical Opiate Withdrawal Scale (COWS)
  
  • COWS worksheet

Informed Consent and Agreement for Treatment

• Expectations the physician may want to convey to the patient
  
  • Sample #1 – Patient information and consent to treatment
  • Sample #2 – Patient information and agreement for treatment
  • Sample #3 – Patient information and agreement for treatment
  • Sample #4 – List of patient responsibilities and agreement
  • Sample #5 – Patient information and agreement for treatment
• Consent for Release of Information

Intake history and physical examination

• Sample form #1
• Sample form #2
• Intake questionnaire for treatment planning for new patient
• Patient management at follow-up appointments
• Sample progress notes
• Sample form for Medication Inventory
• Notes about Physician Billing (powerpoint)

Other

• Commonly Abused Drugs
• Web sites re: buprenorphine treatment and drug abuse treatment
• Package Insert for Suboxone® and Subutex®
• Federation of State Medical Boards Guidelines for Treatment of Opioid Addiction in the Medical Office
• Notification Form to be faxed to SAMHSA

Buprenorphine Links

• Form to Notify Department of Health and Human Services of Intent to Use Buprenorphine
  Notification of Intent to Use Schedule III, IV, or V Opioid Drugs for the Maintenance and Detoxification Treatment of Opiate Addiction under 21 USC Section 823(g)(2)
• CSAT List of Physicians Who Can Prescribe Buprenorphine
• American Academy of Addiction Psychiatry (AAAP)
• American Society of Addiction Medicine (ASAM)
• SAMHSA Buprenorphine Web Site
• Centers for Disease Control and Prevention (CDC). Viral Hepatitis
• The College on Problems of Drug Dependence
• The National Association of Alcoholism and Drug Abuse Counselors
• The National Clearinghouse for Drug and Alcohol Information catalog
• National Institute on Alcohol Abuse and Alcoholism (NIAAA)
• National Institute on Drug Abuse (NIDA)
• National Institute on Drug Abuse (NIDA) Buprenorphine Update
• Office of National Drug Control Policy
• Substance Abuse and Mental Health Services Administration (SAMHSA)

Powerpoint Presentations from CSAM's Conference"Buprenorphine in Office-Based Treatment of Opiate Dependence" 10/9/02

• Drug Addiction Treatment Act of 2000 / Judith Martin, MD
• Opiate Receptor Pharmacology / Donald Wesson, MD
• Applied Pharmacology of Buprenorphine / John Mendelson, MD
• Dosing Strategies: Finding the Right Dose / Paul Cassadonte, MD
• Common Medical Problems in Opioid Addicted patients / Diana Sylvestre, MD
• Monitoring Treatment Progress and Managing Threats to Stability / Judith Martin, MD
• Pain Management in Patients Maintained on buprenorphine / Karen Miotto, MD
• Therapeutic Discontinuation of Buprenorphine / Donald Wesson, MD