- Next Steps: Get Started Prescribing Buprenorphine!
- How to Assess and Treat Patients with Comorbid Health Issues
- How to Conduct Buprenorphine Induction
- How to Establish and Manage a Buprenorphine Practice
- How to Manage Challenging Patients
- How to Comply with Rules, Regulations, and Recordkeeping
- Federal (DEA) Recordkeeping Requirements for Buprenorphine Treatment
- Federal Guidelines for Dispensing Buprenorphine Tablets in the Office
- Guidelines for Writing a Prescription for Buprenorphine
- DEA Oversight and Audits of Buprenorphine Treatment Programs
- Patient Privacy Issues for Buprenorphine Treatment
- Medical Recordkeeping Guidelines for Substance Abuse Patients
- How to Understand Insurance and Billing Issues
- How to Screen for Substance Abuse
- How to Refer Patients to an Addiction Specialist
- Review: What is Buprenorphine?
There are no special guidelines for writing a prescription for Suboxone® and giving it to a patient to get filled at the pharmacy of his/her choice. However, all prescriptions should have your DEA number plus the "X" DEA number (which denotes buprenorphine prescriber status) written on them or the pharmacy may not fill it.
Also note that under the Code of Federal Regulations Title 42 Part 4 (Confidentiality of Alcohol and Drug Abuse Patient Records) - you must receive full permission from the patient before you can fax the prescription to a pharmacy. Buprenorphine is a Schedule III drug and and so DEA guidelines as well as state guidelines for Schedule III drugs must be followed; the stricter guideline always applies.
Additionally, note that physicians who have their patients get their prescription filled and return to the office for induction are NOT subject to the same recordkeeping guidelines as physicians who store and dispense the tablets or film in-office.
- Buprenorphine tablets and film (like other Schedule III medications) can be refilled up to 5 times. Most physicians begin by prescribing limited initial quantities of medication and then write prescriptions for larger quantities and refills when the patient achieves stability (negative urines, psychosocial treatment adherence, etc.)
- If a buprenorphine prescription is written for an off-label use (i.e. not for opioid dependence), then no "X" number should appear on the prescription. Also, patients who are treated for off-label use are not considered to be part of the 30 or 100 patient limit.
- The patient is considered to be under your care and is part of your roster for the duration of the last prescription issued. For example, if you write a prescription for a month's supply of buprenorphine then the patient will remain on your roster even if he/she misses all appointments and seems to have dropped out of treatment. When the last prescription that you wrote terminates, then you may remove the patient from your roster.