Planning for Patient Waiting Between Doses

Buprenorphine induction is often uncomfortable for patients, since they have to enter into withdrawal before taking their first dose and can take a long time.

When patients come in to the office and are in withdrawal, assess them right away and provide a dose of buprenorphine so as to keep them from being uncomfortable any longer than necessary. You may also want to have them get their initial buprenorphine doses from the pharmacy before the induction appointment so there is no wait time for the medication.

Conducting induction in your office

If a separate room is not possible, patients can wait in the general waiting room and should be told to inform staff immediately if their withdrawal symptoms worsen or return.

Conducting induction at home

Another option for induction is to have your patients come to the office for evaluation of withdrawal symptoms and to take the initial buprenorphine dose. Then they can leave the office and return home where they can have some privacy and comfort. You can then ask the patient to come back to the office 1-2 hours later for re-evaluation of withdrawal symptoms and another dose of medication. Some physicians even allow trustworthy patients to call into the office if withdrawal symptoms return, and then prescribe an additional dose over the phone.