Clinicians who are prescribing buprenorphine should:

  • Understand the phases of buprenorphine treatment: induction, stabilization, and maintenance
  • Taper methadone and have patients abstain from opioids so that they are in mild to moderate withdrawal prior to induction
  • Follow dosing protocols but monitor and adjust as needed
  • Have a contingency plan in place for potential complications during induction
  • Determine maintenance dose (usually 12-16mg) based on the lowest dose needed for absence of withdrawal symptoms
  • Monitor patients during tapering and encourage use of non-pharmacological support
  • Be familiar with the alternative of medically supervised withdrawal (detoxification) for patients who do not want to be maintained on buprenorphine