Experienced prescriber

Description: 
Slides describe the process of applying to prescribe buprenorphine for 275 patients by submitting a Waiver Notification form to SAMHSA.
Source: 
Synectics for Management Decisions, Inc. © 2016
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Physician stage in practice: 
Description: 
Describes reporting rule for those approved to prescribe buprenorphine to up to 275 patients.
Source: 
Federal Register
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Physician stage in practice: 
Description: 
This web page provides information for the patient on pronunciation, brand names, common uses, how to use, missed doses, precautions, side effects, drug interactions, proper storage, and more.
Source: 
Kaiser Permanente
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Description: 
This web page provides information for the patient on pronunciation, brand names, common uses, how to use, missed doses, precautions, side effects, drug interactions, proper storage, and more.
Source: 
Drugs.com
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Description: 
PCSS-MAT provides ongoing mentoring programs aimed at improving providers confidence in treating opioid use disorder. The PCSS-MAT program is designed to assist providers in incorporating the use of medications for prescription opioid addicted patients in their practices. The mentoring program is available, at no cost to providers. PCSS-MAT mentors are a national network of trained providers with expertise in medication-assisted treatment and skilled in clinical education. Mentors provide support by telephone, email, or in person if logistically possible. (From the website.)
Source: 
SAMHSA
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Physician stage in practice: 
Description: 
This handout discusses how a prescribing physician may prepare for a visit from the DEA. Such visits are required by law for physicians prescribing buprenorphine, and involve things such as prescription and dispensing records, and adherence to prescribing limits on number of patients.
Source: 
PCSS
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Physician stage in practice: 
Commonly Used Forms: 

Patient Rights: Confidentiality and Consent

Description: 
This is a patient handout to inform patients about their rights when undergoing office-based buprenorphine treatment.

Patient Rights: Confidentiality and Consent

As a patient getting treatment for a substance use disorder, your personal and medical
information is protected under United States confidentiality law. This law states that your provider
is not allowed to tell anyone the reason you are being treated, without your permission. Providers
and treatment programs that provide addiction treatment are not even allowed to tell anyone
whether or not you are a patient.

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Commonly Used Forms: 

Sample Consent Form

Description: 
This is a sample of a consent form that can be used when initiating buprenorphine treatment for a new patient.

BUPRENORPHINE MAINTENANCE TREATMENT

Sample #1 --Patient information and consent to treatment with buprenorphine

Buprenorphine is an FDA approved medication for treatment of people with heroin or other opioid addiction. Buprenorphine can be used for detoxification or for maintenance therapy. Maintenance therapy can continue as long as medically necessary. There are other treatments for opiate addiction, including methadone, naltrexone, and some treatments without medications that include counseling, groups and meetings.

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Resource Type: 
Commonly Used Forms: 

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