PrescriberFriendly Buprenorphine Delivery Model Prescribers Supported Role Formerly

Prescriber-Friendly Buprenorphine Delivery Model Prescriber’s Supported Role Formerly Prescriber’s Tasks Intake Screening Appointment with Physician • Nurse, counselor, other personnel • Determine level of care for patient • Uniform Placement Criteria (UPC) • Patient meets with prescriber before induction. • Prescriber writes buprenorphine prescription for induction. • Nurse, counselor, or other clinician. • Observed induction using COWS • Prescriber may choose to be present for induction. Prescribing Protocol Behavioral Therapy • Graduated prescribing method • 1 st Rx is for 24 hours • Upon certain number of clean urine screens, patient “graduates” to a longer Rx. Refill Protocol • Patient attends a pre-refill visit with an SUD counselor. • Counselor makes prescribing recommendation. (Based on a set of conditions agreed upon by the prescriber; a “check list”) • Prescriber writes Rx; only sees patient if there is a problem. Induction • Run by counselors, other clinicians, or nurses. • Prescriber may attend as often as they would like. Diversion Management • Handled by counselors, nurses, or other clinicians at weekly meetings: • Observed urine screens • Wrapper or pill counts • Drug screenings

Prescriber-Friendly Buprenorphine Delivery Model: Greater Prescriber Involvement Prescriber’s Supported Role Formerly Physician’s Tasks Intake Screening Appointment with Physician • Nurse, counselor, other personnel • Determine level of care for patient • Uniform Placement Criteria (UPC) • Patient meets with prescriber before induction. • Prescriber writes buprenorphine prescription for induction. • Nurse, counselor, or other clinician. • Observed induction using COWS • Prescriber may choose to be present for induction. Prescribing Protocol Behavioral Therapy • Graduated prescribing method • 1 st Rx is for 24 hours • Upon certain number of clean urine screens, patient “graduates” to a longer Rx. Refill Protocol • Patient attends a pre-refill visit with an SUD Counselor and Prescriber. • Prescriber writes Rx for the patient based on the Graduated Prescribing Protocol. Induction • Run by counselors, other clinicians, or nurses. • Prescriber may attend as often as they would like. Diversion Management • Handled by counselors, nurses, or other clinicians at weekly meetings: • Observed urine screens • Wrapper or pill counts • Drug screenings