Clinical case conference: unobserved "home" induction onto buprenorphine

J Addict Med. 2014 Sep-Oct;8(5):309-14. doi: 10.1097/ADM.0000000000000060.

Abstract

Unobserved or "home" buprenorphine induction has become a common clinical practice. Patients take the initial and subsequent doses of buprenorphine after, rather than during, an office visit. This clinical case summarizes an unobserved induction onto buprenorphine in a typical new patient. We review the core issues surrounding patient selection, feasibility, logistics, safety, and effectiveness of unobserved buprenorphine induction. Prescribers, treatment providers, policy makers, and patients should weigh the benefits of observed induction (maximum clinical supervision) with the reduced resource burden, flexibility, and comparable safety of unobserved induction.

Publication types

  • Case Reports
  • Clinical Conference
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Buprenorphine / administration & dosage
  • Buprenorphine / therapeutic use*
  • Female
  • Heroin Dependence / drug therapy*
  • Humans
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / therapeutic use*
  • Opiate Substitution Treatment / methods*
  • Self Care / methods*
  • Treatment Outcome

Substances

  • Narcotic Antagonists
  • Buprenorphine