Steps Physicians Take to Reduce Diversion of Buprenorphine

Steps physicians report taking to reduce diversion of buprenorphine.
Yang A, Arfken CL, Johanson CE.
Am J Addict. 2013 May;22(3):184-7

This was a survey of over 2,000 buprenorphine waivered physicians.  Only 31% of those sent the survey completed it. Physicians were asked to select all steps they take to reduce inappropriate use or diversion of buprenorphine from a list of choices

Limit 30‐day prescriptions to complying patients	72.4%
Prescribe only the lowest effective daily dose	60.6%
Require regular urine screening or other drug screening	59.3%
Highly selective in accepting patients	47.1%
Coordinate services with counselors, pharmacists, and other physicians	46.5%
Require individual/group counseling unless not indicated	41.2%
Require more than monthly visits	34.2%
Random or frequent pill counts/medication recall	29.5%
At least one patient on greater than 16 mg of suboxone for maintenance	55.4%
Reassess patient when dose exceed 16 mg	24.6%
Ask family to observe pill taking	21.5%
Don’t use buprenorphine for maintenance	6.3%
Others	10.1%