ASAM Pocket Guidelines and Patient Guide

ASAM Opioid Use Disorder Patient Guide 2025

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9 Buprenorphine • Buprenorphine acts on the same parts of the brain as opioid medications or drugs. It helps to stabilize them to reduce the desire to use opioids and to prevent withdrawal symptoms. • There are several buprenorphine formulations approved by the FDA for treatment of opioid use disorder. • Buprenorphine comes as tablets or films (for daily use) or extended-release injections (weekly or monthly). The dosage may be adjusted over time to find the dose that works best for the patient. • Many versions of this medication are combined with naloxone to prevent possible misuse. Learn more about naloxone on page 12. When misused (injected, snorted, or other) the naloxone in the buprenorphine medication can bring on withdrawal symptoms. • Insurance coverage and price may help determine which form should be chosen. The clinician will make sure the patient has a dosage and form that meets their medical needs. • Patients may need to see their clinician frequently at the beginning of treatment, until their addiction symptoms have stabilized. • Buprenorphine treatment can be started either at home or in a doctor's office. Both options are considered safe and effective when starting. • Buprenorphine needs to be started carefully to prevent withdrawal symptoms. The clinician may ask the patient to wait until they are experiencing mild to moderate opioid withdrawal symptoms before taking the first dose of buprenorphine. • Many patients will need to continue taking buprenorphine for an extended period of time. Stopping buprenorphine can put the patient at risk for relapse and overdose. This should only be done slowly with careful monitoring by the clinician. • As of 2023, any clinician with a current DEA registration that includes Schedule III authority may now prescribe buprenorphine. This significantly increases the number of clinicians eligible to prescribe buprenorphine, and provides patients with easier access to effective treatments. • Treatment with buprenorphine has been shown to reduce the patient's risk for opioid overdose death.

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