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

Clinical case conference: unobserved "home" induction onto buprenorphine.

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From the Department of Population Health and Division of General Internal Medicine (JDL, JN, EG), New York University School of Medicine, New York; Friends Research Institute (FV), Baltimore, MD; and Department of Internal Medicine (DAF), Yale University School of Medicine, New Haven, CT.


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.

[Indexed for MEDLINE]

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