Determining Appropriateness
for Buprenorphine Treatment
A detailed approach to determining the
suitability of buprenorphine as a treatment
option for patients with opioid addiction is
included in the Guidelines. The evaluation
includes determining if appropriate patient
motivation exists and ruling out contraindicating
medical and psychiatric comorbidities.
Patients for whom buprenorphine may be an
appropriate treatment option are those who
• Are interested in treatment for opioid
addiction
• Have no contraindications to
buprenorphine treatment
• Can be expected to be reasonably compliant
with such treatment
• Understand the benefits and risks of
buprenorphine treatment
• Are willing to follow safety precautions for
buprenorphine treatment
• Agree to buprenorphine treatment after a
review of treatment options
Patients less likely to be appropriate
candidates for buprenorphine treatment of
opioid addiction in an office-based setting are
individuals whose circumstances or conditions
include
• Comorbid dependence on high doses of
benzodiazepines or other central nervous
system depressants (including alcohol)
• Significant untreated psychiatric
comorbidity
• Active or chronic suicidal or homicidal
ideation or attempts
• Multiple previous treatments for drug abuse
with frequent relapses (except that multiple
previous detoxification attempts followed by
relapse are a strong indication for long-term
maintenance treatment)
• Poor response to previous treatment
attempts with buprenorphine
• Significant medical complications
