Pharmacists

Pharmacists play an important role in reducing the risks of accidental overdose, misuse, and abuse, associated with buprenorphine-containing transmucosal products. To help mitigate these risks, pharmacists should:

• Verify that the prescription you receive is from a prescriber who is in compliance with the provisions of the Drug Addiction Treatment Act of 2000 (DATA 2000).
• Keep in mind that a limited supply of buprenorphine-containing products should be dispensed during the initiation of therapy. This is due to the need for prescribers to closely and frequently assess the patients' needs, their symptoms, and potential risk of misuse, diversion, and abuse.
• Check state Prescription Drug Monitoring Programs, where practical, to identify behaviors that may represent abuse and review all medications (e.g., benzodiazepines, other opioids, and CNS depressants) to assess for appropriateness of co-prescribing.
• Provide the Medication Guide to patients each time the medicine is dispensed and discuss the risks and side effects associated with buprenorphine products, including what to do if patients experience side effects.
• Discuss the availability of naloxone for the emergency treatment of opioid overdose with the patient and caregiver. Inform patients and caregivers of their options for obtaining naloxone as permitted by individual state naloxone dispensing and prescribing requirements or guidelines (e.g., by prescription, directly from a pharmacist, or as part of a community‑based program).
• If naloxone is prescribed, also advise patients and caregivers:
  • How to treat with naloxone in the event of an opioid overdose
  • To tell family and friends about their naloxone and to keep it in a place where family and friends can easily access it in an emergency
  • To read the Patient Information (or other educational material) that will come with their naloxone. Emphasize the importance of doing this before an opioid emergency happens, so the patient and caregiver will know what to do.
• Remind patients who are picking up induction doses to return as directed to the doctor's office so that they can be supervised while taking the medication.
• Explain how to safely store the medication out of the sight and reach of all others, especially children.
• Provide appropriate patient counseling on safe use of buprenorphine-containing products and encourage patients to seek psychosocial counseling and support for safe and effective treatment.
• Be vigilant in detecting fraudulent prescriptions or simultaneous prescriptions for the same patient from multiple prescribers.
• Review the brochure Office-Based Buprenorphine Therapy for Opioid Dependence: Important Information for Pharmacists for additional information.