ASAM COVID-19 TASK FORCE RECOMMENDATIONS
ACCESS TO BUPRENORPHINE IN OFFICE-BASED SETTINGS
A guide for addiction treatment clinicians and programs working to treat patients with substance use disorders safely and effectively during the COVID-19 pandemic. For additional recommendations for the Ongoing Management of the Continuum of Addiction Care during COVID-19, please click here.
Buprenorphine is a life-sustaining medication. Abrupt discontinuation can lead to withdrawal as well as return to pretreatment substance use, overdose, and overdose death. The anxiety and stress associated with the COVID-19 pandemic, and the societal response to it, is exacerbating symptoms of opioid use disorder for many people. In addition, ongoing changes to the drug supply has increased the need for treatment. Every effort should be made to ensure that patients currently taking buprenorphine have timely access to refills of this medication and that any new patients in need of treatment for opioid use disorder can initiate treatment in a timely manner.
1This resource was developed by a Task Force appointed by ASAM’s Executive Council. To enable more rapid development and dissem-ination it was not developed through ASAM’s normal process for clinical guidance development that is overseen by the ASAM Quality Improvement Council.
These materials seek to provide guidance to ambulatory addiction treatment clinicians, including those working in primary care, and in addiction treatment programs as they strive to ensure that patients continue to have safe, appropriate access to buprenorphine1 during the COVID-19 pandemic.
Access to Buprenorphine in Office-Based Settings
 This resource was developed by a Task Force appointed by ASAM’s Executive Council. To enable more rapid development and dissem-ination it was not developed through ASAM’s normal process for clinical guidance development that is overseen by the ASAM Quality Improvement Council.
 Throughout this document, the term ‘buprenorphine’ will be used to refer to any formulation of buprenorphine including those containing both buprenorphine and naloxone.
[3 ] Paone D, Tuazon E, Stajic M, et al. Buprenorphine infrequently found in fatal overdose in New York City. Drug Alcohol Depend. 2015;155:298– 301. doi:10.1016/j.drugalcdep.2015.08.007
 Cicero TJ, Surratt HL, Inciardi J. Use and misuse of buprenorphine in the management of opioid addiction. J Opioid Manag. 2007;3(6):302–308. doi:10.5055/jom.2007.0018
 Fox AD, Chamberlain D, Sohler NL, Frost T, Cunningham CO. Illicit buprenorphine use, interest in and access to buprenorphine treatment among syringe exchange participants. J Subst Abuse Treat. 2015 Jan;48(1):112-6. PMC4250323
 https://pubmed.ncbi.nlm.nih.gov/22065255/ ; https://www.nejm.org/doi/full/10.1056/nejmoa055255 ; https:// pubmed.ncbi.nlm.nih.gov/24656054/ ; https://pubmed.ncbi.nlm.nih.gov/22348921/ ; https://pubmed.ncbi.nlm.nih.gov/22938914/.
This Clinical Guidance (“Guidance”) is provided for informational and educational purposes only. It is intended to provide practical clinical guidance to ad- diction medicine physicians and others caring for individuals with substance use disorders during the COVID-19 pandemic as it unfolds. Adherence to any recommendations included in this Guidance will not ensure successful treatment in every situation. Furthermore, the recommendations contained in this Guidance should not be interpreted as setting a standard of care or be deemed inclusive of all proper methods of care nor exclusive of other methods of care reasonably directed to obtaining the same results.
The ultimate judgment regarding the propriety of any specific therapy must be made by the physician and the patient in light of all the circumstances pre- sented by the individual patient, and the known variability and biological behavior of the medical condition.
This Guidance and its conclusions and recommendations reflect the best available information at the time the Guidance was prepared. The results of future studies may require revisions to the recommendations in this Guidance to reflect new data. ASAM does not warrant the accuracy or completeness of the Guidance and assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of this Guidance or for any errors or omissions.
If you are a patient or family member or friend in need of immediate assistance:
- Disaster Distress Helpline
Call 1-800-985-5990 or text TalkWithUs to 66746
- National Suicide Prevention Lifeline
Call 800-273-8255 or Chat with Lifeline
About COVID-19 Taskforce Members
If you have questions related to the guidance in this document or suggestions for additional topics, please email COVID@asam.org