Buprenorphine Implementation Toolkit

Implementing diversion prevention procedures

Buprenorphine has street value for people who are opioid dependent and have limited or no access to publicly-funded medication-assisted treatment services. These individuals may seek buprenorphine “on the street” to avoid withdrawal, to stop using heroin on their own, or to otherwise cope with daily withdrawal syndrome  while trying to accomplish the daily activities of work, home, and parenting.

There are many ways to build diversion prevention into your buprenorphine program.

Set clear expectations for patients regarding diversion of medication

This sample therapeutic agreement for buprenorphine services includes obtaining informed consent about diversion.

Develop systems for tracking and preventing diversion

  • Treatment show rates
  • Pill counts
  • Pro-social behavior in treatment and on campus
  • Not refilling lost or stolen prescriptions
  • Not refilling prescriptions early
  • Regular, observed, and random urine drug screens
  • Alcohol biomarkers
  • Buprenorphine levels

See related section, Addressing concerns about diversion