Prescriber-Friendly Buprenorphine Delivery Model Prescriber’s Supported Role Formerly Prescriber’s Tasks Appointment with Physician Intake Screening Induction Nurse, counselor, other personnel Nurse, counselor, other personnel Determine level of care for patient Uniform Placement Criteria (UPC) Nurse, counselor, or other clinician. Observed induction using COWS Prescriber may choose to be present for induction. Patient meets with prescriber before induction. Prescriber writes buprenorphine prescription for induction. Prescribing Protocol Behavioral Therapy Graduated prescribing method 1st Rx is for 24 hours Upon certain number of clean urine screens, patient “graduates” to a longer Rx. Run by counselors, other clinicians, or nurses. Prescriber may attend as often as they would like. Refill Protocol Diversion Management Patient attends a pre-refill visit with an SUD counselor. Counselor makes prescribing recommendation. (Based on a set of conditions agreed upon by the prescriber; a “check list”) Prescriber writes Rx; only sees patient if there is a problem. Handled by counselors, nurses, or other clinicians at weekly meetings: Observed urine screens Wrapper or pill counts Drug screenings

Prescriber-Friendly Buprenorphine Delivery Model: Greater Prescriber Involvement Prescriber’s Supported Role Formerly Physician’s Tasks Appointment with Physician Intake Screening Induction Nurse, counselor, other personnel Nurse, counselor, other personnel Determine level of care for patient Uniform Placement Criteria (UPC) Nurse, counselor, or other clinician. Observed induction using COWS Prescriber may choose to be present for induction. Patient meets with prescriber before induction. Prescriber writes buprenorphine prescription for induction. Prescribing Protocol Behavioral Therapy Graduated prescribing method 1st Rx is for 24 hours Upon certain number of clean urine screens, patient “graduates” to a longer Rx. Run by counselors, other clinicians, or nurses. Prescriber may attend as often as they would like. Diversion Management Refill Protocol Patient attends a pre-refill visit with an SUD Counselor and Prescriber. Prescriber writes Rx for the patient based on the Graduated Prescribing Protocol. Handled by counselors, nurses, or other clinicians at weekly meetings: Observed urine screens Wrapper or pill counts Drug screenings