Clinical case conference: Unobserved "home" induction onto buprenorphine

Joshua D. Lee, Jennifer McNeely, Ellie Grossman, Frank Vocci, David A. Fiellin

Research output: Contribution to journalArticlepeer-review


Unobserved or "home" buprenorphine induction has become a common clinical practice. Patients take the initial and subsequent doses of buprenorphine after, rather than during, an office visit. This clinical case summarizes an unobserved induction onto buprenorphine in a typical new patient. We review the core issues surrounding patient selection, feasibility, logistics, safety, and effectiveness of unobserved buprenorphine induction. Prescribers, treatment providers, policy makers, and patients should weigh the benefits of observed induction (maximum clinical supervision) with the reduced resource burden, flexibility, and comparable safety of unobserved induction.

Original languageEnglish (US)
Pages (from-to)309-314
Number of pages6
JournalJournal of Addiction Medicine
Issue number5
StatePublished - Sep 1 2014


  • Buprenorphine
  • Induction
  • Medication adherence
  • Opioid-related disorders
  • Patient compliance
  • Unobserved induction

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)


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