Please read the following information carefully. If you have any questions or concerns, please discuss them with your medical provider before beginning treatment.

About Buprenorphine

Suboxone® (buprenorphine/naloxone) is an FDA-approved medication used to treat opioid use disorder. Buprenorphine is a partial opioid agonist, meaning it activates opioid receptors enough to reduce cravings and withdrawal symptoms while carrying a lower risk of overdose than full opioid agonists. Naloxone is included to discourage injection misuse and has little effect when the medication is taken as prescribed.

Medication is only one part of treatment. Recovery looks different for every person, and your treatment plan will be individualized based on your goals, medical needs, and preferences.

Starting Buprenorphine

If opioids are still active in your body when buprenorphine is started, the medication may cause precipitated withdrawal, which is a rapid onset of withdrawal symptoms.

To reduce this risk, it is important that you:

Tell your provider honestly about all opioids or other substances you have recently used, including fentanyl, heroin, prescription pain medications, methadone, kratom products, or other medications.
Share approximately when you last used these substances.
Follow your provider's instructions regarding when and how to begin buprenorphine.
Providing accurate information helps us develop the safest treatment plan possible. Our goal is to support you—not to judge or punish you.

During Treatment

Many people feel significantly better within the first few days of treatment, although it may take several days or longer to find the dose that works best for you.

Once you are taking buprenorphine regularly:

It helps reduce cravings and withdrawal symptoms.
Other opioids may have reduced effects.
Trying to overcome buprenorphine's effects by taking large amounts of opioids can increase the risk of overdose, especially as the effects of buprenorphine wear off.
Please let your provider know before starting, stopping, or changing any prescription medications, over-the-counter medications, or supplements whenever possible.

Medication Safety

Buprenorphine can cause sleepiness, slowed breathing, or overdose when combined with certain substances, particularly:

Alcohol
Benzodiazepines (such as Xanax®, Ativan®, Valium®, or Klonopin®)
Sleeping medications
Muscle relaxants
Other opioids
Other medications or substances that cause sedation
These medications are not always prohibited, but they require careful evaluation and close monitoring. Never take medications prescribed for someone else.

Physical Dependence

Taking buprenorphine regularly will result in physical dependence. This is an expected effect of long-term treatment and is different from addiction.

If buprenorphine is stopped suddenly, withdrawal symptoms may occur, including muscle aches, abdominal cramping, nausea, diarrhea, anxiety, insomnia, and other flu-like symptoms. Withdrawal from buprenorphine is generally milder and develops more gradually than withdrawal from many other opioids.

If you and your provider decide it is appropriate to stop treatment, your dose will usually be reduced gradually to minimize withdrawal symptoms.

How to Take Buprenorphine

Take your medication exactly as prescribed.

Place the tablet or film under your tongue (or inside your cheek if directed).
Allow it to dissolve completely before swallowing.
Avoid eating or drinking until the medication has completely dissolved.
Do not chew, crush, or swallow the medication whole, as this may reduce its effectiveness.

Storage and Protection of Medication

Buprenorphine is a controlled medication and should be stored securely out of the reach of children, pets, and anyone for whom it was not prescribed.

Never share, sell, or give your medication to another person. 

If a child or someone who was not prescribed buprenorphine accidentally takes the medication, seek emergency medical care immediately.

Prescribing Policies

Harmony Medical Clinic provides outpatient treatment for opioid use disorder using evidence-based medications, including buprenorphine.

We do not dispense buprenorphine from our office. Prescriptions are sent electronically to your pharmacy, and medications must be obtained through a licensed pharmacy.

If you require treatment for acute pain, surgery, or another medical condition, please inform all treating healthcare professionals that you are taking buprenorphine. We will work collaboratively with your other healthcare providers whenever appropriate to help ensure safe and effective care.

Missed Doses

If you miss a dose of buprenorphine, take it as soon as you remember unless it is close to the time of your next scheduled dose. Do not take extra medication to make up for a missed dose.

If you have missed several doses or have stopped taking buprenorphine for several days, contact our office before restarting your medication. Your provider can help determine the safest way to resume treatment.

Naloxone (Overdose Reversal Medication)

Although buprenorphine lowers the risk of opioid overdose compared with many other opioids, overdose can still occur, particularly if it is combined with alcohol, sedatives, or other opioids.

We recommend that all patients receiving buprenorphine have naloxone (Narcan®) available. Naloxone is a medication that can temporarily reverse an opioid overdose and may save a life. Family members, friends, or others who may be present in an emergency should know where naloxone is stored and how to use it.

If you or someone around you suspects an opioid overdose, call 911 immediately, even if naloxone has been administered.

Pregnancy and Breastfeeding

Please let your provider know if you are pregnant, planning to become pregnant, or breastfeeding.

Buprenorphine is commonly used during pregnancy to treat opioid use disorder and is generally considered safer than continuing non-prescribed opioid use. Treatment decisions during pregnancy are individualized, and abruptly stopping buprenorphine during pregnancy is generally not recommended without medical guidance.

If you become pregnant while taking buprenorphine, contact our office as soon as possible so we can discuss the best treatment plan for you.

Dental Health

The FDA has reported that buprenorphine products that dissolve in the mouth may increase the risk of dental problems, including cavities, tooth decay, infections, and tooth loss.

To reduce this risk:

Allow the medication to dissolve completely.
After it has dissolved, take a sip of water, gently swish it around your mouth, and swallow.
Wait at least one hour before brushing your teeth.
Maintain routine dental care and regular dental checkups.
Tell your dentist that you are taking buprenorphine.

Safe Disposal of Unused Medication

If you have buprenorphine or other medications that are expired or no longer needed, they should be disposed of safely to help prevent accidental ingestion, misuse, or diversion.

Harmony Medical Clinic provides medication disposal products at no cost to our patients. If you need a disposal pouch or have questions about safely disposing of medications, please ask a member of our team at any visit.

If you are unable to obtain a disposal product from our office, many pharmacies, hospitals, and law enforcement agencies also offer medication take-back programs. Your pharmacist can also provide guidance on safe disposal options.

By signing below, I acknowledge that I have reviewed these expectations, have had the opportunity to ask questions, and agree to participate in my treatment plan.

1. I will keep, and be on time to, all my scheduled appointments.
2. I will adhere to the payment policy outlined by this office.
3. I will courteously conduct myself with the doctor and staff.
4. I will not sell, share, or give any of my medications to another person.  I understand that such mishandling of my medication is a serious violation of this agreement.
5. I understand that my medication/prescription can only be given to me at my regular office visits.  A missed visit may result in my not being able to get my medication/prescription until the next scheduled visit.
6. I understand that securing my medication is my responsibility and that lost or stolen medication will likely necessitate more frequent appointments or a referral to a more structured medication-monitoring program.
7. I will store medication properly.  Medication may be harmful to children, household members, guests, and pets.  The Suboxone should be stored in a safe place, out of the reach of children.  If anyone besides the patients ingests the medication, I agree to call the Poison Control Center (800-222-1222) or 911 immediately.
8. I will notify my treating physician of any other medications obtained from other doctors, pharmacies, or other sources. 
9. Combining buprenorphine with alcohol, benzodiazepines, sleeping medications, or other sedating substances may increase the risk of excessive sedation, respiratory depression, overdose, and death. I agree to discuss these medications with my provider so they can be used as safely as possible.
10. I will read the Medication Guide and consult my doctor should I have any questions or experience any adverse events.
11. I will take my medication as my doctor has instructed and not alter the way I take my medication without first consulting my doctor.
12. If I experience a return to opioid or other substance use, I understand this is important medical information. I agree to discuss it honestly with my treatment team so we can adjust my treatment plan.
13. I agree to the guidelines of office operations.  I understand the procedure for making appointments. I have the phone number of this clinic and I understand the office hours.  I understand that no medications will be prescribed by phone or on weekends. 
14. Medication counts, toxicology testing, saliva testing, breath alcohol testing, or other monitoring may be used as part of safe prescribing. These tools help guide treatment and promote medication safety.
15. If requested, I agree to present my medication for a medication count within the timeframe requested by the clinic unless alternative arrangements have been approved. Failure to participate may result in increased monitoring or changes to my treatment plan.
16. I agree to keep my contact information current and understand that the clinic may contact me regarding appointments, medication recalls, laboratory testing, or other aspects of my care.

17. I understand the clinic routinely reviews the Kansas Prescription Drug Monitoring Program (K-TRACS) as part of safe prescribing.

18.  I will avoid driving or operating dangerous machinery until I know how buprenorphine affects me.

19. Harmony Medical Clinic is committed to providing respectful, evidence-based care. Most concerns are addressed by adjusting the treatment plan rather than discontinuing care. However, the clinic may determine that treatment is no longer safe or appropriate in situations including, but not limited to:

    ·         Diversion or sale of prescribed medication

    ·         Threatening or violent behavior toward staff or other patients

    ·         Repeated inability to safely follow the treatment plan despite collaborative efforts

    ·         Falsification of medical information

    ·         Other circumstances in which the provider determines that treatment cannot be safely continued.

When appropriate, referrals to other treatment resources or higher levels of care will be provided.