Pharmacy committee asks staff to broaden buprenorphine guidance for pharmacists

The California State Board of Pharmacy Communication and Public Education Committee reviewed and requested revisions to a draft informational sheet on buprenorphine at its June 12, 2025 meeting, asking staff to clarify technical terms, add links to clinical guidelines and consider continuing-education resources for pharmacists.

Members said the draft, prepared by staff and outside experts, should more clearly reconcile pharmacists’ “corresponding responsibility” to detect diversion and the clinical role of buprenorphine as treatment for opioid use disorder. Nicole Thiebaud, chairperson of the Communication and Public Education Committee, said the board intends to distribute the informational sheet "through the board's Scribe alert, and it will be included in future newsletters and will be posted on the website."

Why it matters: Buprenorphine is widely used to treat opioid use disorder (OUD). Committee members said ambiguous language in the draft could leave pharmacists unsure how to apply red flags used for other controlled substances to OUD treatment prescriptions.

Renee Barker, a licensee member, thanked staff for the work and urged concrete changes to the draft. Barker asked that the phrase "evaluate the 4 corners of the prescription" be replaced or explained and suggested the document explicitly note that "assuming that buprenorphine is being prescribed inappropriately and wrongly denying care for a person with, OUD ... can have disastrous consequences for the patient." Barker also recommended adding direct links to high-quality, evidence-based clinical practice guidelines from SAMHSA and the American Society of Addiction Medicine (ASAM) and making those links clickable in electronic distributions.

Members discussed practical steps pharmacists could take when a prescription raises questions: verify whether the prescription is for OUD, confirm with the prescriber as needed, and consider available forms of the drug when assessing likely use. Thiebaud said, "Let's call out the fact that buprenorphine is treating substance use disorder," and asked staff to make clearer that the corresponding-responsibility checks used for other controlled substances can conflict with prescribing for OUD and therefore merit explicit guidance.

Julie (staff) clarified the intended audience for the sheet: "I think this is Julie. Just for clarification, I think this information is licensee-facing and not patient-facing." Committee members agreed that the document should remain targeted to pharmacists and other licensees and not publish operational enforcement details that could be used to circumvent screening.

The committee did not take a formal vote on edits; members instead asked staff to revise the draft to (1) replace or explain colloquial terms, (2) add concise clinical guidance and links to SAMHSA/ASAM guidance, and (3) consider whether a continuing-education offering related to buprenorphine would help disseminate the guidance. The draft sheet will be distributed via the board's alert list, posted on the website and placed in future newsletters as the committee indicated.

Ending: Staff indicated they will update the draft per members’ feedback and return with revised materials; no regulatory changes or formal board actions were approved at the meeting.