Prescribers play an important role in reducing the risks of accidental overdose, misuse, and abuse, associated with BTODs. To help mitigate these risks, prescribers should:

• Verify the patient meets appropriate diagnostic criteria.
• Check the patient's prescription profile in the Prescription Drug Monitoring Program, as appropriate, and review all medications (e.g., benzodiazepines, other opioids, CNS depressants) and illicit substances to assess for appropriateness of co-prescribing.
• Discuss the risks (including misuse and abuse) and side effects associated with BTODs, including those described in the Medication Guide. (See the brochure, Important Drug Safety Information for Prescribers for additional safety information regarding these risks.)
• Explain how to store BTODs safely out of the sight and reach of all others, especially children.
• Discuss the importance of having access to naloxone with the patient and caregiver, if there are household members (including children) or other close contacts at risk for accidental ingestion or opioid overdose. 
• Explain what patients should do if they experience side effects.
• Provide induction doses under appropriate supervision.
• Prescribe a limited amount of medication that will last until the patient's next medical appointment.
• Schedule patient appointments commensurate with patient stability (weekly or more frequent medical appointments recommended for the first month).
• Consider “pill/film count”/dose reconciliation.
• Assess whether the patient is receiving counseling/psychosocial support and if not, encourage them to do so.
• Assess whether the patient is making progress toward treatment goals (including, as appropriate, urine toxicology testing).
• Continually assess the appropriateness of maintenance dose.
• Continually assess whether or not the benefits of treatment outweigh the risks.

Click here for a complete list of products covered under the BTOD REMS.