Considerations for Buprenorphine Initiation and Maintenance Care

Wednesday, May 10, 2023, 1 – 4:45 pm ET
Thursday, May 11, 2023,  1 – 4:30 pm ET


The Reagan-Udall Foundation for the FDA, in partnership with the U.S. Food and Drug Administration (FDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA),held a two-part virtual public meeting entitled “Considerations for Buprenorphine Initiation and Maintenance Care.” agenda full

This virtual public meeting explored real-world experiences and scientific evidence for buprenorphine initiation strategies as well as medication dosing and management during continued treatment across different care settings. To support efforts to develop products and approaches to treat Opioid Use Disorder (OUD), presentations and discussions included people who use drugs, their families and community, harm reduction programs, health professionals from inpatient and outpatient settings, academic researchers, and federal partners.  

OUD is a major public health issue. Buprenorphine is a safe and effective prescription medication used for treatment of OUD. One challenge in accessing treatment for OUD with buprenorphine is that initiation of buprenorphine takes careful planning: patients must already be experiencing mild to moderate withdrawal symptoms or risk precipitated withdrawal. An increase in fentanyl in the illicit drug supply has further complicated buprenorphine initiation and maintenance.

Current evidence underlying the best strategy for initiating and maintaining buprenorphine care is mixed. A better understanding of the landscape of available tools and strategies for best practices in OUD care with buprenorphine is needed to advance the development of and access to evidence-based treatment for OUD, a priority under the FDA Overdose Prevention Framework and the U.S. Department of Health and Human Services (HHS) Overdose Prevention Strategy.

Meeting Agenda

Speaker biographies

View Day one slides

View Day two slides

Watch Day one 

Watch Day two

Read Day one transcript

Read Day two transcript

Read the Public Meeting Summary Report


This activity is one part of a multi-part Foundation project related to substance use disorder. The multi-part project is supported by the Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services (HHS) as part of an overall award of $902,109 of federal funds (100% of the project). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by FDA, HHS, or the U.S. Government. For more information, please visit