Expanding access to medication for opioid use disorder (MOUD), particularly long-acting injectable (LAI) buprenorphine, requires more than just willing and able pharmacists. These collaborations also require prescribers who understand their pivotal role in initiating and maintaining collaboration. While recent efforts have equipped pharmacists with new tools and authority to help administer buprenorphine, the success of these models still hinges on prescribers taking the first step.

Even with the PhARM-OUD guideline now offering clear recommendations for pharmacy-based care, no injection can be given without a prescriber explicitly requesting that collaboration. This means that during the prescribing process, the provider must include a comment on the electronic prescription stating: “Pharmacy to administer”.

Without that language, the pharmacy cannot move forward with patient coordination or administration of LAI buprenorphine.

This small but essential act is what makes collaborative care possible.

So why shift to this model? Because it:

• Reduces treatment delays: Pharmacies can often provide same-day LAI injections, while provider-administered models require coordination, shipping delays, and dedicated staff time. 
• Improves retention: Pharmacies already track refills, missed appointments, and medication adherence. 
• Expands reach: Patients may not live near an addiction clinic – but nearly all live near a pharmacy. 

This model also enables providers to focus on diagnosis, counseling, and medical decision-making while pharmacists handle logistical coordination and administration.

If you’re a physician, PA, or NP providing MOUD – or looking to – here are the first steps to consider:

1. Find a Pharmacy Partner
   Use ncpharmacyfinder.com and filter by LAI buprenorphine administration to locate local pharmacies already offering this service.
   If none are listed, reach out to pharmacies administering long-acting antipsychotics—many are well-positioned to expand into MOUD care. 
2. Start the Conversation
   Contact the pharmacy and ask about their readiness to receive buprenorphine prescriptions with the “pharmacy to administer” instruction. See if they are REMS-registered and prepared to coordinate with your practice. 
3. Use the Resources
   Review the PhARM-OUD guideline, and share it with clinical and pharmacy partners. It offers practical steps and clear explanations for both sides of the care team. 
4. Engage with Your Tailored Plan
   Local Medicaid Tailored Plans may offer support, including for uninsured patients, which can help pharmacies offset delivery costs, set-up barriers, or start-up supply chain hurdles.