Your Patient Can't Fill Their Buprenorphine/Naloxone Prescription — Now What?

You've done the assessment, written the prescription, and counseled your patient on what to expect. They leave your office motivated and hopeful. Then they call back an hour later: "My pharmacy doesn't have it."

This scenario plays out daily across the country. Despite Buprenorphine/Naloxone not being in formal shortage, your OUD patients routinely face pharmacy-level access barriers. As a prescriber, you're uniquely positioned to help them navigate these obstacles — and in many cases, prevent them altogether.

This guide outlines practical steps you can integrate into your workflow to ensure your patients can actually access the medication you prescribe.

Current Availability Landscape

As of early 2026, the national supply of generic Buprenorphine/Naloxone (sublingual tablets and films) is stable. Multiple manufacturers produce the generic, and brand options (Suboxone Film, Zubsolv, Bunavail) remain on the market.

Yet patients continue to report difficulty filling prescriptions. The root causes are consistent:

• DEA ordering quotas limit pharmacy-level controlled substance purchases
• Chain pharmacy policies restrict quantities stocked or add dispensing friction
• Stigma — some pharmacies and pharmacists remain reluctant to serve OUD patients
• Rural pharmacy deserts — limited options in areas with few pharmacies
• Manufacturer-specific disruptions affecting particular NDCs or formulations

For a comprehensive overview, see our provider briefing on Buprenorphine/Naloxone supply in 2026.

Why Patients Can't Find It — And Why It Matters

For patients in recovery from opioid use disorder, a gap in medication access isn't a minor inconvenience. Missing doses of Buprenorphine/Naloxone leads to:

• Opioid withdrawal symptoms (within 24-72 hours)
• Intensified cravings
• Increased risk of relapse and illicit opioid use
• Potential fatal overdose (especially if tolerance has decreased during treatment)

Many patients already face significant barriers to entering treatment. When they finally do, a pharmacy access issue can derail their recovery before it has a chance to take hold. Proactive pharmacy planning on your end can make the difference.

What Providers Can Do: 5 Steps

Step 1: Maintain a Trusted Pharmacy List

Identify 3-5 pharmacies in your area that reliably stock Buprenorphine/Naloxone and have experience serving OUD patients. Include at least one independent pharmacy, as they tend to have fewer corporate restrictions.

Keep this list updated and share it with patients at the time of prescribing — don't assume they'll find a pharmacy on their own. If you have front desk or care coordination staff, task them with calling these pharmacies weekly to confirm stock levels.

Step 2: Direct Patients to Medfinder

Medfinder is a real-time pharmacy stock checker that shows patients (and providers) which nearby pharmacies currently have Buprenorphine/Naloxone available. Recommending this tool at the point of prescribing gives patients an immediate action step.

Consider including the Medfinder link in your patient discharge instructions or after-visit summary.

Step 3: Call Ahead When Possible

For new patients or those switching pharmacies, a call from your office to the receiving pharmacy can smooth the process significantly. Pharmacies are more responsive to provider offices, and a brief call can:

• Confirm stock availability for the specific formulation and strength
• Flag the incoming prescription so the pharmacist expects it
• Address any questions the pharmacist has about the prescription
• Reduce the chance of the patient being turned away

Step 4: Prescribe Flexibly

Build flexibility into your prescribing to accommodate supply realities:

• Specify "generic okay" — Unless there's a clinical reason for a specific brand, allowing generic substitution gives the pharmacy more options.
• Consider multiple formulations. If your patient can tolerate both films and tablets, note this in the chart so you can quickly switch if one is unavailable.
• Split fills. Some pharmacies can do partial fills of controlled substances. If a pharmacy has 20 tablets but your patient needs 30, a partial fill buys time while the pharmacy reorders.

Step 5: Offer Long-Acting Injectable Options

For stable patients, transitioning to a long-acting injectable Buprenorphine formulation eliminates pharmacy access issues entirely:

• Sublocade: Monthly subcutaneous injection administered in-office. Requires prior stabilization on sublingual Buprenorphine (≥7 days at 8mg+/day).
• Brixadi: Weekly or monthly subcutaneous injection. Can be used for both induction and maintenance. Provides flexibility in dosing schedule.

These injections are administered in clinical settings and shipped directly to your practice, bypassing retail pharmacy stock issues altogether.

Alternative Medications to Consider

When Buprenorphine/Naloxone access is persistently challenging for a patient, consider these alternatives:

• Buprenorphine monoproduct (Subutex/generic): Sublingual tablets without the Naloxone component. May be available when combination products are not. Primarily indicated for pregnant patients but can be used off-label for others when clinically appropriate.
• Methadone: Requires referral to a certified opioid treatment program (OTP). Appropriate for patients with severe OUD or those who haven't responded to Buprenorphine.
• Naltrexone (Vivitrol): Monthly intramuscular injection. Requires complete opioid detoxification before initiation (7-10 days). No abuse potential.

For a patient-facing comparison, direct your patients to our alternatives guide.

Workflow Tips for Your Practice

Integrating pharmacy access planning into your standard OUD treatment workflow doesn't have to be burdensome. Consider these practical tips:

• Add a "pharmacy confirmed" checkbox to your intake or prescribing workflow to ensure stock is verified before the patient leaves.
• Create a patient handout with your trusted pharmacy list, Medfinder link (medfinder.com/providers), and instructions for what to do if their pharmacy is out of stock.
• Schedule follow-up within 48-72 hours of initial prescribing to confirm the patient successfully filled the prescription.
• Designate a staff member to handle pharmacy coordination for OUD patients, including calling ahead and troubleshooting access issues.
• Track pharmacy reliability — note which pharmacies consistently fill without issues and which ones create barriers, and update your list accordingly.
• Discuss cost upfront. Many patients don't know about discount cards or patient assistance programs. Include cost resources in your initial counseling. See our provider's guide to helping patients save money on Buprenorphine/Naloxone.

Final Thoughts

The Buprenorphine/Naloxone access problem is solvable at the practice level. By maintaining pharmacy relationships, leveraging tools like Medfinder, prescribing flexibly, and offering long-acting alternatives when appropriate, you can dramatically reduce the chance that your patients fall through the cracks.

The patients who come to you for OUD treatment have already taken the hardest step — deciding to get help. The least we can do as providers is make sure they can actually access the medication that will keep them alive.

For the latest on supply and regulatory updates, see our Buprenorphine/Naloxone shortage briefing for providers.