Evaluation of the Buprenorphine Waiver: Addiction Physician Survey

ICR 200305-0930-001

OMB: 0930-0246

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0930-0246 200305-0930-001
Historical Active
HHS/SAMHSA
Evaluation of the Buprenorphine Waiver: Addiction Physician Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 09/04/2003
Retrieve Notice of Action (NOA) 05/30/2003
Approved with change to the race/ethnicity question.
  Inventory as of this Action Requested Previously Approved
09/30/2004 09/30/2004
957 0 0
322 0 0
0 0 0

The Waiver Program permits qualifying physicians to prescribe and dispense buprenorphine, a schedule III narcotic drug recently approved by the FDA for the treatment of opiate addiction. The Drug Abuse Treatment Act specifies that the Secretary of the Department of Health and Human Services make a determination of whether: 1) treatments provided under the Waiver Program have been effective forms of maintenance treatment and detoxification treatment in clinical setting; 2) the Waiver Program has significantly increased (relative to the beginning of such period) the availability of maintenance treatment and..........

None
None


No

1
IC Title Form No. Form Name
Evaluation of the Buprenorphine Waiver: Addiction Physician Survey

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 957 0 0 957 0 0
Annual Time Burden (Hours) 322 0 0 322 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
05/30/2003


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