Physician and staff training

Clinical staff can assist with most steps of the buprenorphine induction process if a consistent plan is in place.

  • Educate the staff on buprenorphine treatment and addiction. The more information and involvement that they have, the smoother your practice will run and the better care your patients will receive.

  • Be sure to explain every staff member's role to your patients so they know who to ask for help or if there is a problem during induction.

Related Resources: 
Description: 
The Objective Opiate Withdrawal Scale (OOWS) contains 13 physically observable signs, rated present or absent, based on a timed period of observation of the patient by a rater.
Source: 
Reprinted from Handelsman, L., Cochrane, K. J., Aronson, M. J., et al. (1987) Two new rating scales for opiate withdrawal. American Journal of Drug and Alcohol Abuse, 13 (3), 293–308. By courtesy of Marcel Dekker, Inc.
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Patient Handouts: 
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Description: 
This form provides a list and a place to document important information that should be recorded during the intake assessment, including whether the patient is pregnant, taking other drugs, on methadone or has other addiction behaviors.
Source: 
Colleen LaBelle, RN/Boston Medical Center
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Commonly Used Forms: 
Description: 
This form can be used by nurses to note the areas that should be covered during a follow-up visit for patients on buprenorphine treatment.
Source: 
Colleen LaBelle, RN/Boston Medical Center
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Resource Type: 
Commonly Used Forms: 
Description: 
This PDF Document contains the Clinical Opioid Withdrawal Scale (COWS), a common instrument used to assess a patient's opioid withdrawal severity.
Source: 
California Society of Addiction Medicine (CSAM)
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Patient Handouts: 
Description: 
This flow chart for buprenorphine treatment displays the steps to patient recovery, from initial patient contact or referral, through intake process, induction, day #2, stabilization, maintenance, and tapering.
Source: 
Colleen LaBelle, RN/Boston Medical Center
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Physician stage in practice: 
Description: 
The Subjective Opiate Withdrawal Scale (SOWS) contains 16 symptoms whose intensity the patient rates on a scale of 0 (not at all) to 4 (extremely).
Source: 
Reprinted from Handelsman et al. 1987, p. 296, by courtesy of Marcel Dekker, Inc.
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Patient Handouts: 
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Description: 
This patient questionnaire from the California Society of Addiction Medicine (CSAM) is useful when beginning a new patient on buprenorphine maintenance treatment.
Source: 
California Society of Addiction Medicine (CSAM)
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Resource Type: 
Commonly Used Forms: 
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If you've successfully requested the required credit for your buprenorphine training activity and obtained your training certificate(s) (one 8 hour certificate for physicians, and two certificates for NPs and PAs - one 8 hour BupPractice certificate and one 16 hour SBIRT+OpioidRisk certificate), the next step is to request your waiver!

Related Resources: 
Description: 
Find information for providers on the waiver application and management process to prescribe or dispense buprenorphine for opioid dependency treatment.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Description: 
This page provides links to the full text, summary, and physician waiver requirements under DATA 2000.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 
Description: 
This webpage provides answers to frequently asked questions from physicians about buprenorphine and the Drug Addiction Treatment Act of 2000 (DATA 2000).
Source: 
CSAT Buprenorphine Information Center
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Description: 
The guideline provides recommendations for practice interventions and evaluations when using opioid therapy to treat chronic non-cancer pain. It is entirely evidence-based and uses clinical algorithms to optimize the use of opioid therapy.
Source: 
Department of Veterans Affairs; Department of Defense
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Description: 
A 585 page report by the National Center on Addiction and Substance Abuse document the evidence defining and describing the disease of addiction/risky substance use. It describes the need for and effectiveness of wide screening and interventions treatment and disease management tools and therapies as well as the populations in greatest need of therapies. The barriers to treatment, training and education gaps, and consequences and costs of inadequate prevention and treatment are all described. Finally, profound gaps between those who need treatment and those who receive quality care are described.
Source: 
National Center on Addiction and Substance Abuse
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Resource Type: 
Description: 
This webpage on the PCSS-MAT website links to list of modules, webinars, waiver eligibility training, and a calendar of events. The monthly webinars are sponsored by several professional societies and are archived. Physicians can register for the webinars online. Experienced mentors can be requested through this website. Resources and Clinical Tools including forms and clinical guidance are also available.
Source: 
PCSS-MAT
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Description: 
This web page is dedicated to motivational interviewing training. It contains links to a variety of articles, addressing all areas of MI from brief overviews to history, philosophy, principles, working with resistance, interaction techniques, and strategies. The site has a library, training information, and special populations information.
Source: 
Mid-Atlantic Addiction Technology Transfer Center
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Description: 
The Substance Abuse and Mental Health Services Administration (SAMHSA) provides this website so that physicians can improve the deliver and financing of prevention, treatment and recovery support services to patients.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Description: 
The California Society of Addiction Medicine (CSAM) website provides information and materials for buprenorphine treatment providers, including screening tools and sample consent and patient agreement forms, and provides links to other helpful resources.
Source: 
California Society of Addiction Medicine (CSAM)
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Description: 
PCSS-MAT is a free mentoring service funded by SAMHSA and coordinated by ASAM. The PCSS-MAT can match you with a physician mentor from your local area with whom you can discuss practice and treatment issues with him/her. NOTE: was previously known as PCSS-B for buprenorphine
Source: 
Physician Clinical Support System (PCSS)
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