Staff Responsibilities During Induction

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.

  • Staff should be prepared to talk about Office-Based Opioid Treatment with prospective patients. it is helpful to have a standardized intake form or checklist available from which to ask questions and gather basic information over the phone.
    • The intake checklist should include questions about opioid use and treatment history and can be administered via phone by administrative or clinical staff with minimal training.
    • You should also gather information about the patient's health insurance and what insurances your practice accepts, because cost of treatment is a significant concern to many patients

Remember that the induction process can cause discomfort and anxiety for patients, so work with your staff to make sure that they are as calm and comfortable as possible.

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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