Resources

OBAT Clinical Tools and Forms

Clinical Pathway for Medication for Addiction Treatment
(Download file)

Algorithms

Buprenorphine Initiation
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Initiation of Monthly Injectable Buprenorphine (Sublocade)
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Methadone to Buprenorphine Transitions
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Naltrexone Initiation for Alcohol Use Disorder
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Naltrexone Initiation for Opioid Use Disorder
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Pain Management While on Buprenorphine for Opioid Use Disorder
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Pain Management While on Naltrexone for Opioid Use Disorder
This clinical algorithm is meant to help inform clinicians regarding the use of medications for opioid use disorder. It is not meant to replace clinical-decision making. Please see the Massachusetts Nurse Care Manager Model clinical guidelines for further information.
(Download file)

Clinic Visit Documentation

Buprenorphine-Naloxone Maintenance Visit Checklist
(Download file)

Checklist Prior to Buprenorphine-Naloxone Induction
(Download file)

Checklist Prior to Naltrexone Induction
(Download file)

Nursing Follow Up for Buprenorphine-Naloxone
(Download file)

Nursing Follow Up for Naltrexone
(Download file)

Nursing Intake Form
(Download file)

Telephone Screening Form
(Download file)

Clinical Tool

Clinical Statement from BMC Regarding Formulation Change During Pregnancy
This statement, from Project RESPECT within Boston Medical Center, details the evidence-based practice of using the buprenorphine-naloxone films for pregnant women instead of the buprenorphine monotherapy.
(Download file)

Considerations for Medication for Addiction Treatment in HCV+ Patients
(Download file)

Considerations for Medication for Addiction Treatment in Patients with HIV
(Download file)

COWS Scale Opioid Withdrawal Record Induction Form
(Download file)

DSM-5 Checklist of Diagnostic Criteria Opioid Use Disorder
(Download file)

Patient Medication Guide for Injectable Buprenorphine (Sublocade)
(Download file)

Perioperative Management
This document gives management guidelines for patients maintained on buprenorphine who are scheduled for surgery or other procedures.
(Download file)

Pharmacotherapy for Alcohol Use Disorder
(Download file)

Pharmacotherapy for Opioid Use Disorder
(Download file)

Transfer Guidelines for Methadone to Buprenorphine or Buprenorphine to Naltrexone Transition
(Download file)

Consents and Treatment Agreements

Appointed Pharmacy Consent Form
(Download file)

Consent for Release of Information
(Download file)

Consent for Treatment with Buprenorphine-Naloxone
(Download file)

Consent for Treatment with Buprenorphine-Naloxone in Pregnancy
(Download file)

Consent for Treatment with Disulfiram
(Download file)

Consent for Treatment with Injectable Buprenorphine
(Download file)

Consent for Treatment with Naltrexone
(Download file)

Treatment Agreement for Buprenorphine-Naloxone
(Download file)