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Opioid Use Disorder Resources & Buprenorphine Treatment

In order to enhance local opioid treatment services, improve education around opioid use disorder and better meet the needs of Sheboygan and its surrounding communities, HSHS St. Nicholas Hospital in Sheboygan, WI has developed these resources.

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This project is funded by a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) administered by the Wisconsin Department of Health Services, Division of Care and Treatment Services. Click here to learn more about the grant. 

For Patients

Medication-assisted treatment

HSHS St. Nicholas Hospital in Sheboygan, Wisconsin offers a medication assisted treatment option, buprenorphine, 24/7 in our emergency department. This allows patients in withdrawal from heroin or pain pills the ability to walk into our hospital and be seen anytime, day or night. Click here to learn about our buprenorphine treatment option for the public.  

How to refer

No referral is necessary. If you have a patient who is ready to start their journey toward recovery, they can walk in anytime to the HSHS St. Nicholas Hospital Emergency Department. Thanks to grant funding, HSHS St. Nicholas Hospital’s buprenorphine induction to recovery service is available at no cost to patients without insurance.

Recovery from addiction is possible and you can help! For flyers or posters to help educate patients and the public about this treatment option, contact us. 

For Medical Professionals

Resources and education

HSHS St. Nicholas Hospital in Sheboygan, Wisconsin has a variety of educational resources and videos about 
opioid use disorder, medication assisted treatment (such as buprenorphine), how to care for patients with opioid use disorder, stigma reduction and more.  Check out our library of resources.  

Toolkit

HSHS St. Nicholas Hospital developed a toolkit for organizations who are interested in implementing a buprenorphine treatment program like ours in your emergency department. Within the toolkit, you’ll find multi-disciplinary training, process tools, best practices and how to expand access to opioid treatment within your organization.

Learn about what to do when a patient presents to the ED, how to best identify substance use disorder and the steps to start induction of buprenorphine as well as follow through on treatment. The toolkit is also equipped with provider resources, FAQs, ED workflows, EPIC tools and more. 

Interested in becoming a buprenorphine prescriber?

Medical providers can prescribe buprenorphine, a type of medication-assisted treatment. The federal government has made it easier to become a buprenorphine waivered provider, and HSHS St. Nicholas Hospital can offer resources and assistance through our grant to help you achieve this status. It can be easy and rewarding to provide medication-assisted treatment. If you are already seeing these patients and referring them to another provider for medication-assisted treatment, you can be the one to provide this much needed lifesaving treatment.

What’s changed? SAMHSA now allows providers to file a notice of intent to prescribe buprenorphine. Filing this notice allows you to obtain your buprenorphine waiver and see up to 30 patients at one time. You can also attend a free training SAMHSA offers to obtain your buprenorphine waiver, 8 hours for physicians and 24 hours for other qualified health professionals. 

To get started, visit the SAMHSA website and click on Become a Buprenorphine Waivered Practitioner. 

Medication-Assisted Treatment and Buprenorphine FAQ

No, buprenorphine may be dispensed by a non-waivered practitioner for up to 72-hours in the ED. "The 72-hour rule" (Title 21, Code of Federal Regulations, part 1306.07(b)) allows physicians to administer narcotic drugs for the purpose of reliving acute withdrawal symptoms when necessary while arrangements are being made for referral to treatment."
Buprenorphine is an opioid partial agonist. When taken as prescribed it is safe and effective. It has unique pharmacological properties that diminish withdrawal symptoms and cravings.  

Sublingual buprenorphine takes 15 minutes to act when held under the tongue and peaks in one hour. 
The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative effects of the abused drug.
No. Buprenorphine is not an opiate substitute and does not provide feelings of getting “high” or extreme euphoria. Research has identified that patients undergoing buprenorphine treatment do not suffer the same social and behavioral destabilization that correlates in active drug addicts and abusers.

Buprenorphine is a medication, prescribed by physicians and taken under supervision. It is a safe and effective medication for treating opiate dependency and substance use disorder. 

Treatment with buprenorphine and methadone, both opioid agonists, is effective in reducing withdrawal symptoms, cravings, HIV transmission and other infectious diseases, interactions with the judicial system, as well as improving social relationships and becoming functional members of society.
Diversion of buprenorphine is less frequent than with other opioids. When individuals are obtaining buprenorphine off the street, they are mainly trying to reduce withdrawal symptoms. Anytime time there is one less use of injection drugs on the streets, there is one less opportunity for overdose and death.
Buprenorphine is a schedule III medication approved by the FDA for the treatment of opioid use disorder, acute and chronic pain and opioid withdrawal. Buprenorphine has been around since the 1970’s; however, in early 2002, a safety profile sublingual buprenorphine was approved for opioid substitution treatment. 
Medication-assisted treatment, or MAT, is the use of FDA-approved medications in the treatment of substance use disorders.
SUBOXONE is the trademark name for buprenorphine and naloxone. The naloxone component is an abuse deterrent that is not active when taken sublingually, and the naloxone is only active if injected. 
The FDA has approved the use of methadone, buprenorphine and naltrexone for the treatment of opioid dependence and addiction to short-acting opioids such as heroin, morphine and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.
MAT is primarily used to help individuals who are dependent on opioids such as heroin and prescription pain relievers that contain opiates.
Emergency department’s that have ED-initiated buprenorphine protocols have not noted an overwhelming number of patients in their emergency department. In fact, the patients with opioid use disorder are already visiting emergency departments, whether that be for life-threatening conditions like overdose or less urgent concerns such as skin infections or withdrawal.

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