Buprenorphine Home Start Guide
To be used for patients who are not actively withdrawing in the ED (recent opioid use)
Step 1: Place a 20mcg patch Butrans Patch for indication of PAIN.
*****IT IS OK EVEN IF NOT IN ANY WITHDRAWAL.****
Step 2: Contact the Substance Use Navigator (SUN)
SUN will problem solve, motivate, and arrange follow up.
Step 3: Prescribe at least one week supply of Suboxone sublingual strips
8 mg BID (14 strips)
Step 4: Explain home starts protocol to patient as follows:
1,2,3....Wait, withdrawals, dose
Wait ( 12 hours)
Make sure you feel really bad from withdrawals.
Take 8mg tablet or strip UNDER YOUR TONGUE.
If you don’t feel better in an hour take another 8mg tablet or strip.
You shouldn’t don’t need more than 4 strips (32 mg) in a single day.
Next Day, Begin Suboxone 8 mg sublingual twice daily dosing starting next morning/evening
Follow up in Bridge Clinic as scheduled
Contact SUN or return to the ED for questions, concerns, or precipitated withdrawal
Step 5: Provide Naloxone kit and overdose education