top of page

Buprenorphine Home Start Guide

To be used for patients who are not actively withdrawing in the ED (recent opioid use)

Buprenorphine Home Start Guide

Print out the home start guide here

Step 1: Place a 20mcg patch Butrans Patch for indication of PAIN. 


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

bottom of page