Boston Medical Center (BMC) Grayken Center for Addiction Training and Technical Assistance (TTA)

A Resource for Healthcare and Social Services Professionals

Resources

OBAT Clinical Tools and Forms

Clinical Pathway for Medication for Addiction Treatment
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Words Matter
A one-page handout with words to use and avoid when talking about addiction.

English
Spanish

Clinic Visit Documentation

Buprenorphine Initiation Note
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Buprenorphine-Naloxone Maintenance Visit Checklist
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Checklist Prior to Buprenorphine-Naloxone Induction
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Checklist Prior to Naltrexone Induction
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Initial Screening Note Template
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OBAT Nurse Intake Form
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OBAT Nursing Follow-up Note Template
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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.
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Considerations for Medication for Addiction Treatment in HCV+ Patients
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Considerations for Medication for Addiction Treatment in Patients with HIV
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COWS Scale Opioid Withdrawal Record Induction Form
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DSM-5 Checklist of Diagnostic Criteria Opioid Use Disorder
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Novel Naloxone Distribution Strategies
This document outlines potential strategies to increase patient access to nasal naloxone by serving as a guide for administrators, healthcare providers, and non-medical providers attempting to create reimbursable streams for naloxone.
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Patient Medication Guide for Injectable Buprenorphine
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Patient Medication Guide for Injectable Naltrexone (Vivitrol)
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Perioperative Management
This document gives management guidelines for patients maintained on buprenorphine who are scheduled for surgery or other procedures.
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Pharmacotherapy for Alcohol Use Disorder
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Pharmacotherapy for Opioid Use Disorder
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Transfer Guidelines for Methadone to Buprenorphine or Buprenorphine to Naltrexone Transition
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Consents and Treatment Agreements

Consent for Release of Information (CFR 42)
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Consent for Treatment with Buprenorphine-Naloxone in Pregnancy
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Consent for Treatment with Disulfiram

English
Haitian Creole
Portuguese
Spanish

Consent for Treatment with Injectable Buprenorphine

English
Haitian Creole
Portuguese
Spanish

Consent for Treatment with Naltrexone

English
Haitian Creole
Portuguese
Spanish

Sample OBAT Treatment Agreement

English
Haitian Creole
Portuguese
Spanish

Transmucosal Buprenorphine Consent Form

English
Haitian Creole
Portuguese
Spanish

Grayken Center for Addiction TTA is a program of Boston Medical Center (BMC), a 514-bed academic medical center located in Boston's historic South End and the largest safety-net hospital in New England.

Funding for Grayken Center for Addiction TTA is provided by:

Massachusetts Department of Public Health Bureau of Substance Abuse Services (BSAS)
GE Foundation
Opioid Response Network

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