Dose of Reality: Resources for Professionals

Doctors can help prevent opioid misuse by safely reducing opioid prescriptions and becoming trained to treat opioid use disorder in their practice.

Key principles for patient care and safety

• Take a medical history and perform a physical examination.
• Perform a screening to assess potential risk for a substance use disorder.
• Make a treatment plan after talking about the risks and benefits of all options—opioid medications and nonopioid therapies.

Guidance for prescribing opioids

• Check the Wisconsin Enhanced Prescription Drug Monitoring Program to assess risk and prevent misuse.
• Use immediate-release opioids instead of extended-release or long-acting opioids for fewer days.
• Use the lowest possible effective dosage to start and reassess benefits and risks when considering dose increases.
• Add a prescription for naloxone. (See our statement on long-acting/high-dose opioid overdose reversal medication)

Consult the opioid prescribing guidelines from the Wisconsin Medical Examining Board for more information.

Know opioid use disorder treatment options

• If you are unable to support the opioid use disorder treatment needs of a patient in your practice, clinic, or health system, contact the UW Addiction Consultation Provider Hotline to discuss next steps. This hotline is open to all health care professionals.
• You also can encourage patients to contact the Wisconsin Addiction Recovery Helpline to explore treatment options available to them.
• If you are seeking drug-free housing for a patient, consult the Wisconsin Recovery Residence Directory (PDF).

TIP 63: Medications for Opioid Use Disorder

This document from the Substance Abuse and Mental Health Services Administration reviews the use of three Food and Drug Administration-approved medications used to treat opioid use disorder—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support recovery for people with an opioid use disorder. View TIP 63: Medications for Opioid Use Disorder.

Education and training opportunities

Information for Oral Health Professionals
We've created a library of resources for oral health professionals to support services that respect the health and dignity of people who use drugs.

Opioid Treatment and Recovery in the Emergency Department
We've partnered with Wisconsin Voices for Recovery and UW-Madison's School of Medicine and Public Health on a six-part video series that provides treatment tools and recommendations for treating opioid use disorder in the emergency department.

Person-Centered Planning Training
We've created a recorded webinar that provides an overview of the core components and elements of Person-Centered Planning practice.

Substance Use Treatment Project ECHO®
We've partnered with UW-Madison's School of Medicine and Public Health to share information on substance use treatment strategies for all populations. Live webinars are held the third Friday of every month from 12:15 p.m. to 1:15 p.m.

Statewide naloxone standing order for nurses

The statewide naloxone standing order for nurses (PDF) authorizes trained registered nurses and licensed practical nurses who work outside of traditional health care settings in Wisconsin such as local public health departments and schools to:

• Possess and maintain a supply of naloxone for the purposes of distribution.
• Distribute naloxone to any person at risk of experiencing an opioid-related overdose or a family member, friend, or other person in a position to assist a person at risk of experiencing an opioid related overdose.
• Administer naloxone to a person who is experiencing an opioid overdose.

See our statement on long-acting/high-dose opioid overdose reversal medication.

Do you have a question about the statewide naloxone standing order for nurses? Send an email to: dhsopioids@dhs.wisconsin.gov.

View maps showing naloxone access points in Wisconsin

On the front lines of dispensing opioid pain medications and providing medication-related services, pharmacists serve as a first line of defense by engaging in prevention and treatment efforts of opioid use disorder and overdose. Pharmacists should:

• Assess. Look for “red flags” that patients might have an opioid use disorder or be diverting medications. Promote the Wisconsin Addiction Recovery Helpline as a resource for patients who may be misusing drugs.
• Verify. Validate prescriber Drug Enforcement Administration registration and patient identification.
• Consult. Check the Wisconsin Enhanced Prescription Drug Monitoring Program as well as patient records.
• Communicate. Contact the prescriber with questions or concerns, talk to the patient, and submit information to the Wisconsin Enhanced Prescription Drug Monitoring Program.

Pharmacists can educate patients about:

• Proper use: Discuss how to take medication(s) exactly as prescribed and the risks of using medication(s) inappropriately.
• Side effects: Review most common side effects and stress the importance of reporting them to their prescriber or pharmacist for effective management.
• Medication fills: Discuss and manage expectations regarding refill requirements and the importance of using one pharmacy for all medications.
• Safe storage: Explain why locking up medications at home can prevent misuse, theft, or accidental ingestion by a child or pet.
• Stockpiling medication: Counsel patients about the dangers of saving unused medication. Explain why disposing unused medication at a local take back site or drop box can prevent misuse and accidental ingestion by a child or pet. Share information about safe disposal options.

HIPAA and the opioid epidemic

Guidance from the U.S. Department of Health and Human Services Office for Civil Rights explains when HIPAA permits health care providers and other covered entities to share a patient’s health information with loved ones and others involved in a patient’s care.

• Providers can share information with an individual patient's loved ones in certain emergency or dangerous situations, such as when the patient is in a crisis and incapacitated, or is facing a serious and imminent threat of harm.
• Patients with decision-making capacity retain their right to decide when and whether their information will be shared, unless there is a serious and imminent threat of harm.
• Patients' personal representatives, who have authority under state law to make health care decisions for patients, may request and obtain information on behalf of patients.

Statewide naloxone standing order for pharmacists

The statewide naloxone standing order for pharmacists delegates authority to pharmacists and outlines the policies and procedures necessary for dispensing naloxone without a prescription to patients at risk of an opioid overdose or to people in a position to assist a person at risk for overdose.

All pharmacists dispensing naloxone under the statewide standing order must:

• Complete the required training upon initially signing on and be familiar with naloxone rescue kits and the patient education materials.
• Educate the patient and distribute patient education materials at the time of dispensing.
• Maintain dispensing records according to Wis. Admin. Code § Phar 7.11 requirements (pharmacy records).
• Report to DHS all naloxone dispensed through the statewide standing order using prescriber number 1952745234.
• Submit quarterly reports to DHS through an individualized link emailed to the pharmacy contact.

To obtain a copy of the statewide standing order for pharmacists, complete this form.

Training requirement
All pharmacists dispensing naloxone under the statewide standing order must complete a one-hour training when they initially sign the standing order. The training should include, at a minimum, identification of patients at risk for opioid overdose, administration of intranasal and intramuscular naloxone, patient education and counseling, naloxone precautions and contraindications, and medication storage.

The Pharmacy Society of Wisconsin has developed a training that meets this requirement.

Follow these steps to access this training:

1. Go to the Pharmacy Society of Wisconsin's Online CE webpage
2. Type “Naloxone Statewide Standing Order Training" in the search box.
3. Select the “Naloxone Statewide Standing Order Training" course title in the list of options that appear.
4. Select the "Register" button in the course description screen and follow the prompts to register.

Training is not required for pharmacists resigning the statewide naloxone standing order.

It is recommended all pharmacy staff periodically receive training on opioid overdose recognition and naloxone administration to remain current on best practices.

See our statement on long-acting/high-dose opioid overdose reversal medication.

Do you have a question about the statewide naloxone standing order for pharmacists? Send an email to: dhsopioids@dhs.wisconsin.gov.

View maps showing naloxone access points in Wisconsin

Naloxone Direct Program agencies are required to have at least one staff member attend a naloxone train-the-trainer course and use the curriculum provided to train others on how to administer naloxone. This course is not designed for people who only want to learn how to administer naloxone. The course is designed for people employed by a Naloxone Direct Program agency who want to learn how to train others to administer naloxone.

This course is presented virtually.

Registration is required.

• August 21, 2025: 12:00 p.m. to 2:00 p.m.
• September 17, 2025: 10:00 a.m. to 12:00 p.m.

Register now for one of these Naloxone Direct Program courses.

Drug Checking Technologies Program agencies are required to have at least one staff member attend a train-the-trainer course and use the curriculum provided to train others on how to use fentanyl test strips and/or xylazine test strips. This course is not designed for the general public. The course is designed for people employed by a Drug Checking Technologies Program agency who want to learn how to train others to use fentanyl test strips and/or xylazine test strips.

This course is presented virtually on the days listed below from 10 a.m. to 12 p.m.

• July 22, 2025
• August 26, 2025
• September 23, 2025
• October 28, 2025
• November 19, 2025
• December 16, 2025

Registration is required. Register now for one of these Drug Checking Technologies Program courses.

Fentanyl

Go to the Dose of Reality: Get the Facts page for information that you can share in your community regarding fentanyl test strips.

Fentanyl Test Strip Instructions, P-03360A (PDF)

Social media posts

Xylazine

Xylazine Test Strip Instructions, P- 03534 (PDF)

Xylazine fact sheet, P-03490 (PDF)