Dose of Reality: Resources for Professionals

As Wisconsin's opioid epidemic continues to change, we must take a pragmatic, evidence-based approach to saving lives, reducing risk, and removing barriers to effective interventions. This requires that we provide services that respect the health and dignity of people who use opioids. Working together, we can ensure equitable access to essential care without stigma. 

Person holding a pill bottle

Tips for speaking with patients

There are things professionals can do to better support the needs of their patients. It starts with real talks. Here are some tips for having real talks with patients. 
  • Avoid using language that may cause people to react defensively. 
  • Use clear explanations—avoid technical terms.
  • Ask open-ended questions. 
  • Listen actively and express empathy. 

Guidance for prescribers and pharmacists

Prescribers and pharmacists can help address the opioid epidemic by:

Information for prescribers

Prescribers 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. 

Consult the opioid prescribing guidelines from the Centers for Disease Control and Prevention and Wisconsin Medical Examining Board for more information. 

Know opioid use disorder treatment options

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. Read the full document now or order a printed copy.

Get qualified to prescribe buprenorphine

Only a fraction of people with opioid use disorder receive treatment. That's why we're asking all clinicians who are eligible to prescribe buprenorphine to offer it as part of their practice. Buprenorphine is a medication used to treat opioid use disorder. The guidelines for prescribing buprenorphine were recently expanded. View more information about the new buprenorphine prescribing guidelines

 

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.

View the guidance.

Education and training opportunities

Addiction Medicine Toolkit
The Centers for Disease Control and Prevention and the American Society of Addiction Medicine have partnered to provide an introductory overview of addiction medicine for clinicians and provide strategies that can be implemented by practitioners. 

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.

Women's Substance Use Treatment Project ECHO®
We've partnered with Wisconsin Connect to share information on substance use treatment strategies for women. Live webinars are held the second Thursday of every month from 11:00 a.m. to 12:00 p.m.

Information for pharmacists

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:

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.

View the guidance.

Standing orders for naloxone

Standing orders for naloxone are intended to ensure Wisconsin residents have access to naloxone, the opioid overdose reversal drug. People who are at risk of experiencing an opioid-related overdose or who may be in a position to assist a person at risk of experiencing an opioid-related overdose should carry naloxone.

Statewide standing order

The statewide standing order for naloxone was implemented in 2016. All pharmacies are encouraged to use it.

Requirements, Procedures, and Sample Statewide Standing Order, F-01802 (PDF)

Obtain the signed standing statewide order

Local standing order

The local standing order for naloxone is for pharmacists interested in using their own medical provider to issue a prescription order for naloxone.

Local Prescriber Naloxone Standing Order for Pharmacists, F-01802A (Word)


Standing order training requirement
All pharmacists dispensing naloxone under a standing order must complete a one hour training developed by the Pharmacy Society of Wisconsin.

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.

Do you have a question about the standing orders for naloxone? Email us.


NARCAN® Direct Program

Our NARCAN® Direct Program provides NARCAN® at no cost to community agencies. These organizations distribute the NARCAN® they receive at no cost to people at risk for an opioid overdose and people who may witness an opioid overdose. NARCAN® is the nasal spray formulation of naloxone.

Do you have a question about the NARCAN Direct Program? Email us.


 


View a spreadsheet of all of the locations offering NARCAN® for purchase without a prescription under a standing order or for free after completion of a training session through the NARCAN® Direct Program (Excel). NOTE: NARCAN® Direct Program agencies are marked with (**) on the spreadsheet.

NARCAN® Direct Program

The NARCAN® Direct Program provides free NARCAN® for community distribution. The NARCAN® is given to agencies that serve people who are using opioids or people who may witness an opioid overdose. People receiving the free NARCAN® must attend a training hosted by a trainer associated with the NARCAN® Direct Program agency on how to identify an opioid overdose and how to use NARCAN® to reverse an opioid overdose.  

The following agencies may apply to participate in the NARCAN® Direct Program.

  • County or municipal public health departments (or their designee)
  • Tribal health clinics (or their designee)
  • Syringe access programs 
  • Recovery community organizations (Programs with recovery coaches and certified peer specialists/certified parent peer specialists)
  • Opioid treatment programs (Program certified under Wis. Admin. Code § DHS 75.15)
  • Emergency department induction sites (funded by State Opioid Response grant dollars)
  • County jails (approved by the Badger State Sheriffs' Association)

Do you have a question about the NARCAN Direct Program? Email us.

Train-the-trainer course schedule​​

NARCAN® 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 NARCAN® Direct Program agency who want to learn how to train others to administer naloxone.

The following courses will be presented using Zoom. There is no cost to attend. Attendance is limited to 25 people per course.

  • Tuesday, October 18: 1:00 p.m. to 4:00 p.m.
  • Monday, November 7: 1:00 p.m. to 4:00 p.m.
  • Tuesday, December 13: 1:00 p.m. to 4:00 p.m.

Registration is required. Register now.

Resources for certified trainers

Handouts
These resources are available in English, Hmong, and Spanish.

NARCAN® — a Lifesaving Dose of Reality, P-03092
This flyer answers frequently asked questions about NARCAN® and provides information on how to recognize and respond to an opioid overdose.

Carrying NARCAN® — a Lifesaving Dose of Reality, P-03093
This flyer answers frequently asked questions about NARCAN®.

Signs of an Overdose/How to Administer NARCAN®, P-03094
This wallet card provides an overview of the signs of an opioid overdose and how to administer NARCAN®.

Videos

NARCAN® training video produced by DHS staff

Videos produced for the Dose of Reality campaign (English only)

Conferences and trainings

We sponsor conferences and trainings for all professionals responding to Wisconsin's opioid epidemic. These events cover best practices for prevention, harm reduction, treatment, and recovery support services. 

 

Funding opportunities

Recovery Housing Vouchers
A voucher program has been created to support people in recovery who are homeless or at-risk for homelessness. These vouchers will pay for rent at state-registered recovery residences (PDF). Wisconsin continuum of care agencies are eligible to apply for these funds. A virtual meeting to discuss this funding opportunity will be held August 24, 2022, at 9:30 a.m. Registration is required. Register now.

Community Driven Approaches to Prevent Opioid Harms in Disproportionally Affected Populations
Applications are due by 11:59 p.m. August 31, 2022 (PDF).

Technical Assistance Provider and Evaluator for Community Driven Approaches to Prevent Opioid Harm in Disproportionally Affected Populations Grantees
Applications are due by 11:59 p.m. September 7, 2022 (PDF).


 

Promote the Dose of Reality initiative

Join us in building healthy communities by promoting the Dose of Reality initiative in your practice and community. We have developed drop-in articles, flyers/handouts, online display advertisements/website images, social media posts, and videos for you to share.

Two people in conversation

 

Last Revised: August 4, 2022