To provide the most comprehensive care and

effective addiction treatment the following process

has been established.

1. Information Packet Mailed to Client

After initial inquiry about treatment or referral

to the suboxone program all prospective clients

will be sent an information packet. The packet will

contain

− BridgePoint Health Suboxone Program Brochure

− Welcome Letter

− Questionnaire

− Adult Intake Form

2. Meet with Suboxone Case Manager Upon receipt of the information packet the Suboxone case manger will be in touch to schedule a meeting. During the meeting the Suboxone case manager will review the information packet, intake, and go over the Suboxone Agreement.

3. Appointment with Substance Abuse Counselor The case manager will set-up an appointment with one of our Licensed Clinical Substance Abuse Counselor either Mike Huber, CSAC or Rachel Gretebeck, CSAC. Clients will be required to meet with counselors 1-3 times prior to the Suboxone Team staffing meeting.

4. Suboxone Team Meeting/ Staffing The Suboxone Treatment team will meet to staff cases and determine if clients are appropriate for buprenorphine medication treatment and assign a physician.

5. Appointment with Suboxone Physician The case manager will set-up an appointment with one of our Suboxone certified physicians. Clients will meet with one of our physicians for a evaluation. Medication is NOT prescribed at this evaluation. If appropriate an induction appointment will be scheduled following the evaluation.

Suboxone

Program

WHAT

TO

EXPECT

Thank you for inquiring about the

BridgePoint Health Suboxone Program.

This pamphlet will give you guidelines

about what to expect from our office as

well as what we expect from you.

Our Suboxone Treatment Team has

created a comprehensive program to

provide you with effective opioid addiction

treatment.

It is important to keep in mind just as the

recovery process will take time, so will the

induction process. It is estimated that this

process may take up to four weeks from

initial point of contact to the actual

Suboxone induction.

Clients will be subject to random urine

drug screens that are billed through

Millennium Labs. That cost will be in

addition to any treatment costs.

Please also keep in mind your medication

costs will be in addition to any treatment

costs.

TREATMENT PROCESS

• I understand that on the day I start

Suboxone treatment, I should come to the

office already in opiate withdrawal. If I am

not having observable signs of opiate

withdrawal, induction onto Suboxone may

be delayed a day or more.

• Medication will be prescribed in quantities

to last from visit to visit . The frequency of

visits depends on how I am progressing. I

understand that my doctor rarely

schedules appointments more than 3

weeks apart.

• I agree to get permission from my

Suboxone provider before starting any

medication prescribed by another doctor.

I will not take opioids or sedatives, and I

understand that overdose deaths have

occurred when patients have taken other

medications with Suboxone (particularly

medications like Xanax, Ativan, and other

sedatives).

• I agree to staff-observed random urine

testing, which is used to detect early

relapse and to document my progress in

treatment.

• I agree that being financially responsible

for my medical care is a requirement for

ongoing therapy and is a demonstration of

my commitment to my recovery. If I have

an outstanding balance of $50 or more for

60 days, treatment will be discontinued.

* A complete list of Subxone requirements will be listed

in the Suboxone Agreement

SUBOXONE GUIDLINES

BRIDGEPOINT HEALTH

BRIDGEPOINT HEALTH

BRIDGEPOINT HEALTH

SUBOXONE

BRIDGEPOINT HEALTH, LLC CONTACT US

3425 Superior Avenue

Sheboygan, WI 53081

Phone (920) 458-5557

Fax (920) 458-2692

www.BPHealth.org

OFFICE HOURS Monday & Tuesday 8:30AM— 8:00PM Wednesday & Thursday 8:30AM— 6:00PM Friday 9:00AM— 5:00 PM

SUBOXONE TREATMENT TEAM

CAROLYN J. BAXTER, MD

Board Certified Adult Psychiatrist

JOHN L. OLSEN, MD

Board Certified Adult Psychiatrist

RACHEL J. GRETEBECK, MS, CSAC

Certified Psychotherapist Licensed Clinical Substance Abuse Counselor

MICHAEL G. HUBER, MA, CSAC

Licensed Psychotherapist Licensed Clinical Substance Abuse Counselor

JULIE

Suboxone Case Manager

PROGRAM

How Buprenorphine Works

Opioid Receptor is Empty

Opioid Receptor Satisfied with

Full-Agonist Opioid

Opioid Replaced and Blocked by

Buprenorphine

For more information please visit

www.naabt.org/education/buprenorphine_treatment.cfm The graphics above were created by the National Alliance of Advocates for

Buprenorphine Treatment. The above illustrations are for educational

purposes and do not accurately represent the true appearance.

Over time (24-72 hours)

Buprenorphine Dissipates