This page provides tools for organizations and hospitals who are interested in or already implementing medication treatment for opioid use disorder.

Examples of buprenorphine programs in Washington State

There are many ways to set up your buprenorphine program. This article provides a helpful overview of clinical protocols that can help, or get in the way of, care prior to and during treatment.

Below are examples of policies and procedures for buprenorphine programs in Washington State.

Office-Based Opioid Treatment Policy & Procedure Manual: Adult Medicine Clinic, Harborview

HMC OBOT manual

Download full manual (pdf)
Download patient agreement (pdf)

  • Team based approach that focuses on “patient engagement, patient retention in care, and patient progress in one or more life domains.”
  • Counseling is optional but strongly encouraged.
  • Patients are not discontinued from treatment if they continue to use opioids or other drugs.

Low Barrier, High Capacity Buprenorphine Treatment for High Risk/Low Access Population: Olympia Bupe Clinic, Capital Recovery Center

History and Current Status: July 2019 | Policy and Procedures

  • Low-barrier clinic.
  • Peer-delivered model that includes onsite dispensing and pharmacy support.
  • Team of rotating buprenorphine prescribers, each utilizing their own DEA waiver.
  • Co-located with a syringe exchange program, offers case management as well.
  • No commitment to “recovery” and no counseling required. Patients set their own goals for treatment.

Buprenorphine Induction Handout for Patients: Neighborcare

Download handout

Neighborcare, a network of Federally Qualified Health Centers in King County, offers appointment-based primary care buprenorphine as well as a low-barrier buprenorphine program within community-facing clinic settings.

This handout describes the process for at-home induction of buprenorphine for patients.

Other states' guides for implementing buprenorphine or medication first programs

Implementing Transmucosal Buprenorphine for Treatment of Opioid Use Disorder

From New York State
Download this document (pdf)


  • Counseling should be offered but not required.
  • “An extensive assessment is not necessary.” A focused assessment should include patient history, physical exam, relevant lab tests, HIV/HCV testing.
  • Patients should not be discontinued from buprenorphine for the use of other drugs.
  • “Patients, particularly those opting to stop medication, should also be referred to harm reduction, peer, or other supportive services.”

Provider Implementation Guide: Using a Medication First Model

From Missouri Department of Mental Health, Division of Behavioral Health
Download this guide (pdf)

This implementation guide describes Missouri’s State Targeted Response program goals, and implementation of their medication-first model. The goal of the program is to save lives through patient-centered care involving medications for opioid use disorder.

Information about low-barrier buprenorphine

Goal: The goal of low-barrier buprenorphine, a new and growing model of care for opioid use disorder (OUD), is to reduce opioid overdose deaths and improve health and quality of life for all people with OUD.

Strategy: Increase access to buprenorphine for people with OUD by creating patient-centered programs that are easy to access, offer a high quality of care, and eliminates hurdles to access or stay in care for OUD.

Rationale: Medications are the front-line treatment for opioid use disorder and are underutilized.

Read more about low-barrier buprenorphine here.

Emerging issues

Local Examples of Washington State Organizations Providing Medications for Opioid Use Disorder During COVID-19, Addictions, Drug & Alcohol Institute (ADAI), University of Washington, April 2020