Withdrawal Management Services Toolkit
This toolkit was created for providers working in residential community-based withdrawal management services (WMS) to standardize care, improve documentation and information sharing, and provide quick access to relevant information. You can download the entire toolkit or the individual tools (see below).
Introduction to the WMS toolkit
Intake
A tool for screening potential clients prior to withdrawal management services (WMS) admission.
Part of WMS toolkit
Version date: 25 January 2024
A template for assessing a client’s risk of medical complications upon admission to withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2022
A form for collecting a client’s medical history on admission to withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
A consent form for a withdrawal management service (WMS) to share or receive a client’s personal health information.
Part of WMS toolkit
Version date: 25 January 2022
Treatment
A decision-making tool for managing alcohol withdrawal in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
An order set for the management of alcohol withdrawal in withdrawal management services (WMS).
Part of WMS toolkit
Part of RAAM clinic toolkit
Version date: 25 January 2024
A decision-making tool for managing opioid withdrawal and initiating opioid agonist therapy (OAT) in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
An order set for the management of opioid withdrawal and initiation of opioid agonist therapy (OAT) in withdrawal management services (WMS).
Part of WMS toolkit
Part of RAAM clinic toolkit
Version date: 25 January 2024
A form for clients who decline opioid agonist therapy (OAT) in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
An algorithm for managing stimulant use in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
An algorithm for managing benzodiazepine use in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
An algorithm for managing cannabis use in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
A medical directive form authorizing nurse practitioners, registered nurses, and registered practical nurses to use a breathalyzer and perform urine dipstick analysis in withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2022
Recommendations for managing unique concerns for withdrawal management services (WMS) clients.
Part of WMS toolkit
Version date: 25 January 2024
Emergency department
An algorithm for determining when a withdrawal management services (WMS) client needs to be transferred to the emergency department (ED).
Part of WMS toolkit
Version date: 25 January 2024
A checklist for client transfer from emergency department (ED) to withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
Discharge
A form for a client’s discharge from withdrawal management services (WMS).
Part of WMS toolkit
Version date: 25 January 2024
A template for a discharge note to primary care after a client has been started on buprenorphine (Suboxone) in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024
A form advising clients of a loss of opioid tolerance on discharge from withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024
A template for a discharge note to primary care after a client has been started on naltrexone in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024
A template for a discharge note to primary care after a client has been started on gabapentin in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024
A template for a discharge note to primary care after a client has been started on depot buprenorphine (Sublocade) in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024
Sample Policies
A sample document for withdrawal management services (WMS) outlining the suggested policies and procedures for the storing, dispensing, and disposal of client medications.
Part of WMS toolkit
Version date: 25 January 2024
A sample document for withdrawal management services (WMS) outlining the suggested policies and procedures for cannabis use onsite.
Part of WMS toolkit
Version date: 25 January 2022
A sample document for withdrawal management services (WMS) outlining the suggested policies and procedures regarding smoking and nicotine replacement therapy (NRT) onsite.
Part of WMS toolkit
Version date: 25 January 2022
Scales
The subjective opioid withdrawal scale (SOWS) is used to quantify the severity of someone’s opioid withdrawal.
Part of WMS toolkit
Version date: 25 January 2022
The level of agitation scale is used to quantify the degree to which a client is agitated/distressed.
Part of WMS toolkit
Version date: 25 January 2022
The CIWA-Ar is a validated scale for measuring the severity of alcohol withdrawal, for use in in various settings, including withdrawal management and the emergency department (ED).
Part of WMS toolkit
Part of RAAM clinic toolkit
Version date: 25 January 2022
Appendices
This toolkit was created for providers working in residential community-based withdrawal management services (WMS) to standardize care, improve documentation and information sharing, and provide quick access to relevant information.
Authors: Katie Dunham, Mareena Mathew, Karan Cheema, Laura Jones, Kristine Rivest, Jared Bonis, Meldon Kahan, and Jennifer Wyman
Version date: 25 January 2024
Katie Dunham BSc, BScN, MN, NP-PHC
Mareena Mathew NP-Adult
Karan Cheema BScN, MN, NP-PHC
Melanie Vandewiel MN, NP-PHC
Laura Jones BSc, BScN, MN, NP-Adult
Kristine Rivest BScInf, MScN, NP-PHC
Jared Bonis BscN, MScN, TITC-CT, NP-PHC
Meldon Kahan MD, CCFP, FRCPC
Jennifer Wyman MD, FCFP, DABAM, MPH
Rachel Alexander, Peer Advisor, META:PHI
Cassel Busse RN, PhD
Jarel Calumpang RN, BScN, MN
Christina Henry RN, BScN, BA
Nina Kovacic BA, MSW
Larry Nijmeh MD, CCFP(EM) FCFP
Robyn Nocilla BScN, MSc, NP-PHC
Rose Patterson BscN, MN, NP-PHC
Josh Richardson RP, RPN, PNC, BA-Hons
Rosanra (Rosie) Yoon MN, NP-Adult
Maria Zhang RPh, BScPhm, PharmD, MSc