WHO recently launched new guidance on Opioid agonist maintenance treatment as an essential health service: implementation guidance on mitigating disruption of services for treatment of opioid dependence.

In 2022, an estimated 60 million people worldwide engaged in non-medical opioid use, including substances such as heroin, morphine, codeine, fentanyl, methadone and tramadol. According to the latest WHO estimates, opioids are responsible for a significant proportion of drug-related mortality, accounting for approximately 450 000 of the 600 000 deaths attributed to drug use globally. Infectious diseases, including HIV and viral hepatitis, and opioid overdose are among the leading causes of death associated with opioid use.

Opioid agonist maintenance treatment (OAMT) for people with opioid dependence is a cost-effective intervention that reduces mortality, morbidity, non-medical opioid use, and HIV and hepatitis C virus (HCV) transmission. It lowers risky behaviours, crime, and social costs, while improving treatment retention and overall well-being.

OAMT should be widely accessible, provided free of charge or covered by public health-care insurance, with an appropriate system of governance. Ideally, opioid dependence treatment should be fully integrated into health-care systems, within a framework of clinical governance and clear lines of clinical accountability to ensure that minimum standards are consistently met.

When unplanned interruptions of OAMT are expected, contingency measures must be implemented early to minimize harm. These include community consultations on mitigation measures, scaling up community management of opioid overdose with naloxone, reinforcing take-home opioid agonist schemes in case of workforce shortages, increasing psychosocial support and ensuring multi-stakeholder coordination.

Unplanned reductions in OAMT dosage can be life-threatening. If opioid withdrawal is unavoidable, people must receive adequate medical support in following established protocols for pharmacologically assisted withdrawal management.

WHO calls on countries, service planners, providers, policy-makers, and all stakeholders involved in treatment and overdose prevention programmes to ensure live-saving interventions are maintained.

Join WHO, the International Network on Health and Hepatitis in Substance Users (INHSU) and Médecins du Monde (MdM), on 17 December in the global webinar on the new guidance.