Table 1.
Guidance and recommendations on maintaining opioid treatment programs during coronavirus disease 2019
| No. | Institution/Country/Authors | Date | Guidance/Recommendation | Content on maintaining opioid treatment programs |
| 1 | United Nations Office of Drugs and Crime | March 2020 | Suggestions about treatment, care and rehabilitation of people with drug use disorder in the context of the COVID-19 pandemic (https://www.unodc.org/unodc/en/covid-19-policy-documents.html) | Address continued access to the servicesAddress the safety of the staff and the patients at the servicesContinuity of low-threshold servicesContinuity of psycho-social therapiesContinuity of pharmacological therapyMake sure the premises of the services areclean and hygienicProvide people with information on and means to protect themselves at every possible occasionSupport homeless people, including people with drug use disordersUnder no condition should a person be denied access to healthcare based on the fact that they use drugs |
| 2 | United States DEA | March 2020 | Use of Telephone Evaluations to Initiate Buprenorphine Prescribing (https://www.deadiversion.usdoj.gov/coronavirus.html) | Prescribing buprenorphine to new patients with OUD for maintenance treatment or detoxification treatment following an evaluation via telephone voice calls, without first performing an in-person or telemedicine evaluation |
| 3 | SAMHSA | March 2020 | OTP Guidance (https://www.samhsa.gov/coronavirus) | Flexibility of take-home medication |
| 4 | EMCDDA | Updated March 2020 | The implications of COVID-19 for PWUD and drug service providers (https://www.emcdda.europa.eu/publications/topic-overviews/covid-19-and-people-who-use-drugs_en) | Ensuring service continuityService provider protection during the pandemic – important interventions to consider |
| 5 | Farhoudian, A., Baldacchino, A., Clark, N., et al. ISAM | March–April 2020 | COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine Practice and Policy Interest Group Position Paper (http://bcn.iums.ac.ir/browse.php?a_code=A-10-2476-1&sid=1&slc_lang=en) | Protocol for opioid pharmacotherapy provisionConsiderations regarding different stages of maintenance therapyUrine/Saliva drug testing |
| 6 | SDF | Updated May 2020 | Guidance on contingency planning for people who use drugs and COVID-19 (http://www.sdf.org.uk/covid-19-guidance/) | Maintaining services that support and treat people who are affected by problem drug useEnsuring that people using their service and others are supported to comply with government guidance on social distancing, self-isolating, and shielding |
| 7 | CRISM | May–July 2020 | A series of six national guidance documents in relation to the COVID-19 pandemic and people who use substances (https://crism.ca/projects/covid/) | Supporting people who use substances in shelter settings during the COVID-19 pandemicTelemedicine support for addiction servicesHarm reduction worker safetyRecovery environmentsSupporting people who use substances in acute care settings during the COVID-19 pandemicStrategies to help individuals self-isolate for people who use drugs |
| 8 | The Chinese Association of Drug Abuse Prevention and TreatmentThe Academic Group of Drug Dependence of the Chinese Society of PsychiatryThe Academic Group of Addiction of the Chinese Society of Psychosomatic MedicineThe Specialty Committee of Addiction Medicine of the Chinese Psychiatrist Association | July 2020 | Expert consensus on the prevention and treatment of substance use and addictive behavior-related disorders during the COVID-19 pandemic (https://gpsych.bmj.com/content/33/4/e100252) | Provide a safer medical environment and alleviate patient concerns about infection during daily medicationPay more attention to the education and prevention of COVID-19 and screening evaluationsMaintain the stability of the treatment plan and prevent additional substance addiction |
| 9 | ACMT | August 2020 | ACMT Position Statement: Caring for Patients with Opioid Use Disorder during Coronavirus Disease Pandemic (https://link.springer.com/article/10.1007/s13181-020-00800-9) | Recommendations on Government/Drug Enforcement Agency, Healthcare Systems and Facilities, Payers and Local Initiatives to Increase Access to Care, and Healthcare Providers to modify regulations and practices related to providing treatment for OUD while reducing the need for in-person visits |
| 10 | CIHR | November 2020 | Rapid review of the impacts of ‘Big Events’ on people who use drugs and delivery of harm reduction and drug treatment services: Implications for strengthening systems in response to COVID-19 (https://cihr-irsc.gc.ca/e/52044.html) | Drug market and service disruptions increase drug-related risksPsychological and financial instability increase drug-related riskThe need for flexibility to support people who use drugs to reduce riskPreparedness plansConsiderations for women, Indigenous peoples, and visible minorities who use drugs |
| 11 | England | Updated January 2021 | COVID-19: guidance for commissioners and providers of services for people who use drugs or alcohol (https://www.gov.uk/government/publications/covid-19-guidance-for-commissioners-and-providers-of-services-for-people-who-use-drugs-or-alcohol/covid-19-guidance-for-commissioners-and-providers-of-services-for-people-who-use-drugs-or-alcohol) | Access to opioid substitution treatmentDepot buprenorphine, NSPsDrug detoxification |
ACMT, The American College of Medical Toxicology; CIHR, Canadian Institutes of Health Research; COVID-19, coronavirus disease 2019; CRISM, Canadian Research Initiative in Substance Misuse; DEA, Drug Enforcement Administration; EMCDDA, European Monitoring Centre for Drugs and Drug Addiction; ISAM, International Society of Addiction Medicine; NSPs, needle and syringe programs; OTP, Opioid Treatment Program; OUD, opioid use disorder; PWUD, people who use drugs; SAMHSA, Substance Abuse and Mental Health Services Administration; SDF, Scottish Drugs Forum.