WHO revises guidelines on opioid dependence and overdose prevention

The World Health Organization (WHO) announces the update of several recommendations in the forthcoming guidelines for the treatment of opioid dependence and community management of opioid overdose.

Opioid dependence continues to pose significant challenges to global health, contributing to morbidity and mortality rates. In 2023, it is estimated that 316 million individuals worldwide engaged in drug use, including approximately 61 million who participated in non-medical opioid use. Opioids remain the primary substance responsible for the majority of health burdens associated with drug use, including fatal overdoses. Among an estimated 600,000 deaths globally linked to drug use, around 450,000 are attributed to opioid-related causes.

It is crucial to ensure that individuals with opioid dependence—and those at risk for opioid overdose—have access to affordable, ethical, high-quality, and evidence-based support and care. While approximately 64 million people globally suffer from drug use disorders, fewer than 10% currently receive the necessary treatment.

To assist countries in addressing this gap, the WHO is developing and updating guidelines focused on the treatment of opioid dependence and community management of opioid overdose. These guidelines aim to increase access to effective care and reduce deaths from opioid overdose through evidence-based recommendations.

In line with WHO's rigorous methodology for guideline development, the updated recommendations are based on a thorough process that examined the balance of benefits and harms, values and preferences, cost-effectiveness, equity, acceptability, and feasibility. The Guideline Development Group (GDG) reviewed extensive findings from systematic literature reviews containing both quantitative and qualitative evidence, enabling them to update existing recommendations and formulate new ones.

In the updated guidelines, the WHO reaffirms its recommendation for opioid agonist maintenance treatment (OAMT), which involves the administration of rigorously evaluated opioid agonists by accredited professionals within established medical frameworks to individuals with opioid dependence to achieve specific treatment objectives. In addition to its strong recommendations for OAMT using methadone and oral buprenorphine, the WHO now also includes new formulations of long-acting injectable buprenorphine as a conditional recommendation.

Under the supervision of the WHO Guidelines Review Committee, in collaboration with the Guideline Development Group (GDG) and the guidelines methodologist, the Steering Group is advancing the peer review, finalization, and publication of the comprehensive guidelines, which are expected to be released later this year or in early 2027. These guidelines will provide detailed recommendations, the rationale behind them, evidence profiles, implementation considerations, identified research gaps, and additional relevant information.