WHO announces development of updated guidelines for the psychosocially assisted pharmacological treatment of opioid dependence and community management of opioid overdose
In 2022, approximately 60 million people globally engaged in non-medical opioid use, including the use of drugs like heroin, morphine, codeine, fentanyl, methadone, tramadol, and other similar substances. Their regular non-medical use, prolonged use, use by injection, misuse and use without medical supervision can lead to opioid dependence and other health problems, and associated with significant health burden. Out of 600,000 deaths attributed to drug use, about 450 000 are due to use of opioids according to the latest WHO estimates.
It is crucial that people with opioid dependence and those at risk of opioid overdose have access to prevention, harm reduction, treatment, and care, which are of good quality, affordable, ethical and evidence based. While some 64 million people globally are estimated to live with drug use disorders, access to treatment remains very limited, with less than 10% having access to it.
To address the issue, WHO has published guidelines for the psychosocially assisted pharmacological treatment of opioid dependence (2009) and community management of opioid overdose (2014).
In the guidelines, WHO recommends the use of a range of treatment options for opioid dependence. These include opioid agonist maintenance treatment (or OAMT) with medicines such as methadone and buprenorphine, pharmacological treatment with opioid antagonists (such as naltrexone) as well as psychosocial support. In the choice of treatment, WHO recommends OAMT to be used for most patients as the intervention with strongest evidence of effectiveness for variety of outcomes. These include reduction in non-medical opioid use, mortality and morbidity (including due to opioid overdose, HIV and viral hepatitis), lowering risk of crime and incarceration, better retention in treatment, quality of life and overall wellbeing. In the guidelines on community management of opioid overdose, WHO recommends that people who are likely to witness an opioid overdose, including people who use opioids, and their family and friends should be given access to naloxone and training in its use so that they can respond to opioid overdose in an emergency.
Currently, WHO is convening a guideline development group (GDG) for update of both guidelines with an aim to improve availability and access to treatment of opioid dependence and reduce the number of deaths from opioid overdose by providing evidence-based recommendations on the psychosocially assisted pharmacological treatment and interventions on prevention and management of opioid overdose.
A GDG meeting will be held in Geneva in October 2025. Evidence, including systematic reviews, about treatment of opioid dependence and management of opioid overdose will be presented to the GDG. GDG members will contribute to the review of systematic reviews, evidence summaries, technical updates, and will propose recommendations.
Guideline development group composition
In accordance with WHO guidelines for developing recommendations, the steering group for the guidelines development includes members from multiple WHO teams in Headquarter and Regional Offices, including departments directly working in the area of drug policy, such as the Departments of Mental Health, Brain Health and Substance Use (UCN/MSD), Access to Medicines and Health Products (MHP/HPS), and Global HIV, Hepatitis and STIs programmes (UCN/HHS).
The Guideline Development Group (GDG) is composed of members from all WHO regions, serving in their individual capacities rather than as representatives of affiliated organizations. GDG members were selected by WHO technical staff based on their technical expertise, their role as end-users (e.g., programme managers and healthcare providers), and their representation of affected communities. Members do not receive financial compensation for their contributions to this process.
Call for public comments
To ensure transparency and inclusivity, WHO invites members of the public and interested organizations to review the biographies of the GDG members and provide feedback. Comments can be submitted via email to msd-ada@who.int by latest 25 February 2025.
This feedback helps WHO develop high-quality guidelines that reflect diverse perspectives and respond to the needs of communities worldwide.