Does opioid substitution treatment have a protective effect on the clinical manifestations of COVID

British Journal of Anaesthesia

Does opioid substitution treatment have a protective effect on the clinical manifestations of COVID-19? Comment on Br J Anaesth 2020; 125: e382–3

Authors: MarieEagleton(Senior Biochemist)1SiobhanStokes(Principal Biochemist)1FionaFenton(Consultant Psychiatrist in Addictions)1EamonKeenan(National Clinical Lead)2

Editor -
A recent letter acknowledged the perceived clinical vulnerability to SARS-CoV-2 infection of groups chronically treated with or using opioids but noted there was little published clinical data to support this prediction1. Other international reports have described an unexpectedly low incidence of COVID-19 in people who misuse drugs.2 In Ireland, a rapid response to the pandemic was introduced to ensure that those already treated with opioid substitution treatment could continue and that those who were newly identified with opioid use disorder were rapidly inducted onto opioid substitution treatment (methadone or buprenorphine). Many patients with opioid use disorder are considered to be more vulnerable to SARS-CoV-2: a significant number have dual diagnoses and complex care needs including homelessness and underlying conditions such as hepatitis C virus infection, HIV infection, or chronic respiratory conditions. Due to their increased vulnerability, extensive protective measures were introduced for this population on opioid substitution treatment, including twice weekly review of their COVID-19 status, provision of accommodation and take away medication.

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