UNODC HIV/AIDS Section organizes CND side event on take-home opioid substitution therapy in the context of COVID-19: successes and opportunities

16 April 2021 - Vienna - A side event on “Take-home opioid substitution therapy in the context of COVID-19: Successes and opportunities” was conducted within the frame of the 64th session of the Commission on Narcotic Drugs (CND) with an aim to raise awareness about the positive results of the expansion of the take-home opioid substitution therapy (OST) during the COVID-19 pandemic and the state of emergency declared in many countries. The virtual event was co-chaired by Médecins du Monde and UNODC HIV/AIDS section and moderated by Ms. Samantha Hodgetts, Harm Reduction Advocacy Advisor at Médecins du 

Monde. This meeting attracted over 50 participants and included country presentations from Moldova, Kenya, Myanmar and Ukraine with Questions and Answers session at the end of the meeting. Samantha Hodgetts opened the side event and highlighted in her remarks that in the context of COVID-19, the situation has been very difficult for everyone and that the state of emergency that governments implemented showed that there is a need to rapidly adapt many health services. Ms. Hodgetts further noted that this adaptation is important to make sure that we continue the access to and continuity of service delivery of harm reduction treatment to people who use drugs.
  
Monica Ciupagea, MD, Expert on drug use and HIV at the UNODC HIV/AIDS Section, a co-chair of the meeting, underlined that UNODC HIV/AIDS Section started a study with a focus on high priority countries for drug use and HIV. In her presentation about continuity of the opioid agonist treatment in UNODC high priority countries for drug use and HIV during COVID-19 pandemic, Ms. Ciupagea highlighted several preliminary results of the study that illustrated that despite COVID-19-related challenges, the treatment for patients in the pandemic isolation continues with a good adherence to treatment. In addition, the preliminary results of the study showed that take-home dose policy along with a virtual support increased satisfaction among patients and implementers.
  
The experience of Moldova on how the substitution treatment program had been organized for the patients during the COVID-19 pandemic was presented by Dr. Lilia Fiodorova, psychiatrist-narcologist at the Republican Narcology Dispensary of Moldova. Ms. Fiodorova emphasized that given the state of emergency in Moldova, according to the recommendations of the Ministry and UNODC, and taking into consideration patients’ needs, an internal Instruction on individual provision of take-home methadone and buprenorphine to patients was adopted.
  
Ms. Helgar Musyoki, the Head of the Prevention Unit and Program Manager, NASCOP Ministry of Health of Kenya presented an overview on medication-assisted therapy and take-home doses in Kenya where specific service delivery strategy was adopted in the context of the COVID-19 pandemic. The main objectives of this strategy in Kenya include the support for key population-focused programs and provision of continuity of HIV prevention, testing and treatment for key populations.
   
The Myanmar country example was presented by Dr. Minn Thit Aung, Médecins du Monde Myanmar in Kachin. Since the start of the COVID-19 pandemic in Myanmar, Médecins du Monde set up infection prevention and control measures at methadone maintenance treatment (MMT) centers and ensured social distancing, provision of face masks for clients and temperature monitoring. According to the order issued by the Ministry of Health and Sports of Myanmar, methadone replacement therapy (MRT) clients were provided with take-home doses for 14 days with an aim to avoid COVID-19 transmission in MMT centers. Mr. Minn Thit Aung noted that given the current political situation and the state of emergency in the country, almost all methadone centers continue to provide take-home doses to the clients that contributes to a longer treatment retention.

 

The presentation of Ms. Kateryna Terykh, Specialist of the Viral Hepatitis and Opioid Dependency Department, Public Health Center of the Ministry of Health of Ukraine, concluded this side event. In her presentation Ms. Terykh outlined several recommendation letters prepared by the Ministry of Health of Ukraine together with the Public Health Center on the organization of the OST program during the COVID-19 pandemic including transfer of patients to take-home medication. Ms. Terykh added that in the context of COVID-19 it is necessary to take measures to control the intake of home-take doses of OST medication that will allow to increase adherence to this form of medication and to prevent the risk of its improper use.

To access recorded video of this side event, please click here.

To access the video with the patients’ voices from Myanmar, please click here.