WHO announces revisions to several recommendations in its upcoming guidelines on the treatment of opioid dependence and the community-based management of opioid overdose.

Opioid dependence continues to be a significant driver of illness and death worldwide. In 2023, an estimated 316 million people globally used drugs, including about 61 million who reported non-medical use of opioids. Opioids remain responsible for the greatest share of drug-related harm, particularly fatal overdoses. Of the roughly 600 000 deaths linked to drug use each year, approximately 450 000 are associated with opioid consumption.

It is critical to ensure that individuals living with opioid dependence—and those vulnerable to overdose—can obtain affordable, ethical, high-quality, and evidence-based services and care. Although around 64 million people worldwide are affected by drug use disorders, fewer than one in ten currently have access to treatment.

To help countries close this treatment gap, WHO regularly develops and updates guidance on managing opioid dependence and responding to opioid overdose in community settings. The objective of these guidelines is to broaden access to proven interventions and to decrease mortality related to opioid overdose through clear, evidence-informed recommendations.

Following established WHO procedures for guideline development, the revised recommendations were shaped through a thorough evaluation process. This process assessed the balance between benefits and risks, as well as values and preferences, cost-effectiveness, equity, acceptability, and feasibility. Extensive systematic reviews of both quantitative and qualitative research were analyzed by the Guideline Development Group (GDG), which reviewed existing guidance and formulated new recommendations where appropriate.

In the updated document, WHO maintains its recommendation for opioid agonist maintenance treatment (OAMT), defined as the supervised provision of carefully evaluated opioid agonist medications by qualified professionals within recognized medical practice to individuals with opioid dependence, with the aim of achieving specific therapeutic goals. In addition to its continued strong endorsement of OAMT using methadone and oral buprenorphine, WHO now also includes guidance on new long-acting injectable formulations of buprenorphine, issued as a conditional recommendation.

Under the supervision of the WHO Guidelines Review Committee, and in collaboration with the GDG and the guideline methodologist, the Steering Group is moving forward with peer review, final editing, and preparation for publication of the complete guidelines. Release is anticipated later this year or in early 2027. The finalized document will provide comprehensive recommendations, explanations of the supporting evidence, detailed evidence profiles, practical considerations for implementation, identified research priorities, and other relevant information.