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Heroin Addiction and Related Clinical Problems: 2026, 28: 69-72

Continuation of COVID-19-Era Modifications to Opioid Agonist Treatment: Telemedicine, Reduced Supervision, and the Post-Pandemic Care Model

Des Crowley, and Marie Claire Van Hout

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2026-9

Summary: Background: During the COVID-19 pandemic, opioid agonist treatment (OAT) services implemented major service adaptations to maintain treatment continuity while reducing infection risk. These included telemedicine consultations, reduced supervised dosing, expanded take-home medication supplies, and reduced monitoring requirements. Many jurisdictions have continued or formalised these changes beyond the pandemic. Methods: A narrative review of literature published between 2012 and 2026 was conducted using PubMed and relevant policy sources. Studies addressing OAT delivery models, telemedicine, supervision practices, and take-home dosing policies were prioritised. Results: Evidence suggests that telemedicine-based buprenorphine treatment demonstrates retention outcomes comparable to traditional in-person care. Expanded methadone take-home dosing implemented during the COVID-19 pandemic has not been associated with increased overdose mortality. Reduced supervision and less frequent routine drug testing may support more individualised, patient-centred treatment models. Conclusions: A blended model of care combining telemedicine, expanded take-home dosing, and proportionate monitoring appears safe and effective. Post-pandemic OAT policy should focus on maintaining flexible treatment delivery while ensuring appropriate safeguards and equitable access to care.

Keywords: opioid agonist treatment; methadone; buprenorphine; telemedicine; take-home dosing; COVID-19