阿片类激动剂维持治疗作为一项基本卫生服务：减轻阿片类药物依赖治疗服务中断的实施指南

implementation guidance on mitigatingdisruption of services for treatment of opioiddependence Opioid agonist maintenancetreatment as an essentialhealth service: implementation guidance on mitigatingdisruption of services for treatment of opioiddependence © World Health Organization2025 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0IGOlicence (CCBY-NC-SA3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, providedthework is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorsesany specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then youmust license your work under the same or equivalent Creative Commons licence. If you create a translation of this work,you should add the following disclaimer along with the suggested citation:“This translation was not created by the WorldHealth Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original Englishedition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules ofthe World Intellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules/). Suggested citation. Opioid agonist maintenance treatment as an essential health service: implementation guidanceon mitigating disruption of services for treatment of opioid dependence.Geneva: World Health Organization;2025.https://doi.org/10.2471/B09543. Licence:CCBY-NC-SA3.0IGO. Cataloguing-in-Publication (CIP) data.CIP data are available athttps://iris.who.int/. Sales, rights and licensing.To purchase WHO publications, seehttps://www.who.int/publications/book-orders. Tosubmit requests for commercial use and queries on rights and licensing, seehttps://www.who.int/copyright. Third-party materials.If you wish to reuse material from this work that is attributed to a third party, such as tables, figuresor images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission fromthe copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work restssolely with the user. General disclaimers.The designations employed and the presentation of the material in this publication do notimply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country,territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dottedand dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed orrecommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted,the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, thepublished material is being distributed without warranty of any kind, either expressed or implied. The responsibility for theinterpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Contents Acknowledgements Key messagesvi Introduction1 Global opioid use2Opioid agonist maintenance treatment2 Uninterrupted OAMT is critical5 Mitigationmeasures in case of unplanned interruptions6Ensuring the continuityand integration of OAMT in times of crisis6Community-led resilience and multi-stakeholder coordination in OAMT disruptions7Consideration of take-home doses8Overdose management9Assistedwithdrawal management9Relapse prevention with other forms of evidence-based pharmacotherapy11Psychosocial support11 References12 Annex. Development process of the implementation guidance13 Acknowledgements This document is the result of collaboration between the World Health Organization (WHO) Department ofGlobal HIV, Hepatitis and Sexually Transmitted Infections Programmes and Department of Mental Health,Brain Health and Substance Use. The work was coordinated by (in alphabetical order) Anja Busse, DzmitryKrupchanka, Niklas Luhmann and Annette Verster, with supervision by Dévora Kestel (Department of MentalHealth, Brain Health and Substance Use) and Meg Doherty (Department of Global HIV, Hepatitis and SexuallyTransmitted Infections Programmes), under the overall leadership of Jérôme Salomon (Assistant Director-General, Universal Health Coverage/Communicable Diseases, Noncommunicable Diseases and Mental Health).Ernst Wisse (consultant, WHO) was the main technical writer, supported by the abo