Drug Deaths Taskforce: COVID-19 and opiate replacement therapy

Information from the Drug Deaths Taskforce regarding the challenges presented by COVID-19 to community pharmacies and the risk of overdose for opiate replacement therapy (ORT) patients.

Statement from the Drug Deaths Taskforce

The guidance from SDF this week is very welcome and we recommend all to follow this.  This statement relates specifically to risk of overdose for patients on opiate replacement treatment (ORT).  We have also sought and been reassured by Scottish Government that ORT (and IEP) remain essential services and will be prioritised.


Balancing risk of death from overdose against risk of death from COVID-19 for ORT patients, whilst taking account of risks to all vulnerable patient groups using pharmacies and of course pharmacy staff, is challenging.  Community Pharmacies have put in place social distancing measures to manage customer throughput and minimise contact risk for COVID-19 for all patients, customers and staff. However we recognise that pharmacies are under considerable additional work burden in the current COVID-19 emergency due to increasing demand and reducing workforce.


We have gathered information on what plans are discussed (and in some cases already in place) to inform this recommendation. In light of the considerable risk of overdose for people being able to take home ORT prescriptions we urge caution in your response.  A measured and tiered response is recommended. 

  1. Changes in practice should be informed by an overdose and safety risk assessment.
  2. Those at highest risk should still receive supervised consumption.
  3. Those deemed suitable can be moved to daily pick up.
  4. Moves to two or three times weekly should be considered rather than moving to weekly dispensing.
  5. We do not recommend a blanket change to prescriptions at service or prescriber level.  Instead changes, if required should be made when a new prescription is due or when a consultation takes place to ensure key overdose prevention and safe storage advice is given. 

In addition to these recommendations on ORT we recommend:

  1. Naloxone is provided to patients on ORT and IEP.
  2. There is maintained access to injecting equipment.
  3. Teams continue with non-fatal overdose post-incident management and response.




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