COVID-19 and Mental Health (CMH) Initiative: Research

A Rapid Review of Opioid Substitution Therapy During Major Disruptions to Medical Care

Key Messages

  • Disaster planning must take into account the health care of people who use drugs (PWUDs) and, specifically, individuals suffering from opioid use disorder
  • There is an identified need for:
    • centralized databases with essential information regarding PWUDs, their medical records, and their medications and dosages
    • standardized but flexible guidelines for OST clinic operation during a disaster
    • communication strategies that connect PWUDs with OST clinic staff and with alternative sources of treatment
    • networks of OST clinics that support each other during an emergency
    • transportation strategies based upon links with public and private transport companies


  • Opioid
  • Opioid use disorder
  • Methadone
  • Buprenorphine
  • Opioid substitution therapy
  • Disruptions to medical care
  • COVID-19
  • Pandemic
  • Disaster preparedness


  • Nominated Principal Applicant: Dr. Ross Upshur, Lunenfeld-Tanenbaum Research Institute (Toronto)
  • Nominated Principal Applicant: Dr. Abhimanyu Sud, Family & Community Medicine, University of Toronto (co-PI)
  • Fabio Salamanca-Buentello, Lunenfeld-Tanenbaum Research Institute (Toronto);
  • Darren K. Cheng, Lunenfeld-Tanenbaum Research Institute – Bridgepoint (Toronto);
  • Ross Upshur, Lunenfeld-Tanenbaum Research Institute (Toronto);
  • Abhimanyu Sud, Family & Community Medicine, University of Toronto

For more information, please contact: Abhimanyu Sud,

Related Syntheses


(External links)

Full PDF

Lay Summary PDF


People Who Use Drugs (PWUD) and Substance Use


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