Background. The management of COVID-19 disease is threatening health systems globally. People who use drugs, in particular opioid users, have increased vulnerability. Targeted adaptations of opioid agonist treatment (OAT) are required to protect this vulnerable population and the healthcare workers providing services.

Aim. To describe and discuss the associated evidence for the measures implemented to reduce the risks associated with COVID-19 to Irish OAT services.

Results: Irish OAT services have implemented the following measures: reduced supervision requirements, increased the use of virtual patient care, streamlined assessment and induction processes to remove barriers to OAT access, provided home delivery of medications, increased access to naloxone and overdose programmes, targeted health and social interventions for the homeless and reduced our prison population. For now, non-essential services including drug and blood-borne virus screening and hepatitis C treatment have been postponed. Planning and review of Irish OAT services is ongoing so that further adaptations can be implemented as challenges emerge.

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