Goffman defined stigma as an “attribute that is deeply discrediting” and in the last two decades research on this subject grew substantially.Opioids were ranked as the second most common form of illicit drug used worldwide and there is consensus in the literature that opioid substitution therapy (OST), methadone or buprenorphine, are the most effective treatments, although remain underutilized. People with an history of substance use disorders (SUD) are widely stigmatized, a significant barrier to detection and treatment efforts. Care workers were cited as the second most common source of stigma.

The aim is to do a review of the literature of stigma as a significant barrier to OST and present several potential strategies to reduce stigma.

Non-systematic review of the literature with selection of scientific articles published in the last 5 years; by searching the Pubmed and Medscape databases using the combination of MeSH descriptors. The following MeSH terms were used: Opioid Use Disorder; Stigma; Opioid Substitution Therapy

OST providers should actively bring up the topic of stigma in clinic appointments to determine whether the patient is experiencing stigma, and if so, whether it is adversely affecting their ability to continue in the treatment. More active measures need to be taken to help reducing the stigma through public awareness campaigns at local levels, continuing education of health care providers regarding substance OST, and greater incorporation of family members into the program.

In conclusion, further research is required to understand and address this issue.

No significant relationships.

COVID-19 has been declared as a pandemic by the World Health Organization on March, 2020. Opioid substitution therapy (OST) for opioid-dependent patients is an evidence-based, effective outpatient (OPD) based treatment maintained on medications(, buprenorphine-naloxone combination). These are difficult times for patients with addictive disorders. Authors came up with an idea of implementing “walk through” out patient model inspired by “Drive through” model of Mc Donalds in which Doctor and Nurses run open space OPD near to Medical record section to reduce the waiting time of patient, quick delivery and minimize droplet exposure.

To study the efficacy of Mc Donald’s model of OST in OST centre in Tarn Taran, india.

This was a restrospective-comparative study. We studied records of our patients using streatment as usual from September 2019 to March 2020 and using Mc Donald’s model (From April 2020 to October, 2020) for a period of 6 months during and before lockdown.

The average number of patients attending OST clinics during Covid lockdown was 352.8. The compliance rates significantly improved (57.82%), The drop out rates were much lower (20.78%), using Mc Donald’s model than usual treatment.

As per our knowledge, this study is first of its kind to study the efficacy of OST drug deliverance in pre Covid and Covid times and suggest, the new findings which can be inculcated in the other OSTs.