This article briefly describes opioid treatment programs (OTPs) and highlights the experiences of two OTPs during the COVID-19 pandemic. One of the OTPs, The Hope House, is a residential treatment program with two locations in Scottsdale, Arizona. The other, Western Wake Treatment Center, is a clinic-based OTP in Apex, North Carolina. The article's objective is to help Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) sites determine the best strategies to handle the impacts of the pandemic on their opioid use disorder programming/OTPs.