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Effects of Medication-Assisted Treatment (MAT) for Opioid Use Disorder on Functional Outcomes: A Systematic Review
Rand Health Quarterly
|June 26, 2020
Summary
Medication-assisted treatment (MAT) for opioid use disorder (OUD) shows mixed functional outcomes. While beneficial compared to no treatment, MAT patients had poorer cognitive function than healthy individuals, with low-quality evidence overall.
Area of Science:
- Pharmacology and Addiction Medicine
- Neuroscience and Behavioral Science
Background:
- Opioid Use Disorder (OUD) significantly impacts individuals' functional capacity.
- Medication-assisted treatment (MAT) is a cornerstone of OUD management, utilizing medications like buprenorphine, methadone, and naltrexone.
- The effects of MAT on diverse functional outcomes require comprehensive evaluation.
Purpose of the Study:
- To systematically review the effects of MAT for OUD on functional outcomes.
- To compare MAT efficacy against various control conditions, including wait-list and no medication.
- To investigate impacts on cognitive, physical, occupational, social/behavioral, and neurological functions.
Main Methods:
- Systematic literature search across five databases (inception to 2017) and reference mining.
- Screening of 6,292 citations, with 1,327 full-text articles reviewed.
- Inclusion of 37 studies, with critical appraisals and meta-analyses for result synthesis.
Main Results:
- MAT demonstrated significant improvements in some functional outcomes compared to non-MAT interventions for OUD.
- Conversely, MAT patients exhibited worse performance on certain cognitive measures relative to healthy controls.
- The overall quality of evidence was rated as low or very low due to moderate-to-high risk of bias in most studies.
Conclusions:
- Current evidence on MAT's functional effects in OUD is limited and of low quality.
- Further research is crucial, focusing specifically on functional outcomes and comparing different MAT types, administration routes, and treatment durations.
- Robust studies are needed to clarify the nuanced impact of MAT on overall patient functioning.
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