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A comprehensive literature search that screened over 6,000 research citations on the topic identified only 27 randomized controlled trials and ten observational studies that reported on functional outcomes

• No randomized control trial was rated as high quality, but several observational studies were methodologically sound.
• The only functional measures reported in more than one study were verbal memory, attention, insomnia, fatigue, and criminal activity.
• MAT users had twice the risk of injurious traffic accidents than nonusers, according to one large observational study.
• Based on two studies, it appears that MAT users do not perform worse on verbal memory tasks than healthy controls.
• One study showed that patients taking buprenorphine or methadone scored higher in aggressive responding than healthy controls.

Evidence was mixed when MAT patients were compared with persons with OUD who were not on MAT

• One cohort comparison found that fewer buprenorphine patients reported fatigue than did persons with OUD who did not receive MAT; other physical and behavioral/social function outcomes had mixed findings or showed no differences.

There was little statistically robust evidence that treatment effects systematically vary by medication

• A comparison across randomized controlled trials found a significantly lower prevalence of fatigue in buprenorphine patients compared with methadone patients.

Direct comparisons of functional effects by route of administration, length of treatment, and treatment modality were scarce and reported mixed results and pointed to important research gaps that should be addressed in future studies