Benefits people experiencing opioid use disorder derive from opioid agonist therapies

Opioid use disorder has become an epidemic over the past 20 years. Contamination of the street sourced drug supply with fentanyl and fentanyl analogues has resulted in a substantial increase in the associated overdose rate. Evidence-based treatments exist; however, much of the evidence supporting their use is based on demonstrations of mortality benefit, abstinence rates, treatment retention and cravings reductions. While these are important outcomes, they do not provide a complete picture of the benefit patients derive from these outcomes. As novel approaches and therapeutic agents are brought into practice, a more thorough understanding of the beneficial outcomes derived from existing therapies is needed both to guide implementation and improve access to therapy. Using the methodology of an integrative review this paper seeks to answer the question: beyond mortality benefit, treatment retention, craving reduction, and abstinence, what beneficial outcomes do people experiencing opioid use disorder derive from opioid agonist therapy? The findings of this review, while limited by the both the quantity and quality of evidence found, suggest that beneficial outcomes of opioid agonist therapy include improved mental and physical health, increased economic participation, reduced criminal activity, and improved quality of life. Associated recommendations for integrating the findings into clinical practice, policy, and research are discussed.