Opioid maintenance treatment is the most common form of treatment for people with opioid dependence in Norway. The treatment is often lifelong and constitutes a major interference in everyday life, partly because of frequent supervised administration of the opioid agonist drug, counselling sessions and supervised urine tests. This systematic review compares effect of unobserved with observed administration of opioid agonist drugs for people receiving opioid maintenance treatment.

After a systematic literature search in relevant databases, we included five primary studies that investigated unobserved compared to observed administration of opioid agonist drugs. The most common used opioid agonist drugs are represented in these studies (methadone, buprenorphine and buprenorphine-naloxone). There was a variation in how participants in the unobserved administration group received the drug and how many take-home doses they were given every time.

Summarised, we found the quality of the evidence to be very low. For that reason we are uncertain if unobserved administration compared with observed administration for people in opioid maintenance treatment influence:

• retention in treatment after 1, 4, 12 and 26 weeks
• use of illicit / not prescribed opioides after 12 weeks
• number of persons that commited crimes after 12 weeks
• patient satisfaction and self-reported use of illicit drugs
• adverse events

There is a lack of evidence concerning mortality.