Impact of opioid agonist treatment on mental health in patients with opioid use disorder: a systematic review and network meta-analysis of randomized clinical trials

Background: There is a knowledge gap in systematic reviews on the impact of opioid agonist treatments mental health.Objectives: We compared health outcomes between different and placebo/waitlist, opioids themselves.Methods: This meta-analysis randomized clinical trials (RCTs) was pre-registered at PROSPERO (CRD42018109375). Embase, MEDLINE, PsychInfo, CINAHL Complete, Web Science Core Collection were searched from inception to May 2020. RCTs included if they agonists with each other or placebo/waitlist treatment patients use disorder reported least one outcome after 1-month post-baseline. Studies psychiatric care, adjunct psychotropic medications, unbalanced psychosocial services excluded. The primary overall symptomatology, e.g. Symptom Checklist 90 total score, placebo/waitlist. Random effects models used for all meta-analyses.Results: Nineteen studies narrative synthesis 15 quantitative synthesis. Hydromorphone, diacetylmorphine (DAM), methadone, slow-release oral morphine, buprenorphine, among interventions. Based network outcomes, buprenorphine (SMD (CI95%) = ?0.61 (?1.20, ?0.11)), DAM (?1.40 (?2.70, ?0.23)), methadone (?1.20 (?2.30, ?0.11)) superior waitlist/placebo health. Further direct pairwise indicated that improved more (?0.23 (?0.34, ?0.13)).Conclusions: Opioid improve independent services.