Supporting the update of the NSW Clinical Guidelines for Opioid Dependence Treatment (ODT): an Evidence Check rapid review brokered by the Sax Institute for the NSW Ministry of Health

The supervised administration of opioid dependence treatments such as methadone and buprenorphine remains a central feature of opioid dependence treatment models in Australia. Given significant changes in both clinical practice and the treatment landscape—particularly the expansion of long-acting injectable buprenorphine and increased attention to patient-centred care—a timely and systematic review of the evidence for supervised versus unsupervised dosing is warranted. The aim of this Evidence Check rapid review was to identify, appraise and synthesise literature comparing supervised and unsupervised dosing of opioid dependence treatments with a focus on safety, effectiveness, retention and treatment experience. The review was designed to prioritise evidence applicable to the Australian context and inform recommendations for the revision of clinical guidelines and support evidence-based decision-making regarding dosing supervision within NSW. A secondary aim was to identify best practice across recent (published since 2020) Australian and comparable international guidelines for opioid dependence treatment.