Compared with unsupervised consumption of a long‐acting opioid substitution medication or routine counseling for people with opioid dependence, supervising the consumption of a long‐acting opioid substitution medication did not have a clear impact on the numbers of people completing the study protocol (retention), nor in the numbers of people staying abstinent from unsanctioned opioid use, engaging in inappropriate medication use (such as selling or sharing medication), or dying or experiencing any other serious adverse event. However, all the randomized controlled trial evidence was of very low to low quality, so no firm conclusions of equivalence between unsupervised and supervised consumption can be made.