ABSTRACT AN EVALUATION OF FUNCTIONAL OUTCOMES FOR PATIENTS WITH OPIOID USE DISORDER IN A MEDICATION TREATMENT PROGRAM: WITH A FOCUS ON PREGNANT WOMEN July 2023 KRISTY PEREIRA, B.S.N., COLLEGE OF OUR LADY OF THE ELMS M.S.N, AMERICAN INTERNATIONAL COLLEGE Ph.D., UNIVERSITY OF MASSACHUSETTS AMHERST Directed by: Raeann Leblanc Opioid misuse leading to opioid use disorder (OUD) is a growing concern in the U.S. Medication Treatment (MT) with buprenorphine is considered the gold standard for OUD treatment. Traditionally, success in treatment is measured by abstinence from opioids and other drug use. Urine drug screens are used to determine abstinence from opioids and other drug use. There is little evidence on alternative measures to determine treatment success in OUD treatment. The purpose of this descriptive study was to provide evidence that functional outcomes are an important piece in defining treatment success for these individuals. The first study aim was to determine if functional risk score is a better predictor of treatment success when compared to opioid use. The second aim was the same as the first, except analyses were limited to only pregnant patients. This correlational, retrospective study analyzed EHR data obtained from a multisite, multistate outpatient treatment facility that provided buprenorphine treatment for individuals ≥ 18 years of age from 2016–2018. Included were 416 patients with OUD in MT, of whom 140 were pregnant (Aim 2). Predictors were functional risk score and opioid use. Outcomes were treatment utilization, medication utilization, and treatment retention. Findings reveal that functional outcomes were a significant predictor of treatment utilization in almost all models for the entire sample. Opioid use was a more significant predictor of medication utilization for both aims. Functional risk score and opioid use were comparable predictors of treatment retention among the non-pregnant sample. Neither functional risk score nor opioid use were predictors of treatment retention in the pregnant sample. Treatment success for individuals with OUD in MT has been incorrectly defined. Often, it is speculated that a person who has a positive urine screen and is not abstinent from opioid use 100% of the time is not complying with treatment. The current study findings indicate that functional outcomes were better predictors of treatment utilization when compared to opioid use in both the general and pregnant populations. Incorporating functional outcomes in addition to urine drug screens may provide further insight in gauging treatment success for individuals with OUD in MT.