Issues <p>Disability in opioid use disorder (OUD) encompasses cognitive, emotional, physical, and social impairments. How disability is conceptualised and measured in the literature on OUD and how it aligns with the International Classification of Functioning, Disability and Health (ICF) remains unclear.</p> Approach <p>A literature search was carried out in August 2025 across PubMed, Scopus, and Web of Science. English-language empirical studies describing functional impacts in populations with OUD were included. Data were extracted on study characteristics, outcomes, tools, and ICF domains, and synthesized narratively with thematic mapping.</p> Key Findings <p>All 32 included studies reported impairments in body functions domains, predominantly cognitive and emotional deficits. Few studies focused on activity limitations (<i>n</i> = 10) and participation restrictions (<i>n</i> = 10), including self-care, mobility, work, social relationships, employment, and parenting. Environmental factors (e.g., stigma) and personal factors (e.g., trauma) were reported less frequently (<i>n</i> = 4 and 10). Measurement tools were diverse and targeted mostly neurocognitive impairments, with explicit ICF use rare (<i>n</i> = 2). Disability also appears to vary across clinical states of OUD.</p> Implications <p>The review highlights the need for comprehensive standardized evaluation of disability grounded in ICF framework to inform relevant interventions and support holistic care and recovery in OUD.</p> Conclusions <p>Disability in OUD is a multidimensional phenomenon that requires a biopsychosocial framework such as ICF to fully capture it. Body dysfunctions and impairments are well documented but functional limitations and contextual factors are underexplored. Future studies should adopt longitudinal designs and ICF-aligned assessments to evaluate disability, guide interventions, and improve recovery.</p>