Men’s Health: Opioids, Alcohol and “Low T”

Substance Use Disorders and Reduced Sexual Functioning:
Studies in opioid pill, heroin addicts and heavy alcohol users, compared to healthy controls, have demonstrated decreased testosterone levels in males resulting in significant sexual dysfunction:

  • Decreased Libido
  • Erectile Dysfunction
  • Impotence
  • Decreased Testicular Tissue
  • Ejaculation Problems
  • Decreased Sperm Count
  • Decreased Testicular Fluid
  • Decreased Sperm Motility
  • Decreased Fertility
  • Enlarged Prostrate
  • Enlarged Breasts

Testosterone Levels are not usually Effected by Suboxone, Subutex, or Sublocade.

Testosterone Levels in Methadone and Suboxone Treated Patients
In methadone treated male patients, several studies have demonstrated decreased testosterone levels.

  • This is a dose-response effect;
  • In patients on “low dose” methadone (10-60 mg/day) there was no evidence of lowered testosterone;
  • In “high dose” methadone (80-150 mg/day), there was significant reduction in testosterone

The Impact of Opioids on the Endocrine System:  Massachusetts general Hospital   N. Katz. MD

One study compared:

  • Endocrine function in 17 men treated with Buprenorphine (Suboxone or Subutex) for addiction, 37 men on high-dose methadone and 51 healthy blood donors served as controls;
  • Patients treated with Buprenorphine had significantly higher testosterone levels and a significantly lower frequency of sexual dysfunction compared with patients treated with methadone;
  • The testosterone level of Buprenorphine treated patients did not differ from healthy controls.

All male patients treated with Suboxone or Methadone should be closely monitored for sexual dysfunction and as indicated be tested for “Low T”.

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