Erectile Dysfunction Among Male Heroin Addicts Receiving Methadone Maintenance Treatment in Guangdong, China
ABSTRACT : Erectile dysfunction (ED) is common among methadone-maintained patients and reduces their quality of life. This study reports the prevalence of ED among male heroin addicts receiving methadone maintenance treatment (MMT) in China and describes factors that may contribute to ED.
: Seventy-four male heroin addicts enrolled in 4 MMT clinics for the first time were interviewed about general baseline characteristics. Scales for assessing erectile function and psychological disorders were completed monthly. Blood was drawn for serum hormone-level measurement at the baseline and at a 3-month follow-up. Daily methadone dosages were recorded by physicians.
: Erectile dysfunction was reported in 75.7%, 88.7%, 80.8%, and 80.9% of the patients at the baseline, 1-, 2-, and 3-month follow-ups, respectively. No significant differences in the prevalence of ED were found during the course of treatment. About two-thirds of the patients who had ED at the 3-month follow-up had had the condition while on heroin. The delayed erectile function was significantly associated with duration of treatment (odd ratio, OR1-month vs baseline = 1.86, P = 0.021; OR2-month vs baseline = 1.67, P = 0.066) and methadone dosage (OR = 1.02, P = 0.038). Ongoing substance, serum hormone levels, and psychological disorders were not associated with ED.
: The prevalence of ED among male methadone-maintained patients in China is very high and individuals with altered erectile function while on heroin represent a high-risk group for the development of ED upon initiation of MMT. In the setting of delayed erectile function after receiving methadone, a trial of dosage reduction and symptomatic treatments may be a reasonable initial approach.
SourceAvailable from: Surendra K. Mattoo[Show abstract] [Hide abstract]
ABSTRACT: There are limited numbers of studies which have evaluated the sexual dysfunction (SD) in patients with alcohol and opioids dependence. This article reviews the existing literature. Electronic searches were carried out using the PubMed, Google Scholar, and ScienceDirect to locate the relevant literature. Subjects addicted to heroin or on methadone maintenance treatment (MMT) or buprenorphine maintenance treatment (BMT) show higher rates of SD in comparison to the general population. SD rates have ranged 34-85% for heroin addicts, 14-81% for MMT, 36-83% for BMT, and 90% for naltrexone maintenance. The rates of SD in alcohol-dependent population have ranged 40-95.2%, with rates being consistently much higher in alcohol-dependent population than in the healthy controls or social drinkers. The common SDs reported have been erectile dysfunction followed by premature ejaculation, retarded ejaculation and decreased sexual desire among men, and dyspareunia and vaginal dryness among women. This review suggests that long-term use of alcohol and opioids are associated with SD in almost all domains of sexual functioning. There is a need to increase the awareness of clinicians about this association as many times SD in patients with substance abuse lead to poor treatment compliance and relapse. Further, there is a need to carry out more number of studies to understand the relationship in a better way.Indian Journal of Psychological Medicine 10/2014; 36(4):355-65. DOI:10.4103/0253-7176.140699
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ABSTRACT: Methadone maintenance treatment is proven to be effective treatment for opioid dependence. Of the many adverse events reported, sexual dysfunction is one of the most common side effects. However, there may be other clinical factors that are associated with sexual dysfunction among methadone users. We conducted a meta-analysis to examine the clinical factors associated with sexual dysfunction among male patients on methadone and buprenorphine treatments, of which eligible studies were selected using prior defined criteria. A total of 2619 participants from 16 eligible studies, published from inception till December 2012, were identified from the PubMed, OVID and EMBASE databases. The included studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval (CI), 0.39–0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (odds ratio=4.01, 95% CI, 1.52–10.55, P=0.0049). Our study shows that eight clinical factors are associated with sexual dysfunction among men receiving opioid substitution treatment, namely age, hormone assays, duration of treatment, methadone dose, medical status, psychiatric illness, other current substance use and familial status, and methadone versus buprenorphine treatment. Despite the methodological limitations, the findings of this meta-analysis study may offer better insights to clinicians in dealing with both sexual dysfunction and its related problems.International Journal of Impotence Research 07/2014; DOI:10.1038/ijir.2014.18 · 1.37 Impact Factor
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ABSTRACT: IntroductionThere is limited literature on opioid dependence patients for the prevalence of sexual dysfunction as assessed by validated questionnaires.AimTo study the prevalence and specified demographic and clinical correlates of sexual dysfunction in men seeking treatment for opioid dependence by using multiple validated instruments.Methods Men with opioid dependence for at least 1 year as per DSM-IV (confirmed by Mini International Neuropsychiatric Interview) (OD group, N = 100) and matched healthy controls (HC group, N = 50) were evaluated for sexual dysfunction.Main Outcome MeasuresArizona Sexual Experience Questionnaire (ASEX), International Index of Erectile Function (IIEF) and Changes in Sexual Functioning Questionnaire Short-Form (CSFQ-14).ResultsIn men seeking treatment for opioid dependence sexual dysfunction was recorded in 48% by ASEX, and in at least one of the domains in 92% by IIEF and in 90% by CSFQ; in comparison with the healthy controls, the prevalence of sexual dysfunction in patients with opioid dependence was significantly higher by each measure.Conclusions Compared with healthy controls, sexual dysfunction rates are higher in patients seeking treatment for opioid dependence. Venkatesh K, Mattoo SK, and Grover S. Sexual dysfunction in men seeking treatment for opioid dependence: A study from India. J Sex Med **;**:**–**.Journal of Sexual Medicine 06/2014; 11(8). DOI:10.1111/jsm.12588 · 3.15 Impact Factor