Erectile Dysfunction Among Male Heroin Addicts Receiving Methadone Maintenance Treatment in Guangdong, China

Article (PDF Available)inJournal of Addiction Medicine 6(3):212-8 · May 2012with48 Reads
DOI: 10.1097/ADM.0b013e318259b2c4 · Source: PubMed
  • 26.35 · Sun Yat-Sen University
  • 2nd Xin Li
  • 53.82 · University of South Carolina
  • Last Qun He
    17.56 · Guangdong provincial Institute of Public Health
: 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.

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Available from: Wen Chen, Dec 13, 2015
    • "Although reduction of the dose or discontinuation of methadone would be expected to improve sexual function, conflicting results have been obtained in previous studies[5,7]. Other possible confounders, such as depression, older age, psychological disorders, medical conditions such as obesity and viral hepatitis, and unhealthy lifestyle[9,181920, can have negative effects on sexual function. Methadone is a slow-and long-acting opiate agonist that stimulates μ-opioid receptors in various areas of the brain. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction: Methadone has long been regarded as an effective treatment for opioid dependence. However, many patients discontinue maintenance therapy because of its side effects, with one of the most common being sexual dysfunction. Buprenorphine is a proven alternative to methadone. This study aimed to investigate sexual dysfunction in opioid-dependent men on buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT). The secondary aim was to investigate the correlation between sexual dysfunction and the quality of life in these patients. Methods: Two hundred thirty-eight men participated in this cross-sectional study. Four questionnaires were used, the Mini International Neuropsychiatric Interview, Opiate Treatment Index, Malay version of the International Index of Erectile Function 15 (Mal-IIEF-15), and World Health Organization Quality of Life-BREF Scale. Multivariate analysis of covariance was used to examine the relationship between MMT and BMT and the Mal-IIEF 15 scores while controlling for all the possible confounders. Results: The study population consisted of 171 patients (71.8%) on MMT and 67 (28.2%) on BMT. Patients in the MMT group who had a sexual partner scored significantly lower in the sexual desire domain (p < 0.012) and overall satisfaction (p = 0.043) domain compared with their counterparts in the BMT group. Similarly, patients in the MMT group without a sexual partner scored significantly lower in the orgasmic function domain (p = 0.008) compared with those in the BMT group without a partner. Intercourse satisfaction (p = 0.026) and overall satisfaction (p = 0.039) were significantly associated with the social relationships domain after adjusting for significantly correlated sociodemographic variables. Conclusions: Sexual functioning is critical for improving the quality of life in patients in an opioid rehabilitation program. Our study showed that buprenorphine causes less sexual dysfunction than methadone. Thus, clinicians may consider the former when treating heroin dependents who have concerns about sexual function.
    Full-text · Article · Jan 2016
    • "Only a few studies could be meaningfully compared. For instance, the two studies [1,37] from China applied the same definition and questionnaire (IIEF-5) in the Chinese ethnic group when making comparisons. We derived the prevalences from the combined report of both studies and noticed 76% (513 out of 686) of these men were reported to have ED. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction For many years, methadone has been recognized as an effective maintenance treatment for opioid dependence. However, of the many adverse events reported, sexual dysfunction is one of the most common side effects. Aim We conducted a meta-analysis to evaluate the prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments. Methods Relevant studies published from inception until December 2012 were identified by searching PubMed, OVID, and Embase. Studies were selected using prior defined criteria. Heterogeneity, publication bias, and odds ratio were assessed thoroughly. Main Outcome Measures To examine the prevalence and odds ratio of sexual dysfunctions among the methadone and buprenorphine groups. Results A total of 1,570 participants from 16 eligible studies were identified in this meta-analysis. The 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 (OR = 4.01, 95% CI, 1.52–10.55, P = 0.0049). Conclusions Evidence showed that the prevalence of sexual dysfunction was higher among the users of methadone compared with buprenorphine. Patients with sexual difficulty while on methadone treatment were advised to switch to buprenorphine. Yee A, Loh HS, Hisham Hashim HM, and Ng CG. The prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments: A meta-analysis study. J Sex Med 2014;11:22–32.
    Article · Jan 2014
    • "IDUs also report significantly more suppressed sexual drive than non-IDUs. Erectile and other sexual dysfunctions are commonly found among MMT participants with intensive drug use [46,47]. This is consistent with the study finding of an inverse association between risk of HIV infection and having had sex in the past three months. "
    [Show abstract] [Hide abstract] ABSTRACT: Methadone maintenance treatment (MMT) has been available in Guangdong province, China since 2006. This study aims to estimate the prevalence levels of HIV, Hepatitis C (HCV), Tuberculosis (TB) and their co-infections and associated demographic and risk behaviours among MMT entrants. A total of 2296 drug users at the time of their MMT enrolment were recruited from four clinics during 2006-2011. Participants' demographic characteristics, infection status and self-reported high-risk drug-use and sexual behaviours were surveyed. Log-linear contingency analysis was employed to investigate the demographic and behavioural differences between gender and drug-user type, while multivariate regression analysis was used to identify the associated factors of HIV, HCV and TB infections. Female drug users demonstrate significantly higher frequency of daily drug consumption (Log-linear contingency analysis, G(2)=10.86, p=0.013) and higher proportion of having had sex in the past three months (G(2)=30.22, p<0.001) than their male counterparts. Among injecting drug users, females also inject (χ(2)=16.15, p=0.001) and share syringes (χ(2)=13.24, p=0.004) more frequently than males. Prevalence of HIV, HCV and TB among MMT entrants are 6.3%, 78.7% and 4.4% respectively. Co-infections of HIV/HCV, HIV/TB, HCV/TB and HIV/HCV/TB reportedly infect 5.6%, 0.5%, 3.8% and 0.3% of study participants. Infection risks of HIV, HCV and TB are consistently associated with increasing length of drug use, injecting drugs, financial dependence and reduced sexual activities. Injecting drug use is the major contributing factor in prevalence levels of HIV, HCV and TB among MMT entrants. Female drug users are more disadvantaged in their social status and risk-taking in their drug use behaviours than males.
    Full-text · Article · Oct 2013
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