Opiates have been used for a long time in pain management. They are the best in dealing with chronic pain and so have been used worldwide to help patients with chronic pain especially cancer patients to cope with their pain and promote their recovery. The use of opiates in pain management however is little understood by the general public especially because the media has never portrayed them favorably. However the public are slowly waking up to the realization that opiates are not as bad as they are purported to be but are very essential in our hospitals to day. They have become a necessity for analgesia and patients undergoing chronic [pain have become dependent on them. Without these opiates the patients will suffer greatly.
The use of opiates in treatment of chronic pain has however been associated with deficiency in androgens. Testosterone is one of the most crucial hormones in the body as they are responsible for sex. In case deficiency in testosterone a person will suffer low sex drive. It may lead to hypogonadism which today is one of the problems that see men weep in the night for failing to rise to occasion and satisfy the sexual needs of their marital partners. Apart from hypogonadism and low levels of androgens, the long term use of these opiates may also cause such problems as adrenal dysfunction, pituitary dysfunction, and abnormality in growth and reduced bone density. When a patient has used the opiates for a long time it lowers the levels of testosterone, it is this hormone that is responsible for masculinity, bone density and even sound sex life. All these problems arise as a result of decline in testosterone and other sex hormones, opiates use being the cause of the decline in the sex hormones. Several studies have revealed that long term use of opiates in pain management causes opiate induced hypogonadism characterized by very low levels of androgens especially the testosterone hormones. The use of opiates in pain management has not only been linked to decline in sex hormones but also abnormalities in glucose and lipid metabolism.
There some side effects that patients who have used opiates in managing pain for a long time suffer, these side effects are often well managed through myriads of medical practices that may also involve hormone therapy to restore balance in hormones and help evade all the gross problems that are associated with deficiency in crucial hormones in the body. Specifically symptoms that are often associated with opiate induced hypogonadism include sexual dysfunction, osteoporosis, lack of libido, low sex drive, reduced muscle mass and loss of strength in men. In most study reports osteoporosis and poor sex functions are credited to low levels of testosterone hormone. Women are also not spared since long term use of opiates will also alter the functions of estrogen hormones making them prone to these symptoms as well.
A patient undergoing opiate treatment will suffer these side effects but all will be well after some time when they have broken free from the dependence on these drugs. The levels of testosterone will surge to normal levels and so will estrogen in women. This process occurs naturally, however some people will opt for hormone supplementation which may work as the process of treatment is going on but doctors advise that this may not be good as it discourages the body to signal its natural hormone production.
Patients have suffered opiate induced hypogonadism but most cases go unrecognized hence the patients are not easily helped to deal with the situation. The decline in testosterone levels is caused by opioid drug inhibition of Luteinizing Hormone often abbreviated as LH. LH is a pituitary hormone which is involved in testosterone production. LH also helps in direct inhibition of testosterone itself. It also causes the inhibition of the entire endocrine system and adrenal hormone suppression.
Researchers have also found that it is not only opiates that are used in pain management that causes decline in sex hormones and all the other symptoms associated with the fall in level of those hormones. Another cause of decline in these sex hormones is the treatments that are used to help the patients to overcome dependency on these opiates. These substances may include methadone which is commonly used in treating patients who have become dependent on opiates after long term use to manage pain. As shown in a new study treating opioid dependence with methadone can dramatically lower testosterone levels with men being the victims.
A cross-sectional study of more than 1000 adults led by Dr. Zena Samaan showed that the men who were treated with methadone for opioid addiction had roughly one quarter of the testosterone found in the men who did not use opioids. This study shows how methadone has adverse effects on testosterone levels in men. In women however there was no notable change.
“We expected that men would have lower testosterone. That was not something new,” principal investigator Zainab (Zena) Samaan, MD, PhD, associate professor in the Department of Psychiatry and Behavioral Neurosciences in the School of Medicine at McMaster University in Hamilton, Ontario, Canada, told Medscape Medical News.
“What was surprising was the magnitude of the reduction,” Dr. Samaan concluded.
She opined that doctors should be updated by following research findings on this issue so that they will know how to manage these symptoms that are associated with decline in testosterone. She encouraged doctors to check the hormonal levels of patients before putting them on opioid therapy and continue with this check in regular intervals to help manage testosterone levels.
There are various natural addiction treatment mechanisms that can help patients addicted to opiates other using methadone that may lead to decline in testosterone levels. Here at AWAREmed Health and Wellness Resource Center we encourage natural addiction training for physicians, Nurse, practitioners, Physician assistants and counselors so that they can avail a better alternative to opiates addicted patients. Dr. Dalal Akoury (MD) is committed to availing help to every patient. Call on her at Myrtle Beach, South Carolina for help.