Heroin Dependence Duration Influences the Metabolic Parameters

Pereska, Zanina; Boz̆inovska, C.; Dimitrovski, Cedo; Cakalarovski, Koco; Chibishev, Andon; Zdravkovska, Milka; Babulovska, Aleksandra; Janicevic, Daniela

doi:10.1097/adm.0b013e31826bd76c

Cited by 9 publications

(6 citation statements)

References 46 publications

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“…A noteworthy finding from the present study was the association between long-term exposure to methadone therapy and metabolic syndrome. It was supported by the fact that chronic administration of heroin and agonist opiates causes an insulin resistance state similar to type 2 diabetes mellitus in HUD individuals 5-13…”

Section: Discussionmentioning

confidence: 99%

“…3 Moreover, methadone has also been associated with metabolic and endocrine alterations. 4 In several observational studies, heroin use and methadone therapy have been linked to abnormalities in glucose metabolism, specifically insulin resistance 5 – 10 and elevated prevalence of diabetes. 11 – 15 In contrast, the administration of opiate antagonists such as buprenorphine and naltrexone has not been related to glycemic deregulation 16…”

Section: Introductionmentioning

confidence: 99%

“…Insulin resistance plays a key role in the pathogenesis of this syndrome in the general population. 19 , 20 As a consequence, it is probable that its prevalence is high in OUD individuals on methadone therapy, since chronic administration of agonist opiates potentially causes a situation of insulin resistance 5-10…”

Section: Introductionmentioning

confidence: 99%

“…19,20 As a consequence, it is probable that its prevalence is high in OUD individuals on methadone therapy, since chronic administration of agonist opiates potentially causes a situation of insulin resistance. [5][6][7][8][9][10] The study of metabolic syndrome in OUD individuals receiving opioid agonist therapy is, thus, clinically interesting, in order to ascertain its prevalence and associated factors and incorporate preventive measures into the medical care of these subjects. The aim of this study was to analyze the prevalence and associated factors for metabolic syndrome in individuals with heroin use disorder (HUD) who were receiving agonist therapy with methadone at a drug abuse outpatient center.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome among Individuals with Heroin use Disorders on Methadone Therapy: Prevalence, Characteristics, and Related Factors

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome among Individuals with Heroin use Disorders on Methadone Therapy: Prevalence, Characteristics, and Related Factors

et al. 2018

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“…The improvement in body composition has importance because men on opioids are susceptible to developing metabolic abnormalities and cardiovascular disease. 15,22,29 Loss of lean mass, particularly in older men on opioids, could also predispose to falls. 25,36 …”

Section: Discussionmentioning

confidence: 99%

Effects of testosterone replacement in men with opioid-induced androgen deficiency

Basaria

Travison

Alford

et al. 2015

Pain

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Symptomatic androgen deficiency is common in patients taking opioid analgesics, as these drugs potently suppress the hypothalamic–pituitary–gonadal axis. However, the efficacy of testosterone replacement in this setting remains unclear. The objective of this trial was to evaluate the efficacy of testosterone replacement on pain perception and other androgen-dependent outcomes in men with opioid-induced androgen deficiency. We conducted a randomized, double-blind, parallel placebo-controlled trial at an outpatient academic research center. Participants were men aged 18 to 64 years on opioid analgesics for chronic noncancer pain, and total testosterone levels were <350 ng/dL. Participants were randomly assigned to 14 weeks of daily transdermal gel that contained 5 g of testosterone or placebo. Primary outcomes were changes in self-reported clinical pain and objectively assessed pain sensitivity. Sexual function, quality of life, and body composition were also assessed. The mean age was 49 years. The median total and free testosterone levels at baseline were 243 ng/dL and 47 pg/mL and 251 ng/dL and 43 pg/mL in the testosterone and placebo arm, respectively. Of the 84 randomized participants, 65 had follow-up data on efficacy outcomes. Compared with men assigned to the placebo arm, those assigned to testosterone replacement experienced greater improvements in pressure and mechanical hyperalgesia, sexual desire, and role limitation due to emotional problems. Testosterone administration was also associated with an improvement in body composition. There were no between-group differences in changes in self-reported pain. In conclusion, in men with opioid-induced androgen deficiency, testosterone administration improved pain sensitivity, sexual desire, body composition, and aspects of quality of life.

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