Sexual Dysfunction Among Male Patients Receiving Buprenorphine and Naltrexone Maintenance Therapy for Opioid Dependence

Abstract

Introduction Opioid-dependent men suffer from sexual dysfunctions in the short and long term. The medications used for long-term pharmacotherapy of opioid dependence also affect sexual functioning, though this has been a poorly investigated area so far. Aim To study the sexual dysfunction in opioid-dependent men receiving buprenorphine and naltrexone maintenance therapy. Methods A semistructured questionnaire and Brief Male Sexual Functioning Inventory (BMFSI) was administered to a sample of 60 sexually active men, receiving buprenorphine (n = 30) and naltrexone (n = 30) maintenance therapy for opioid dependence. Main Outcome Measures Prevalence of premature ejaculation, erectile dysfunction, low sexual desire, weakness due to semen loss, and overall satisfaction. Results About 83% of the men on buprenorphine and 90% on naltrexone reported at least one of the sexual dysfunction symptoms. The commonly reported dysfunctions were premature ejaculation (83% in buprenorphine and 87% in naltrexone), erectile dysfunction (43% in buprenorphine and 67% in naltrexone), and loss/reduction in sexual desire (33% in buprenorphine and 47% in naltrexone). On BMSFI however, there were no significant differences among both the groups. Conclusion Opioid dependence as well as its pharmacological treatment is associated with sexual dysfunctions, which has clinical implication. Future research should explore this further using biochemical analyses.

Very early disengagement and subsequent re-engagement in primary care Office Based Opioid Treatment (OBOT) with buprenorphine

“…Others may find buprenorphine ineffective at controlling cravings, or they cannot tolerate side effects. (Gryczynski et al, 2014; Ramdurg, Ambekar, & Lal, 2012) These results affirm existing practices of buprenorphine programs that escalate treatment intensity for patients who test positive for opiates as they are the most unstable and vulnerable. (Alford et al, 2011) Physicians and other prescribers should consider offering these patients both intensification of buprenorphine treatment (e.g., increased clinic visits, counseling, buprenorphine dosage) or facilitated transfer to a methadone program, if needed.…”

The Prevalence of Sexual Dysfunction among Male Patients on Methadone and Buprenorphine Treatments: A Meta-Analysis Study

“…Sexual dysfunctions such as erectile dysfunction (ED), ejaculatory disturbances, and lack of desire for sexual relations are often reported in a considerable number of male patients on methadone maintenance [11][12][13][14][15][16]. The exact prevalence of sexual dysfunction among this population is yet to be determined as they vary from study to study.…”

“…The questions asked in the IIEF to assess ED were numbers 1, 2, 3, 4, 5 and 15. This IIEF-1 scale is scored as no ED (score[26][27][28][29][30], mild(22)(23)(24)(25), mild to moderate(17)(18)(19)(20)(21), moderate(11)(12)(13)(14)(15)(16), or severe (0-10). The higher the score the lower the ED.…”

Sexual Dysfunction in Men Receiving Methadone Maintenance Treatment: Clinical History and Psychobiological Correlates

“…To increase the complexity of the interpretation of existing data in this field, a high prevalence of common dysfunctions, such as premature ejaculation, erectile dysfunction and reduced desire, have been reported in heroin-dependent patients during opioid receptor antagonists treatment with naltrexone [16] , once again challenging the simplistic view of a direct pharmacological influence of the opioid system on the sexual response. Accordingly, another research group found that sexual functioning does not improve when drug use is stopped [17] , further suggesting the possibility of factors other than the pharmacological effects of drugs contributing to sexual dysfunction.…”