Abstract
BackgroundErectile dysfunction (ED) is common among men on opioid replacement therapy (ORT), but most previous studies exploring its prevalence and determinants yielded contrasting findings. Moreover, the impact of ED on patients’ quality of life (QoL) has been seldom explored.ObjectiveTo explore the prevalence and determinants of ED in men on ORT, and the impact on QoL.MethodsIn a multicentre cross-sectional study, we recruited 797 consecutive male patients on methadone and buprenorphine treatment, collected data on demographic, clinical, and psychopathological factors, and explored their role as predictors of ED and QoL through univariate and multivariate analysis. ED severity was assessed with a self-assessment questionnaire.ResultsNearly half of patients in our sample were sexually inactive or reported some degree of ED. Some demographic, clinical and psychopathological variables significantly differed according to the presence or absence of ED. Multivariate regression analysis indicated that age, employment, smoke, psychoactive drugs, opioid maintenance dosage, and severity of psychopathological factors significantly influenced the risk and severity of ED. QoL was worse in patients with ED and significantly correlated with ED severity. Age, education, employment, opioid maintenance dosage, ED score, and severity of psychopathology significantly influenced QoL in the multivariate analysis.ConclusionsED complaints can be explored in male opioid users on ORT through a simple and quick self-assessment tool. ED may have important effects on emotional and social well-being, and may affect outcome.
Highlights
Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection satisfactory for the completion of sexual activity [1]
quality of life (QoL) was worse in patients with ED and significantly correlated with ED severity
ED complaints can be explored in male opioid users on opioid replacement therapy (ORT) through a simple and quick self-assessment tool
Summary
Erectile dysfunction (ED) is defined as the inability to achieve or maintain an erection satisfactory for the completion of sexual activity [1]. Opioids may increase sexual desire in the short term [6], but their long term use is known to negatively impact on sexual function and to lead to erectile dysfunction (ED) [7,8]. Most studies were on small samples of men on ORT, but a meta-analysis suggested that factors associated with sexual dysfunction include age, familial status, medical comorbidity, psychiatric illness, testosterone levels, opioid dosage, duration of treatment, and other current substance use disorders [13]. Erectile dysfunction (ED) is common among men on opioid replacement therapy (ORT), but most previous studies exploring its prevalence and determinants yielded contrasting findings. The impact of ED on patients’ quality of life (QoL) has been seldom explored
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