Does Methadone Treatment Suppress Testosterone in Opioid Addicts?

Side effects of low testosterone in men include fatigue and erectile dysfunction.

A new study out of McMaster University in Canada has found that common treatments for opioid addiction reduce the level of testosterone in men, but not in women.

The research project, published in the journal Scientific Reports, collected data from 231 opioid addicts receiving methadone treatment in Ontario, as well as 783 people in the province who don’t use opioids. Scientists found that the men receiving methadone had about one-quarter of the testosterone level of men not using opioids. No changes were noted among women.

Low testosterone in men has side effects including mood swings, fatigue and erectile dysfunction. At Hamilton’s John Street Clinic, officials said that about 20 percent of men receiving methadone treatment need some sort of hormone replacement therapy. And since opioids already deplete testosterone due to the way they work on the hypothalamus, many men already have depleted levels of testosterone before starting treatment.

The very notable side effect leaves some health officials worried that men will be reluctant to receive treatment for their opioid addiction. Dr. Zena Samaan, principal investigator of the study, noted that “doctors should ensure the patients are being prescribed the lowest dose of opioids including methadone for effective treatment to minimize testosterone suppression. It’s a conversation that should be happening.”

More Testosterone Research

Other studies have reported similar findings. Dr. Andrea Rubenstein presented her research last April at the American Academy of Pain Medicine meeting, which involved observing 81 men who took opioids for at least three months. She found that those who used long-acting opioids such as methadone were five times more likely to have low testosterone levels than those who used short-acting opioids, such as hydrocodone or immediate-release oxycodone.

Testosterone supplementation is a safe option for those who are receiving opioid addiction treatment, though. Options for this include gels or intramuscular injections.

Is the Reward Worth the Risk?

And despite the potential side effects, methadone treatments for opioid addiction are well-documented in their success. A report earlier this month from the British Columbia medical health office showed that the rate of death for those using Suboxone and methadone as part of opioid substitution treatment is about half of what it is for those using street heroin.

Learn more about the symptoms and signs of drug abuse.