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Bawor M, Dennis BB, Samaan MC, Plater C, Worster A, Varenbut M, Daiter J, Marsh DC, Desai D, Steiner M, Anglin R, Coote M, Pare G, Thabane L, Samaan Z. Methadone induces testosterone suppression in patients with opioid addiction. Sci Rep 2014; 4:6189. [PMID: 25155550 PMCID: PMC4143768 DOI: 10.1038/srep06189] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/06/2014] [Indexed: 11/29/2022] Open
Abstract
Sex hormones may have a role in the pathophysiology of substance use disorders, as demonstrated by the association between testosterone and addictive behaviour in opioid dependence. Although opioid use has been found to suppress testosterone levels in men and women, the extent of this effect and how it relates to methadone treatment for opioid dependence is unclear. The present multi-centre cross-sectional study consecutively recruited 231 patients with opioid dependence from methadone clinics across Ontario, Canada between June and December of 2011. We obtained demographic details, substance use, psychiatric history, and blood and urine samples from enrolled subjects. The control group included 783 non-opioid using adults recruited from a primary care setting in Ontario, Canada. Average testosterone level in men receiving methadone treatment was significantly lower than controls. No effect of opioids including methadone on testosterone level in women was found and testosterone did not fluctuate significantly between menstrual cycle phases. In methadone patients, testosterone level was significantly associated with methadone dose in men only. We recommend that testosterone levels be checked in men prior and during methadone and other opioid therapy, in order to detect and treat testosterone deficiency associated with opioids and lead to successful methadone treatment outcomes.
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Affiliation(s)
- Monica Bawor
- 1] MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON [2] Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON
| | - Brittany B Dennis
- 1] Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON [2] Health Research Methodology Graduate Program, McMaster University, Hamilton, ON [3] Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON
| | - M Constantine Samaan
- Division of Pediatric Endocrinology, Department of Pediatrics, McMaster University, Hamilton, ON
| | | | - Andrew Worster
- 1] Ontario Addiction Treatment Centres, Ontario, Canada [2] Department of Medicine, McMaster University, Hamilton, ON
| | | | - Jeff Daiter
- Ontario Addiction Treatment Centres, Ontario, Canada
| | - David C Marsh
- 1] Ontario Addiction Treatment Centres, Ontario, Canada [2] Northern Ontario School of Medicine, Sudbury, ON
| | - Dipika Desai
- Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON
| | - Meir Steiner
- 1] Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON [2] Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON [3] Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON
| | - Rebecca Anglin
- 1] Department of Medicine, McMaster University, Hamilton, ON [2] Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON
| | - Margaret Coote
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON
| | - Guillaume Pare
- 1] Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON [2] Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON
| | - Lehana Thabane
- 1] Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON [2] Biostatistics Unit, Centre for Evaluation of Medicine, Hamilton, ON, Canada
| | - Zainab Samaan
- 1] Population Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, ON [2] Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON [3] Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON
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Cofrancesco J, Shah N, Ghanem KG, Dobs AS, Klein RS, Mayer K, Schuman P, Vlahov D, Rompalo AM. The effects of illicit drug use and HIV infection on sex hormone levels in women. Gynecol Endocrinol 2006; 22:244-51. [PMID: 16785144 DOI: 10.1080/09513590600687603] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Drug use and HIV infection may affect sex hormone levels in women. One hundred and ninety-six women with and without a history of illicit drug use (50 HIV-negative and 148 HIV-infected), with regular menses, who never used antiretrovirals, were evaluated. Luteinizing hormone levels were significantly higher in women with a CD4 cell count <200/microl (p < 0.002). Current methadone use was associated with lower levels of total testosterone (p = 0.03) and higher levels of prolactin (p = 0.002); mean estradiol levels were 43% lower in women who used intravenous drugs (p < 0.001). Alcohol and crack cocaine use was not associated with sex hormone levels. Age, race, body mass index and degree of HIV immunosuppression were also associated with differences in sex hormone levels.
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Affiliation(s)
- Joseph Cofrancesco
- Johns Hopkins University School of Medicine, Baltimore, Maryland 21287-0941, USA.
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