Long-term opioid use related to erectile dysfunction

by Bruce Sylvester – Long-term use of opioids is linked to an increased higher risk of erectile dysfunction (ED), researchers reported on May 15, 2013 in the journal Spine.

“Men who take opioid pain medications for an extended period of time have the highest risk of ED,” said lead author Richard A. Deyo, MD, MPH, investigator with the Kaiser Permanente Center for Health Research and Professor of Evidence-based Family Medicine at Oregon Health & Science University in Portland, Oregon.

Deyo and colleagues identified 11,327 men in Oregon and Washington enrolled in the Kaiser Permanente health plan who visited their doctors for back pain during 2004. They evaluated pharmacy records for six months before and after the back pain visit.

They categorized the subjects by opioid use. “None” designated those who did not receive a prescription for opioids. “Acute” designated those who took opioids for three months or less. “Episodic” designated those who took opioids for more than three months, but for less than four months and with fewer than 10 refills. “Long-term” designated those who took opioids for at least four months or for more than three months, with 10 or more refills. Anything dosage higher than 120 mg of morphine equivalent was categorized as high-dose.

Over 19 percent of the subjects using high-dose opioids for at least four months also received ED prescriptions. Less than 7 percent of the subjects not using take opioids received ED prescriptions.

While subjects over 60 years old received higher rate ED prescriptions,  after adjusting for age and other factors the investigators still found that men using high-dose opioids were 50 percent more likely to receive ED prescriptions than non-users.

“There is no question that for some patients opioid use is appropriate, but there is also increasing evidence that long-term use can lead to addiction, fatal overdoses, sleep apnea, falls in the elderly, reduced hormone production, and now erectile dysfunction,” said Deyo.

The authors noted that opioid use is growing, with prescription opioid sales quadrupling in the United States between 1999 and 2010.