A large new study has documented what many men who use opioid painkillers already know – long term use of the drugs can lead to erectile dysfunction (ED).
Researchers looked at more than 11,000 men with back pain and examined their health records to see if those who used prescription painkillers were more likely to also receive prescriptions for testosterone
replacement or ED medications such as Viagra.
They found that more than 19% of the men who took high-dose opioids for at least four months also received ED prescriptions. Fewer than 7% of the men who did not take opioids received ED prescriptions.
“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, an investigator with the Kaiser Permanente Center for Health Research and a professor at Oregon Health & Science University.
“This doesn’t mean that these medications cause ED, but the association is something patients and clinicians should be aware of when deciding if opioids should be used to treat back pain.”
The U.S. Centers for Disease Control and Prevention reports that prescription opioid sales quadrupled between 1999 and 2010.
A recent survey, published in the journal Pain, estimates 4.3 million adults in the U.S. use opioid medications on a regular basis, with the most commonly used being hydrocodone, oxycodone and morphine.
The ED-opioid study, which was published in the journal Spine, identified patients in Oregon and Washington state enrolled in a Kaiser Permanente health plan who visited their doctors for back pain during 2004. Researchers examined the men’s pharmacy records for six months before and after their visits.
They found that age was the factor most significantly associated with receiving ED prescriptions. Men 60 to 69 were 14 times more likely to receive prescriptions for ED medication than men 18 to 29.
But even after adjusting for age and other factors, men taking high-dose opioids were still 50% more likely to receive ED prescriptions than men who did not take prescription painkillers.
Nearly one out of five men who took high-dose opioids for at least four months also received ED medications or testosterone replacement.
About one out of eight men who took low-dose opioids (under 120 mg) also received ED medications or testosterone replacement.
Other health conditions like depression and the use of sedative hypnotics like benzodiazepines also increased the likelihood that the men would receive ED prescriptions.
“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 Dr. Deyo.