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Heroin Addiction and Related Clinical Problems: 2018, 20, N1 (pages: 13 - 20)

Opioid Maintenance Therapy with Methadone and Levomethadone - Sexual Dysfunction and Treatment Satisfaction

Schoofs N., Häbel T.H., Bermpohl F., and Gutwinski S.

Summary: Background: Sexual dysfunction (SD) is a common adverse effect of opioid maintenance therapy (OMT). Little is known about its impact on treatment satisfaction. Aim: To explore SD and its impact on treatment satisfaction and wish for advice on that subject in patients receiving OMT compared with a group of patients with other substance use disorders (control group). Methods: 95 patients with opioid dependence receiving OMT and 90 patients with other substance use disorders were included. A self-rating instrument as well as the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) were applied. Results: In the OMT group, 69.1% of the patients reported to suffer from SD, in contrast to 18.2% in the control group (p<0.001). With 40.7%, OMT was the most quoted reason for SD. 55.6% of the patients in the OMT group reported to be willing to quit OMT because of SD. Significantly more patients in the OMT group claimed a wish for advice on SD (p=0.004). In the OMT group, 15.6% of the patients reported to have been interviewed by a doctor concerning this subject, in the control group 4.9% did so (p=0.052). Regarding the IIEF, the patients in the OMT group were significantly less satisfied with their sexual life than patients in the control group (p=0.023). The FSFI revealed no differences. Conclusion: SD is common in OMT in comparison with other substance use disorders and may have a pejorative influence on treatment satisfaction. Despite the patients' wish, advice on the subject was often not provided.