HARCP Archives

Browse by article

Browse by volume

Heroin Addiction and Related Clinical Problems: 2014, 16, 3 (pages: 49 - 54)

Sexual dysfunction in male patients receiving methadone and buprenorphine maintenance treatment in Iran

Tafreshian S., Javadi M., Fakhraei F., and Seddigheh Fatemi S.

Summary: Background: methadone and buprenorphine are the major modalities of substitution treatment for opioid dependence in Iran. There are still only limited data on alterations in sexual function during methadone or buprenorphine maintenance therapy (MMT, BMT) and the impact of sexual dysfunctions on patients' life and treatment. Aims: to evaluate whether the incidence of sexual dysfunctions differs in samples of men in maintenance treatment with methadone or those with buprenorphine; evaluate correlations between sexual dysfunction and substitution treatment of opioid dependence. Methods: 158 opioid-dependent men were recruited from two methadone maintenance clinics in Mashad, Iran, between December 2011 and April 2013. Data were collected by organizing interviews and questionnaires. Sexual function has been investigated with IIEF, an extensively validated questionnaire covering five domains of male sexual function. Results: methadone has stronger effects on sexual dysfunction than buprenorphine. In both groups, erectile dysfunction seems to be the main form of sexual dysfunction. Methadone dose and the duration of therapy showed a correlation with sexual dysfunction: (p=0.011) and (p=0.012), respectively. On the other hand, no valuable statistical correlations were found between duration of opioid use and sexual complaints in our patients. Conclusions: the frequency of sexual dysfunction in people treated with methadone is higher than in the BMT group. Sexual dysfunctions lowered the quality of patients' sexual life and damaged their most intimate relationships. This problem may increase the risk of treatment failure and illicit drug abuse. Thus, physicians should screen sexual dysfunctions in men receiving opioid treatment and carefully assess the issue of the medication of choice. Erectile and orgasmic dysfunctions may respond to methadone dose reduction. Further studies are needed to evaluate the benefits of methadone dose reduction in patients receiving treatment.