Opioid Treatment Specialists Struggle To Address Sexual Dysfunction In Patients

By Lindsey Weedston 03/08/19

Addiction experts worry that people with opioid use disorder may stop medication-assisted treatment due to the side effect of sexual dysfunction. 

opioid specialist talking to a patient

People treating their opioid addiction with drugs like methadone and buprenorphine often struggle with sexual dysfunction, according to a report in Filter.

All opioids lower the amount of free and available testosterone in the human body, and lower testosterone levels are directly associated with a lower sex drive and more difficulty achieving orgasm regardless of gender. However, the actual source of sexual dysfunction can be difficult to determine, and obtaining treatment can be even more challenging.

According to Dr. Alan Wartenberg, former president of the Massachusetts chapter of the American Society of Addiction Medicine, 30 to 40% of individuals taking methadone and 20% of those taking buprenorphine experience sexual dysfunction.

The chances of experiencing this problem increase, the higher the dose of the medication, but some patients may have a low sex drive and related issues due to other aspects of recovery such as stress, co-occurring mental illness, and other medications taken in addition to the methadone or buprenorphine.

Regardless of the source of the problem, medical professionals involved in addiction treatment stress that sexual dysfunction in recovering individuals needs to be addressed. Some patients may leave treatment if the issue becomes intolerable. 

Sexual functioning is considered a key aspect of one’s quality of life. Getting better might not seem worthwhile if a decent sex life is not in one’s future. Sexual dysfunction can also make it more difficult to get pregnant.

“I remember as an administrator at the clinic, there were some patients that decided to end their treatment for a number of reasons, including the issue of having a lowered sex drive,” said President Mark Parrino of the American Association for the Treatment of Opioid Dependence.

In order to effectively address this problem, experts believe that people in addiction recovery need a comprehensive evaluation in order to discover the true cause of sexual dysfunction and determine the best treatment approach.

In anyone else with issues relating to sex, a specialist would be seen and tests would be done to measure hormone levels and screen for depression and performance anxiety. Unfortunately, the social stigma surrounding addiction creates a barrier for those in recovery.

“[T]he American attitude about addicts is that addicts are sick, they need help, but they’re also sinners so we shouldn’t help them too much,” said founding director of the Integrated Substance Abuse Programs at UCLA, Dr. Walter Ling.

At the same time, it’s difficult to find doctors who have a good understanding of both addiction and sexual dysfunction. There is also a general stigma around the issue of sexual dysfunction, and the problem is not well understood in women. This lack of understanding has resulted in a lack of effective treatments for female sexual dysfunction (FSD).

Dr. Karen Boyle, a urologist at the Johns Hopkins Hospital, believes that the lack of treatment options makes it difficult for people to take FSD seriously.

“The gender bias still exists,” she said in an interview with ABC News. “We have so many really good medical treatments for men. When the FDA approves a drug for the treatment of FSD it will give real credibility to the biological basis of this type of disease.”

All of these issue combined makes it very difficult for women in recovery from opioid addiction to address sexual dysfunction.

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Lindsey Weedston is a Seattle area writer focused on mental health and addiction, politics, human rights, and various social issues. Her work has appeared in The Establishment, Ravishly, ThinkProgress, Little Things, Yes! Magazine, and others. You can find her daily writings at NotSorryFeminism.com. Twitter: https://twitter.com/LindseyWeedston