Low testosterone and long-acting pain medications linked in first study

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Men who take long -acting or extended release pain medications are five times more likely to have low testosterone levels compared to short acting opioids, find a new Kaiser Permanente study.

Researchers know pain medications can lead to low levels of the hormone, but the study is the first to show long-acting medications for pain lower testosterone to a greater degree.

The finding is important because low testosterone can lead to loss of muscle mass, osteoporosis, low sex drive and decreased quality of life.

Physicians often prescribe long-acting opioids because there is less chance of abusing the drugs. But study author Andrea Rubinstein, MD of Kaiser Permanente's Santa Rosa Medical Center says studies don't support that the long-acting drugs are safer.

Rubinstein, who specializes in chronic pain management and Anesthesiology, adds there also are no studies supporting better pain control from long-acting opioids.

Oxycontin and Vicodin are used by millions of Americans daily for chronic pain.

In the study, 74 percent of  81 men taking long-acting narcotics had low testosterone levels of less than 250ng/dL, compared to just 34 percent of men taking immediate release forms of the drugs.

Men included in the study had been on opioids for 3 months. None had low testosterone before starting the medications.

Rubinstein says more studies are need to understand unintended consequences of long-acting opioids that can lead to more health problems for men from low testosterone levels. The researchers are planning larger studies to include 1500 men.

Clinical Journal of Pain
January 24, 2013
"Hypogonadism in men with Chronic Pain Linked to Long-Acting Rather than Short-Acting Opioids"
Andrea L. Rubinstein, MD et al.