Opioid painkillers could cause sexual problems for men

Doctors are being advised to inform male patients who are prescribed opioid painkillers that it could affect their sex life. More specifically, these types of medications could leave men at a much higher risk of suffering with erectile dysfunction (male impotence).

The warnings stem from a new study pioneered by lead author Dr Richard A. Deyo, an investigator with the Kaiser Permanente Center for Health Research, whose findings are published in the 15 May online issue of the journal Spine.

The study findings indicate that taking opioid prescription painkillers for the treatment of back pain could lead to the development of erectile dysfunction (ED). Dr Deyo comments: “Men who take opioid pain medications for an extended period of time have the highest risk of ED. 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.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.”

Opioids connect to opioid receptors within the brain, spinal cord, and places around the body. They restrict the ability of pain messages being transmitted to the brain, thus decreasing how much pain we feel. Opioid drugs include codeine, methadone, morphine and oxycodone. They are primarily used to relieve moderate to severe pain which isn’t subsiding after taking other, usually weaker, pain medications.

Dr Deyo and his colleagues decided to conduct their study after acknowledging that many men with chronic pain can also develop erectile dysfunction from a number of reasons including: age, smoking, depression, or opioid-related hypogonadism (low testosterone due to painkiller use).

However, they realised there is very little information regarding any potential correlations with erectile dysfunction in men who are suffering with back pain, and any crucial risk factors that can come into play.

The researchers were curious to find out if men prescribed painkillers, were also later prescribed testosterone replacement or ED treatments such as Viagra, Cialis or Levitra.

To do this, they studied 11,327 males from Oregon or Washington who were enlisted in the Kaiser Permanente health plan. All men had visited their doctor during 2004 complaining of back pain.
Pharmacy records spanning six months prior and six months after the back pain complaint were analysed to see if and/or when the men had been prescribed opioids and testosterone replacement or ED medications.

From the men who were taking low-dose opioids for a period of at least four months, it was found that 12% had also received prescriptions for testosterone replacement or ED medications.

However, it was discovered that over 19% of men who took high-dose opioids (classed as more than 120 mg of morphine-equivalent) for the same amount of time, were then also prescribed testosterone replacement or medications for ED. Dr Deyo says: “That could well be an underestimate, because many don’t bring it to their doctor’s attention, would be embarrassed or wouldn’t connect it to medication.” In addition, 6.7% of the men with back pain had received ED prescriptions, but had not been prescribed any opioids.

Dr Deyo concludes: “Opioid use and erectile dysfunction seem to go together, but we have to be cautious about saying one causes the other.”

Four Welsh drug counterfeiters are sentenced

The UK’s governmental drug body, The Medicines and Healthcare products Regulatory Agency (MHRA), have confirmed that four people based in Wales (three men and one woman) have been handed prison sentences after illegally supplying prescription-only and counterfeit medicine over the internet.

Andrew Luxton was sentenced to 12 months in prison on five counts involving conspiracy to sell or supply prescription-only medicines, possession of counterfeit medicines in breach of trademarks, possession of a Class A controlled drug (Methadone) and supplying a Class C controlled drug (Diazepam).

Samantha Steed also received 12 months in prison suspended for 18 months, on four counts involving conspiracy to supply prescription-only medicines, possession of counterfeit medicines in breach of trademarks and supplying a Class C controlled drug (Diazepam). Ms Steed was also handed a community service order of 18 months.

Carl Willis was sentenced to 6 months in prison suspended for 18 months, on three counts involving conspiracy to supply prescription-only medicines and possession of a class C controlled drug (Diazepam). In addition, Mr Willis must also attend a drug rehabilitation programme.

Anthony Luxton was sentenced to a Supervision Order on three counts which involved conspiracy to supply prescription-only medicines and possession of two Class C controlled drugs (Diazepam and Nitrazepam).

The arrests were carried out following an undercover operation focused on the Ebbw Vale area of Gwent, whereby an MHRA undercover agent obtained medicines online – from a third party based in Pakistan. The guilty foursome were importing the prescription-online medicines from Pakistan and then re-selling them to UK consumers in smaller quantities.

Investigators found large amounts of counterfeit medication and generic prescription-only medicine following searches conducted at the homes of those involved, including: Viagra, Cialis, Diazepam and Methadone. A computer at one of the addresses also unearthed damning evidence in the form of email exchanges between Andrew Luxton, Samantha Steed, Carl Willis and other individuals which showed a history of illegal drug activity.

The four defendants acted as ‘drop shippers’; a term Medical Specialists explained back in January when we reported about Pfizer’s fight against counterfeit drugs.  Although they were receiving large bulks of prescription-only medicine from Pakistan, they aimed to reduce the number of importations to minimise the chance of packages being intercepted upon entering the UK.

Nimo Ahmed, MHRA Acting Head of Enforcement said : “The MHRA is committed to pursuing those involved in the illicit supply of medicines and taking action to ensure the public is protected. These individuals were involved in a concerted conspiracy to supply counterfeit medicine and showed a blatant disregard for public health. Buying medicines from unauthorised sources significantly increases the risks of getting substandard or fake medicines. People who buy medicines without the benefit of a consultation with an appropriate healthcare professional run the risk being supplied with medicines that are not safe or suitable for them to use. You should take prescription-only medicines after an appropriate consultation with your GP.”

However, you can also undergo an online consultation with one of Medical Specialists’ GMC-registered Doctors and we supply prescription-only medicines to treat a wide range of conditions such as: male impotence, male hair loss, female hair loss, acne, obesity, high cholesterol and many more. Once approved by the Doctor, they will then write you a prescription which is passed to our in-house Pharmacy team and subsequently dispensed and dispatched to you within a mere 24 hours! (Allow extra time for overseas deliveries).