title: Sexual Dysfunction in Heroin Dependents: A Comparison between Methadone and Buprenorphine Maintenance Treatment.
abstract: BACKGROUND
  Methadone has long been regarded as an effective treatment for opioid dependence. However, many patients discontinue maintenance therapy because of its side effects, with one of the most common being sexual dysfunction. Buprenorphine is a proven alternative to methadone. This study aimed to investigate sexual dysfunction in opioid-dependent men on buprenorphine maintenance treatment (BMT) and methadone maintenance treatment (MMT). The secondary aim was to investigate the correlation between sexual dysfunction and the quality of life in these patients.
  
  
  METHODS
  Two hundred thirty-eight men participated in this cross-sectional study. Four questionnaires were used, the Mini International Neuropsychiatric Interview, Opiate Treatment Index, Malay version of the International Index of Erectile Function 15 (Mal-IIEF-15), and World Health Organization Quality of Life-BREF Scale. Multivariate analysis of covariance was used to examine the relationship between MMT and BMT and the Mal-IIEF 15 scores while controlling for all the possible confounders.
  
  
  RESULTS
  The study population consisted of 171 patients (71.8%) on MMT and 67 (28.2%) on BMT. Patients in the MMT group who had a sexual partner scored significantly lower in the sexual desire domain (p < 0.012) and overall satisfaction (p = 0.043) domain compared with their counterparts in the BMT group. Similarly, patients in the MMT group without a sexual partner scored significantly lower in the orgasmic function domain (p = 0.008) compared with those in the BMT group without a partner. Intercourse satisfaction (p = 0.026) and overall satisfaction (p = 0.039) were significantly associated with the social relationships domain after adjusting for significantly correlated sociodemographic variables.
  
  
  CONCLUSIONS
  Sexual functioning is critical for improving the quality of life in patients in an opioid rehabilitation program. Our study showed that buprenorphine causes less sexual dysfunction than methadone. Thus, clinicians may consider the former when treating heroin dependents who have concerns about sexual function.
authors.affiliation: University Malaya Center of Addiction Sciences, Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Anne
authors.initials: A
authors.lastname: Yee
authors.affiliation: University Malaya Center of Addiction Sciences, Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Danaee
authors.affiliation: Clinical Academic Unit (Family Medicine), Newcastle University Medicine Malaysia, Nusajaya, Johor, Malaysia.
authors.forename: Huai Seng
authors.initials: HS
authors.lastname: Loh
authors.affiliation: University Malaya Center of Addiction Sciences, Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Ahmad Hatim
authors.initials: AH
authors.lastname: Sulaiman
authors.affiliation: University Malaya Center of Addiction Sciences, Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chong Guan
authors.initials: CG
authors.lastname: Ng
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000139:chemically induced*; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D060046:Maintenance Chemotherapy / Q000009:adverse effects; D008297:Male; D008691:Methadone / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D011788:Quality of Life
chemical_list: D002047:Buprenorphine; D008691:Methadone
references.citation: J Urol. 2003 Jun;169(6):2262-4
references.pmid: 12771765
references.citation: Int J High Risk Behav Addict. 2012 Summer;1(2):66-70
references.pmid: 24971235
references.citation: Eur Rev Med Pharmacol Sci. 2011 Aug;15(8):871-4
references.pmid: 21845796
references.citation: Arch Iran Med. 2012 Dec;15(12):751-5
references.pmid: 23199246
references.citation: Drug Alcohol Depend. 2008 Apr 1;94(1-3):12-8
references.pmid: 18083312
references.citation: Iran J Psychiatry. 2010 Fall;5(4):164-6
references.pmid: 22952511
references.citation: N Engl J Med. 1975 Apr 24;292(17):882-7
references.pmid: 1117911
references.citation: J Sex Med. 2014 Jan;11(1):22-32
references.pmid: 24344738
references.citation: Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2011 Aug;36(8):739-43
references.pmid: 21937799
references.citation: J Sex Med. 2012 Dec;9(12):3198-204
references.pmid: 21366875
references.citation: J Addict Dis. 2010 Oct;29(4):455-60
references.pmid: 20924881
references.citation: J Sex Med. 2010 Apr;7(4 Pt 2):1668-86
references.pmid: 20388164
references.citation: Psychol Health Med. 2013;18(3):321-9
references.pmid: 23092392
references.citation: Drug Alcohol Depend. 1993 Oct;33(3):235-45
references.pmid: 8261888
references.citation: Arch Sex Behav. 2003 Jun;32(3):279-85
references.pmid: 12807300
references.citation: J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
references.pmid: 9881538
references.citation: Int J Impot Res. 2002 Aug;14(4):226-44
references.pmid: 12152111
references.citation: J Clin Endocrinol Metab. 2005 Jan;90(1):203-6
references.pmid: 15483091
references.citation: Int J Impot Res. 2002 Aug;14(4):310-5
references.pmid: 12152122
references.citation: J Addict Dis. 2005;24(2):91-106
references.pmid: 15784526
references.citation: Acta Neurol Scand. 1970;46(S43):223-4
references.pmid: 5466273
references.citation: J Sex Med. 2008 Mar;5(3):684-92
references.pmid: 18093096
references.citation: Int J Androl. 2009 Apr;32(2):131-9
references.pmid: 17971165
references.citation: Med J Malaysia. 2003 Mar;58(1):79-88
references.pmid: 14556329
references.citation: Compr Psychiatry. 2009 Jul-Aug;50(4):353-60
references.pmid: 19486734
references.citation: Endocrinology. 1980 Jun;106(6):1917-22
references.pmid: 7371596
references.citation: Int J Impot Res. 2014 Sep-Oct;26(5):161-6
references.pmid: 24990199
references.citation: Drug Alcohol Depend. 2015 Apr 1;149:1-9
references.pmid: 25702934
references.citation: Prog Neurobiol. 2013 Sep;108:80-107
references.pmid: 23851261
references.citation: J Urol. 1992 Jun;147(6):1542-3; discussion 1543-4
references.pmid: 1593685
references.citation: Psychopharmacology (Berl). 1995 Dec;122(4):330-5
references.pmid: 8657829
references.citation: Malays Fam Physician. 2009 Aug 31;4(2-3):77-82
references.pmid: 25606168
references.citation: J Addict Med. 2012 Sep;6(3):212-8
references.pmid: 22614937
references.citation: Addict Behav. 2012 Jan;37(1):124-6
references.pmid: 21920671
references.citation: J Sex Med. 2009 Jun;6(6):1506-1533
references.pmid: 19453889
references.citation: Am J Drug Alcohol Abuse. 1977;4(1):13-20
references.pmid: 565588