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Study Links the Risk of Hypogonadism in Men to Long Acting Opioids in Patients Using Daily Opioid Therapy for Chronic Noncancer Pain
Date:2/24/2012

levels were taken from each man referred to the clinic that was currently on daily opioid therapy for chronic noncancer pain. The study found that 57 percent of men were hypogonadal overall, but that 74 percent (34/46) of men on long-acting opioids were hypogonadal. Of the men on short-acting opioids, 34 percent (12/35) were hypogonadal, which was statistically significant at p<0.001. The study defined hypogonadism as a total AM testosterone <250 ng/dl.

Using a multivariate analysis correcting for dose, the study found that patients on a long-acting opioid formulation had a 4.78 greater odds of becoming hypogonadal, than did patients on an equivalent dose of a short-acting opioid formulation (95% confidence interval 1.51-15.07, p = 0.008). The study also found that dose was not significantly associated with hypogonadism in the multivariate model.

Although the study was not large enough to examine the differences between specific drugs, a subsequently awarded grant is currently underway to study men across the Kaiser Northern California System on opioids who had their testosterone levels checked. Dr. Rubinstein hopes to see a prospective study examining this question in the future.

About AAPM
The American Academy of Pain Medicine is the premiere association for 2,400 pain physicians and their treatment teams. Now in its 28th year of service, the Academy's mission is to optimize the health of patients in pain and eliminate it as a major public health problem by advancing the practice in the specialty of pain medicine. More information is available at www.painmed.org.


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