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Opioid-Induced Androgen Deficiency in Veterans With Chronic Nonmalignant Pain
Abigail Brooks1, Mitchell Nazario1, Sandra DiScala1
1is a clinical pharmacy specialist in pain management, is a clinical pharmacy specialist in community living center/hospice and palliative care, is chief of the Physical Medicine and Rehabilitation Service, and is the chronic pain management section chief, all at the West Palm Beach VAMC in Florida. is manager of the VISN 8 Pharmacy Benefits Management Program for Pain Management in Bay Pines, Florida.
Patients on long-term opioid therapy face risks of opioid-induced androgen deficiency. Counseling is crucial to inform patients about these potential hormonal side effects.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Chronic opioid therapy is widely used for pain management.
- Opioid-induced androgen deficiency (OPIAD) is a recognized adverse effect.
Purpose of the Study:
- To highlight the importance of counseling patients on chronic opioid therapy.
- To inform patients about the risks of opioid-induced androgen deficiency.
Main Methods:
- Review of existing literature on OPIAD.
- Clinical guidelines for patient counseling.
Main Results:
- Opioid use can suppress the hypothalamic-pituitary-gonadal axis.
- Symptoms of OPIAD include fatigue, decreased libido, and mood changes.
Conclusions:
- Healthcare providers must counsel patients initiating or continuing chronic opioid therapy.
- Informed consent should include discussion of potential androgen deficiency and its management.
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