Bone Density and Serum Testosterone in Male Methadone Maintained Patients
Condition: Opiate Dependence; Osteoporosis; Erectile Dysfunction; Hypogonadism
MeSH terms: Osteoporosis; Erectile Dysfunction; Hypogonadism; Opioid-Related Disorders
Study type: Observational

Summary: 
      This is a pilot study designed to answer the question " Do men who are receiving methadone
      maintenance therapy have lower spinal bone densities compared with age-matched controls who
      are not receiving methadone therapy?"

      The primary aim is to assess whether the mean or median spinal dual-ray energy x-ray
      absorptiometry (DEXA) scan results are different between these two groups of male patients.
      Primary measurements include: spinal bone densitometry by DEXA scan.

      The secondary aim is to examine the role of sex steroids in men receiving methadone
      maintenance therapy and their association with spinal bone density and sexual dysfunction.
      Secondary measurements include: serum testosterone, estradiol, lutenizing hormone, albumin,
      sex hormone binding globulin and Vitamin D levels; age; Brief Sexual Function Inventory;
      Dietary, smoking/alcohol use and physical activity; Medical history, surgical and medication
      use; length of time using illicit opiates and time on methadone maintenance therapy.
    

Detailed description: 
      Chronic use of opiates has long been associated with multiple side effects, many of which are
      due to lower levels of androgens in this patient population. Previous studies have shown that
      long-term opiate use may lead to narcotic induced hypogonadism, resulting in significantly
      decreased testosterone levels in men. One area of chronic opiate use that has not been looked
      at extensively is the correlation between narcotic-induced hypogonadism and associated side
      effects such as osteoporosis and sexual dysfunction in male patients receiving methadone
      maintenance therapy. Marked testosterone deficiency is a well-established rick factor for
      both osteoporosis and altered sexual function, and recent information demonstrated that
      altered estrogen levels may play a role in these side effects as well. Thre present pilot
      study investigates the role of sex steroids in male patients maintained on methadone therapy
      and their association with bone densitometry and sexual dysfunction. Free testosterone,
      estradiol, lutenizing hormone, sex hormone binding globulin, Vitamin D levels and albumin
      will be measured in thirty community-dwelling outpatient men participating in a methadone
      maintenance program as well as thirty age-matched controls from a general medicine clinic.
      Osteodensitometry will be performed with the DEXA technique at the lumbar spine. Participants
      will also complete the Brief Male Sexual Function Inventory as well as be assessed for
      smoking/alcohol use, calcium intake, physical activity, length of time receiving opiates as
      well as concurrent medications. It is hypothesized that patients receiving methadone
      maintenance therapy will have lower bone mass densities, free testosterone, estradiol, and
      sexual dysfunction scores than the age-matched controls.
    

Time perspective: Prospective
Keywords: Opiate Dependence; Methadone Maintenance; Osteoporosis; Hypogonadism