The Facts About Opioids and Sexual Health

Opioids are a class of drugs primarily used to help alleviate pain symptoms. But taking these drugs comes with significant risk in the form of addiction, death and sexual dysfunction.

How have opioids become one of the most overused substances in America? And what are some options for people concerned about their own opioid use or misuse?

Why opioids are prescribed

Opioids are prescribed specifically for the treatment of moderate to severe pain. They are commonly used as a treatment method following serious injury or invasive surgery with potentially extensive recovery times. Opioids are also used to treat illnesses such as cancer that can be accompanied by severe pain or require treatments that cause pain.

Opioids have also been increasingly used in the treatment of chronic pain for ailments such as lower back problems and osteoarthritis. The long-term effectiveness of this use for opioids is debatable and subject to doubt.

Opioids work by blocking pain signals and activating positive feelings, so they can become highly addictive. They should never be taken without explicit instructions from a doctor.

How opioids work

Opioids such as morphine and oxycodone work by activating opioid receptors in nerve cells. The body does produce opioids naturally, though it has recently been found that the body's naturally occurring (endogenous) opioids may differ from pharmaceutical opioids in that they activate opioid receptors in different locations in the nerve cell.

Essentially, opioids relay a signal to your brain and tell it to block pain sensations. At the same time, they cause you to feel calm, happy and euphoric. Medical opiates mimic and amplify these effects to block pain levels and stimulate positive feelings at a level the body simply could not do on its own.

Risks of opioid use

The most commonly known side effect of opioid use is addiction, also known as substance use disorder. In recent years, the public health crisis of opioid addiction has ballooned as people of all ages have succumbed to the seductive effects of painkillers and their easy accessibility through a doctor or illegal alternative.

As many as 1 in 4 patients who receive long-term treatment involving the use of opioids may become addicted to their effects, according to the Centers for Disease Control and Prevention (CDC). In 2016, the CDC reported that more than 11.5 million Americans admitted to misusing prescription opioids.

This trend sparked a controversy around using opioids as a treatment for noncancer-related chronic pain. As the long-term benefits of opioid use for chronic pain are debated, many health professionals view the potential negative effects as outweighing the positive results.

If you have a history of substance use disorder, especially involving prescription medications, your doctor may be reluctant to prescribe these powerful painkillers to you. This is for good reason, because opioid addiction can be incredibly difficult to kick and can cause severe and far-reaching negative effects on a person's life.

But addiction is not the only side effect of opioid use and misuse.

Opioid use can also impact your romantic and/or sexual life in significantly detrimental ways. Both short- and long-term opioid use can correlate to increased risk of depression, development of heart problems and other conditions that may impact your ability to date or participate in meaningful relationships or sexual partnerships over time.

Many drugs, such as antidepressants and antihistamines, include sexual dysfunction as a listed side effect of taking the drug as prescribed. Misuse of these substances alters the pleasure and reward centers of the brain and can impact biological functions such as blood flow and the ability to maintain an erection.

Sexual health and wellness are influenced by many mental health aspects and bodily functions, which are also influenced by the presence of opioids in your system. Ongoing use or abuse of opioids can lead to many different mood- or biology-altering side effects or conditions that may prevent a person from socializing or participating in relationships in a satisfying way.

Opioid use can also damage a person's ability to have a child. High levels of opioid use are connected to DNA fragmentation within sperm, and prolonged opioid use can lead to drops in testosterone levels, which is associated with lowered sperm count. Unchecked, opioid abuse can lead to infertility.

If you are taking opioids and have observed any of these side effects, you may want to consult a doctor. Additionally, if your doctor has discussed using opioids in response to a surgical procedure or injury, be sure to address any concerns you may have relating to sexual or reproductive health before starting treatment.

Alternatives to opioids

Opioids remain the most effective pain management option for some types of pain, including chronic pain caused by cancer. Unfortunately, there are not a lot of alternatives available for blocking moderate to severe levels of pain. For patients with a history of substance use disorder, doctors may not feel comfortable prescribing more than an over-the-counter treatment usually utilized for minor pain, such as acetaminophen.

Some success has been achieved in treating pain with other forms of medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Doctors and scientists continue to experiment with alternative medicines and nonpharmaceutical treatments for chronic pain, as well.

In 2019, a novel compound called AT-121 showed promise as a potential alternative to opioid treatments for pain management, as well as to treat opioid addiction. This compound is theoretically capable of blocking pain signals in a similar way to traditional opioids, but without the addictive side effects.

Resources

If you or someone you know is struggling with opioid addiction, getting help is crucial. Recovery can be a long and arduous process, with a difficult beginning, but kicking the habit should be seen as a potentially life-saving decision.

Knowing how to start the process is often the most difficult part. To avoid the harsh realities of withdrawal, some people may wish to taper off use. Others may require either a more direct or more nuanced approach. The National Institutes of Health and CDC have lots of free resources available to help you educate yourself or seek help from recovery professionals in your area.