(OPIAD)
http://www.ncbi.nlm.nih.gov/pubmed/22786453 (http://www.ncbi.nlm.nih.gov/pubmed/22786453)
Abstract
Opioid therapy is one of the most effective forms of analgesia currently in use. In the past few decades, the use of opioids as a long-term treatment for chronic pain has increased dramatically. Accompanying this upsurge in the use of long-term opioid therapy has been an increase in the occurrence of opioid associated endocrinopathy, most commonly manifested as an androgen deficiency and therefore referred to as opioid associated androgen deficiency (OPIAD).
This syndrome is characterized by the presence of inappropriately low levels of gonadotropins (follicle stimulating hormone and luteinizing hormone) leading to inadequate production of sex hormones, particularly testosterone. Symptoms that may manifest in patients with OPIAD include reduced libido, erectile dysfunction, fatigue, hot flashes, and depression.
Physical findings may include reduced facial and body hair, anemia, decreased muscle mass, weight gain, and osteopenia or osteoporosis. Additionally, both men and women with OPIAD may suffer from infertility. While the literature regarding OPIAD remains limited, it is apparent that OPIAD is becoming increasingly prevalent among chronic opioid consumers but often goes unrecognized. OPIAD can have a significant negative impact on the the quality of life of opioid users, and clinicians should anticipate the potential for its occurrence whenever long-term opioid prescribing is undertaken.
Once diagnosed, treatment for OPIAD may be offered utilizing a number of androgen replacement therapy options including a variety of testosterone preparations and, for female patients with OPIAD, dehydroepiandrosterone (DHEA) supplementation.
Follow-up evaluation of patients receiving androgen replacement therapy should include a review of any unresolved symptoms of hypogonadism, laboratory evaluation, and surveillance for potential adverse effects of androgen replacement therapy including prostate disease in males.
**I've been searching on and off for 2 years for the name of the medical condition, and every symptom on that list that applies to males, I have. Except one. The only symptom that i don't have there on that list any lack in hair growing. Quite the opposite actually, i've always had to get haircuts more regularly then before i started using, but even if i spend 20 min shaving my face after a shower/bath and get it smooth as a babys ass with once of those super overpriced razors that "Now come with 25 BLADES each!" (Said in that cheesy infomercial voice) "But wait...! There's more!!!!"
Obviously I was being sarcastic about the # of blades per razor, but I'll go from a smooth shaved baby-face to a 80 grit sandpaper face by 5pm. My barber I used when I was in my late teens/early 20's told me that hair is the body's way of getting rid of the harder substances in the body. The ones that you cant or don't excrete thru Stool or Urine, or sweat.**
I can tell a large, No...Huge difference between IV'ing and smoking H or whatever my current DOC is, and when i dont take opiates(blasphemy! lol)i'll come back to normal in a months time roughly.
Narcotic long term usage really took the blinders off on how much time,effort, and Money I put into sex. Showing me how I had let some of my past girls especially the gold digger types walk all over me and control me. Now that i'm on long term bupe maintenance its taking much longer to bounce back to my full ravenous sexual appitite which i've experienced on Bupe before.
Having this OPIAD condition has its benefits if your a optimistic type of glass half full kinda bloke like me, I tryto always see a silver lining in everything yada yada yada. Seriously though, now I don't mind being single and I've found that saying "No" to a girl causes a very unusual phenomena to happen Immediately:
*Piss her off(in a good way)!!!! The 1st time I tried this my girl at the time was on top of me in a hot tub, both nude, sitting right on top of my dick, she tried to slide down & when I told her "no, you have to wait and earn it..."
*Telling her a word that she rarely if not ever is used to hearing, she'll assume your joking, then once you make it known that your for real, she'll be surprised almost stunned, then the surprised effects turn to anger (now: there could be a number of reasons why the female was denied my 'sweet sweet lovin' =P, but it doesn't matter, you've now not only got a girl that feels rejected but also confused & denied even though she knows its only temporary, translation. Everyone wants what they cant have, so now you've got a cutie on pins & needles waiting for "The Night", I usually will get the deal done 3-4 days later but I've made a girl wait for 3 weeks before BUT she said it was by far the best sex she ever had and had been thinking about me nightly in the bathtub til the special night arrived, allowing time to get to know someone before being lovers makes for such wonderful intimacy.
*Congrats, you showed her something that goes against everything she thought she knew about guys(aka-'There are guys that aren't just tryin' to fuck me, bullshit, no f'ing way, cuz all girls are convinced that all men are fuckboi's/players.BAM! mind blown, ) Then a phenomenon happens.
* 1.) She doesnt know why you said to wait, is there another girl, is he gay, did i fuck it up...?
2.) This drives the girl crazy, Cuz NOBODY makes her wait, ever. She been conditioned to being cat called holla'd at and putting little to no effort into finding a good guy, let alone a meaningful relationships cuz, why would they? They have the All Mighty Vagina.
3.) So now this girl is bothered by your telling them no...it'll be less then 30 days, Let them know its not forever, it might be tomorrow or in a month, and that if she has a problem with that, explain that you dont wanna be with a girl that you barely know, or that you simply just dont fuck on the 1st date.
*This makes a delightful craving causing their desire for you to go up, plus their not feeling slutty with someone u just met.
* Your done! Now, you have killed many birds with just one stone!
You now have the power to call any time of any day, and within 30 min tops she be there. Wet n ready.
Cause hey, everybody wants what they cant have, more importantly. Every girl knows all guys are only after sex Duh! dont you watch LifeTime movies?
"a guy would never say no to sex with a girl unless he was gay or a serial killer."
To the ladies reading this post im talking about this condition for men thats like having menopause for us, younger Junkies like me, im 32. This seldom occurred to me even on long oxy/H runs, on Bupe maintenance my hormonal levels always went back to 100%.
I've been on Bupe for 8 months, chipping on H once every week or two, so 2-4 times a month but never consecutive days back to back, i like keeping a lil bupe in my system so im not sick while awaiting my next dose of bupe, but if i wanna do some Full Mu agonists i still have some receptors free to cling to.
Ultimately, since there is not much data on this newly known subject I was wondering about going to the doctor to see if i can get some blood tests done to see what going on, i'm burning up everywhere i go, i have a low sex drive when thats NEVER been the case, lack of motivation, i'm lonely, but i can barely put the effort into going to work everyday, let alone having to please someone else while paying for everything. and LA girls will remind you daily that if you cant provide her every-need, there are guys on the regular that would KILL to be with them, and that I should be so lucky...ugh.
So i wanna shout out some Thanks:
*thanks for reading this whole post
*thanks to saving money by not wasting it on gold diggers
*thanks to opiates for making me more picky who i sleep with, no more $5 Holla's behind the 7-11 from the resident trap house skank(lol, kidding)
*I think its the only reason i had unprotected sex with random girls not on birth control, and not getting any off them pregnant.
Ultimately, now that I just finished my first week at my new 1st Career, 1st salary job, and more money at my disposal then i feel comfortable with. I like this new job and I want a good girl to look forward to seeing nights/weekends. But I don't want her to do drugs, only pot & booze. I need a positive influence to balance out my bad boyish nature, while simultaneously keeping me a good boy, Either i stay strong on Bupe Maitinence, or I give in and have a decent sum of savings, with a newly acquired low tolerance, thats the ultimate recipe for your average OD story.
I'll wrap this up the way i should have started, I would like to make these side effects go away, I miss my personality, my sex-drive, my CONFIDENCE for sure!!!! And just overall i want my sense of self back. Been told on several occasions i was smart as well, Normal Sk8Phaze is a happy go lucky, smooth talking, decent looking, charismatic guy with a dirty but funny sense of humor. I've had 2 or 3 situations where a girl wanted to fuck and my dick was more unresponsive then an OD'd freshly out of rehab coppin' a bundle and shoots it all at once. Very embarrassing. But tbh, they weren't my type and i know for a fact its saved me from hooking up with a blonde girl with herpes.
Sorry for the long post, this condition is incredibly annoying as i wake up in w/d's
even if i took my PM dose right before sleep, , i have no urge to masturbate but if i dont it'll cause a wet dream so i gotta get it out whether i want to or not, & i still wake up with watery eyes, goosebumps, depression, lack of motivation until 45-60 min. passed and the bupe + Diazepam is working.
This weekend even if i did have $20k in spending money, i have no interest in going out and doing new things like i used to. The longer I continue this homebody cycle of enjoying isolation the more it consumes me. My monthly schedule is work, come home, watch youtube, and drink/smoke weed, maybe eat. The few girls that call still i dont answer 60% of the time.
Thats not the real me! This never happened on Buprenorphine before. I mean i felt normal and energetic and horny for a couple months last year about 1 month after voluntarily switched from bth to Subs. Then it came back again. @candy and the others here in the medical field, do you have any advice on how to return my endocrinopathic system back to normal. In simple, I need to increase my testosterone levels back to normal. I've tried expensive GNC bottles of Ultra Testosterone Boosters with the flashly labels and the sky high price with minimal to zero results, I've heard or read that in order to really make a difference you must get a RX'd topical Cream or they give iv/im injections.
I would just walk to the hospital and wait in the ER or Urgent Care center and have them refer me to a specialist or order blood work/lab tests, but in order to do so I'll have to tell them that this is caused by Long Term Opioid Maintinence, some legal, some not.
Will they put in my profile that I was an illict IV narcotic user? And not give me the quality and devotion to fixing this hormonal imbalance, or will they just say, "quit drugs and you'll be normal in 6 months tops" while making sure i never get RX'd even a tylenol3 ever again?
I just want to have my energy back, so I can go out and meet new friends, which in turn eventually leads to meetig a girl. So on the bright side of things at least i got time to work it out. Sorry this thread seemed to have two topics merged together but its really one big question, how do i raise my testosterone without becoming some 'roid rage asshole with a high pitch voice.
Sk8Phaze