Thursday, July 18, 2013

Prescription Opioid Use for Low Back Pain associated with Erectile Dysfunction.

Prescription Opioids for Back Pain and Use of Medications for Erectile Dysfunction. 

Spine: 15 May 2013 - Volume 38 - Issue 11 - p 909–915. Deyo, Richard A. MD, MPH*; Smith, David H. M. PhD, RPh; Johnson, Eric S. PhD; Tillotson, Carrie J. MPH; Donovan, Marilee PhD, RN; Yang, Xiuhai MS; Petrik, Amanda MS; Morasco, Benjamin J. PhD§; Dobscha, Steven K. MD§


It is said that most healthcare decisions in families are made by women. This is what I hear day in, day out, in my private practice. "Doc, I wouldn't be here if it weren't for my wife". In fact, many of my male patients initial appointments are made by their spouses.

Low Back Pain Statistics: 
  • Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
  • One-half of all working Americans admit to having back pain symptoms each year.
  • Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
  • Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
  • Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.
  • Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.
Prescription Opioid Narcotics, also known as "Pain Killers" are on the rise. These are available by prescription only and are also readily available on the street. Common Opioid Narcotics: Morphine, Codeine, Hydrocodone, Oxycodone, Methadone, Fentanyl, etc.

Initially intended for acute trauma, post-surgical pain and for terminally ill cancer patients, opioids have since been prescribed for chronic non-cancer pain conditions, without medical evidence that these powerful narcotics were either effective or safe for use in the long-run. The result is that we have a rapidly escalating epidemic of death and addiction, and pain patients with often reduced pain relief and various side effects over time. 

A recent article in the journal Spine found an association between usage of Opioids for pain relief and increased use of those patients for medications for Erectile Dysfunction and Testosterone Replacement Therapy.

In this study, there were 11,327 males with a diagnosis of back pain. Patients prescribed daily opioid doses of 120 mg of morphine-equivalents or more had greater use of medication for erectile dysfunction or testosterone replacement than patients without opioid use (odds ratio, 1.58; 95% confidence interval, 1.03–2.43), even with adjustment for the duration of opioid therapy.


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