Why don't people in opioid maintenance develop breasts?

[plumbus-nine]

I was in maintenance for around four years, first bupe, then methadone and finally morphine XR. During this time I lost my stamina and body shape, developed slight breasts and a belly which both weren't there before. Made a blood analysis for hormones which came back with low test and 4-times increased prolactin. I was also on SSRI during most of that time, but also for years before and had no issues with them besides physical addiction.

Now, most if not all the people I saw in maintenance center were slim, and many of them were also on some SSRI. How does it come? I get that with heroin users it might be the stress of sourcing the drugs and money for them every day but many of the people in maintenance don't have these stressors anymore.

 

[Jabberwocky]

opioids can definitely cause gynecomastia in men, particularly heavy/long term use

but it doesn't happen to everyone, I think younger men are more susceptible

I'm not 100% sure what you're asking though

 

[neversickanymore]

Gynecomastia can't be the result of excessive drug use alone. It develops due to a combination of factors, so I'd say that a person who suffers from it must collect a certain bingo: the appearance of excess estrogen, liver pathology, or even a genetic lack of sensitivity to male sex hormones. Therefore, we can't say with certainty that every man can be at risk. More likely, you're unlucky with this bingo.

why do you feel that extended therapy, use or misuse cant cause this?

 

[fastandbulbous]

Prolactin is what causes breast formation. Dopaminergic activity reduces prolactin levels (and opioids cause dopaminergic activity).
Antipsychotics have gynomastia high up in the list of side effects. Seems to be a consequence of inhibition of the D2 receptor (antipsychotics also massively increase the chances of type 2 diabetes, opioids don't)

 

[THECATINTHEHAT]

Most are also smoking crack every day, end of discussion

 

[neversickanymore]

Long-term Opioids Linked to Hypogonadism and the Role of Testosterone Supplementation Therapy - PMC

Opioids play a pivotal role in managing chronic pain with increasing prescription rates over the last few years. Hence, it is crucial to focus on the adverse effects of narcotics, and one of the lesser-known side effects is hypogonadism. Opioids act ...

www.ncbi.nlm.nih.gov

Hypogonadism in men receiving methadone and buprenorphine maintenance treatment - PubMed

The aim of this study was to determine the prevalence and investigate the aetiology of hypogonadism in men on methadone or buprenorphine maintenance treatment (MMT, BMT). 103 men (mean age 37.6 +/- 7.9) on MMT (n = 84) or BMT (n = 19) were evaluated using hormone assays, body mass index (BMI)...

pubmed.ncbi.nlm.nih.gov

Hypogonadism and Low Testosterone Levels as a Side Effect of Methadone and Buprenorphine

www.ncbi.nlm.nih.gov

Low vitamin d status of patients in methadone maintenance treatment - PubMed

: Low vitamin D status was present in a majority of patients recruited from an MMT program. This raises the question as to whether this is a generalizable phenomenon and whether these patients are at higher risk of complications of low vitamin D status including bone pain, periodontal disease...

pubmed.ncbi.nlm.nih.gov

All chronic opiate patients, methadone patients should regularly have their vitamin D levels checked and males should have their testosterone levels checked. Female endocrine effects of prolonged opiate use need to be studied as well as loss of menstrual cycle seems to be common among opiate addicts.

Methadone programs are so lucrative, often are so greed shady and constitute care for a stigmatized group that proper care is not provided.

I have been posting this for a decade.

 

[negrogesic]

I got a touch of gynecomastia from methadone maintenance, also gained a ton of weight.

I have never enjoyed eating and have little interest in food, never has food every tasted as good as it did when I was on methadone. It was actually quite interesting as it gave me some insight into how much of the rest of the world (with presumably normally functioning endogenous opioid symptoms) perceives food.

However the gynecomastia clearly wasn't from the weight gain alone, and definitely appeared to stem from dysregulation of the endocrine system.

 

[paranoid android]

I have been on some form of opiate treatment since about 2007 i think. I have never had a problem with this on opiates but i did have problems on invega and abilify. But thankfully i lost all the weight when i switched to latuda. But now that im on zyprexa i will be asking my doctor for a blood test for testosterone and prolactin

 

[Phobophobic]

I did, you sexy kitty cats...