Methadone, Tooth Decay, Weight Gain

Okay, a lot of methadone prescribers will try to tell you all kinds of rubbish about methadone not rotting your teeth or causing weight gain, or they will try to tell you some crap about how it's caused by dry mouth. THEY ARE WRONG. Long term use of Methadone and other synthetic opioids with a long half-life causes a condition called Opiate Induced Endocrinopathy. I have been on and off methadone maintenance since 1992, and my last stint has been seven years on 100mls. Even after the first two years on the program my teeth started decaying and most recently they actually began breaking off and I gained a massive amount of weight about four years ago. In addition to this I experienced profuse, constant and extreme sweating (even at normal temperatures with no exertion or stress), overwhelming fatigue, constant headaches, facial flushing, total loss of libido and the weight gain was so severe that I started to develop gynecomastia (man boobs).

While methadone originally gave me the freedom from daily opiate use to keep working, this recently became a lot more difficult.
I had a full-time, high pressure job in financial markets and found that I could no longer function - I started having trouble getting to work in time, I was no longer able to think strategically, I was so tired all the time that I couldn't perform, my teeth got so bad that dental work was costing thousands every month and no matter how hard the dentists tried to save my teeth they eventually got infected and had to be extracted, and the constant sweating was not only embarrassing, it made it impossible to meet clients or senior management.
I was transformed from a healthy, fit goodlooking young man into a toothless, morbidly obese, sweaty eunuch with man boobs and no libido, who looked like Jabba the Hut.

The situation aggravated my depression and I began self-medicating with opiates. Unfortunately I have access to very pure Number 4, and soon found myself with a cross-addiction to both methadone and opiates. My methadone prescriber refused to believe that methadone was the problem behind the deterioration in my quality of life, and insisted on increasing my dose every time I had a dirty u/a. Anyhow, I got to thinking and recalled a time in my teenage years when I had pet rats - at one point I had a male rat who is had neutered so he could live with females without breeding - but as soon as we got him back from the vet he put on a massive amount of weight and became so sluggish he would barely move, so I wondered if I I'd perhaps been castrated by methadone. So I asked for my hormones to be tested, and the results were unequivocal - severe androgen deficiency.

In other words, my body was no longer producing the hormones that made me a man. So I was referred to a specialist endocrinologist who put me through a battery of tests and scans and after establishing that there were no tumors or other abnormalities affecting my thyroid and pituitary glands, told me that what I was experiencing was Opiate Induced Endocrinopathy - a condition caused by long-acting synthetic opiates like methadone and LAAM. Google "Opiate Induced Endocrinopathy" if you want to get a clinical description of this condition, but basically what happens is that opioids which take a long time to leave the body - like methadone which has a 24-48 hour half-life - start to suppress the healthy function of the endocrine system. In my case, methadone had been disrupting my body's production of male hormones, specifically testosterone, and it was the resulting testosterone deficiency that was causing the tooth decay, weight gain and obesity, brittle bones and low bone density, sweating, headaches etc.

The endocrinologists suggested that I reduce methadone to as low a dose as possible (with a view to eventually discontinuing it altogether) and started me on testosterone replacement therapy. The effects were miraculous. As soon as I began testosterone replacement I began rapidly losing weight - without dieting and without exercise - so that after three months I had lost more than 40kg (88.8lb) and was back to my target weight of 85kg (187lb). Additionally the other symptoms such as the constant sweating and the headaches stopped, my libido returned and I not only had more energy, my mood also improved considerably. So I have since started reducing my methadone and am currently on 65ml a day. Not quite sure what the future holds, but I must say that it is a lot brighter than it was 12 months ago. So if you're taking methadone and experiencing tooth decay, weight gain, and all the other horrible life-wrecking symptoms that I was, tell your prescriber about Opiate Induced Endocrinopathy. I don't know why more doctors aren't aware of this condition, but for some reason it seems to be something that only specialist endocrinologists know about.

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