Endocrinopathies and Their Recovery in a 20‐Year Cohort Study of People With Heroin Dependence
Authors' conclusion
Opioid-induced endocrine suppression appears reversible with sustained opioid abstinence. Higher methadone dose, male sex, and depression were associated with hypogonadism. Despite frequent healthcare contact, patients remained undiagnosed, highlighting a gap in clinical awareness of opioid-associated endocrinopathies and the need for routine screening in opioid agonist treatment settings.
Study context
- Population
- People with heroin dependence/opioid use disorder in a long-term prospective cohort, with fasting endocrine assessment (gonadal, adrenal, thyroid, prolactin)complete endocrine data
- Participants
- 123 people
- Exposure
- Opioid-free vs continuing opioid use
- Opioid-freen = 35
- Outcome
- Prevalence of endocrinopathies defined by prespecified biochemical and clinical criteria
- Follow-up
- 18-20 year
Methodological detailsAustralian Treatment Outcome Study 18-20 year follow-up
- Australian Treatment Outcome Study 18-20 year follow-up
Main finding
As reported in the abstract
Endocrinopathy prevalence
Hypogonadism
| Outcome | Opioid-free | Opioid-using |
|---|---|---|
| Hypocortisolism | 0 | 14.8% |
- At least one endocrinopathy (all participants)
- 71 (57.7%)
Observational data: associations, not effects.
Further findings
Factors associated with hypogonadism (Firth logistic regression)
- Methadone dose, male sex and depression independently associated with hypogonadism
Testosterone and LH in men prescribed methadone
- Men prescribed methadone had significantly lower testosterone and LH levels
Prior diagnosis or treatment
- No participant with hypogonadism or hypocortisolism previously diagnosed or treated
Original publication
Endocrinopathies and Their Recovery in a 20‐Year Cohort Study of People With Heroin Dependence. Clin Endocrinol (Oxf). Published 24 February 2026. doi:10.
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