WASHINGTON -- Older men with erectile dysfunction (ED) have an increased risk of substance abuse, including sedatives, opioids, and cocaine, according to a large retrospective study.
ED had the strongest association with sedative abuse, more than twice as likely as a matched cohort without ED. The risk was at least 50% greater for other psychoactive substances (such as ketamine), cocaine, and opioids. The risk of cannabis abuse was 45% greater in men with ED. An ED diagnosis was associated with a reduced risk of nicotine dependence in men of all ages. The analysis did not include alcohol abuse.
Surprisingly, the associations did not hold up in younger men with ED, who are known to have higher rates of depression, which can predispose to substance abuse, said Hossein Zolfaghari, a student at Rutgers New Jersey Medical School in Newark, at the American Urological Association meeting.
"What can explain these findings?" asked Zolfaghari. "There are a few things, the first being that elderly men are medically more complex. They have other prescriptions that can give them access to medications that have abuse potential, such as sedatives and opioids. Additionally, given this medical complexity, clinicians might be inclined to overlook some possible psychiatric causes of their erectile dysfunction."
