When it comes to tapering opioids, testosterone optimization often helps men titrate down and off these drugs with less negative impact to their physical and psychological health.

I’ve been an addiction coach for more than 6 years.

4 years ago, my private coaching practice began to flourish.

An influx of clients for the majority of the past 4 years has allowed me to observe many patterns.

The pattern I’ve chosen to dedicate this essay to is the much higher success rates for my male clients that were on testosterone replacement therapy (TRT) — vs males that were not on a testosterone formulation (eg injections, gel, bio-identical hormones).

Out of this population, the clients that also did a taper protocol, worked out regularly, consumed a muscle-building diet, and took muscle-building supplements… their recovery rates were through the roof.

My intention with this article is to educate you on the importance of testosterone optimization for men on opioids, how this can help them to quit, and what some of the best options are.

Testosterone Replacement Therapy (TRT)

I cut my teeth in the addiction treatment industry by working first as an intern — then 4 months later as a full-time, certified drug and alcohol counselor at an opioid treatment program (OTP).

The majority of my patients at the OTP were on methadone for 21-day detox, long-term detox, or the maintenance program.

The minority were using Suboxone, Subutex, or Vivitrol.

The place I worked at specialized in medication-assisted treatment (MAT), which involves the use of opioid-agonist or antagonist medications for opioid use disorder.

While working at the facility, I often head the same common complaints from many of the patients over the years.

The most common issues male patients reported were:

• Decreased libido (and often zero sex drive)
• Erectile dysfunction
• Muscle loss
• Increased body fat
• Fatigue
• Depression
• Sweating
• Hot flashes

Near the end of my career working as a certified alcohol and drug counselor, a male patient in his forties reported a big reduction in the above-mentioned symptoms soon after beginning testosterone replacement therapy (TRT).

I was 34 at the time and thought testosterone was an illicit drug only.

I was pleasantly surprised to learn that if you’re tested and fall within the low enough range, you have the ability to be prescribed therapeutic dosages of testosterone.

Before TRT, my patient had gained 80 pounds from being on 140 mg of methadone for 6 years (and hydrocodone for many years before that).

After 6 months on TRT, he reported that he lost 40 pounds, had a healthy libido, was in a way better mood, and overall felt more energized and content (with much less sweating too!).

A few years later… and soon it was private coaching clients that were reporting similar or even better results from TRT than my patient at the opioid treatment program.

Soon the pattern was right in front of my face.

The pattern? Males on opioids that were concurrently undergoing testosterone therapy were recovering at elevated rates compared to males not on TRT.

Not long after becoming aware of this pattern, I learned why males on testosterone typically have less side effects from opioids and why TRT may be able to help a person quit opioids, too.

Everything became crystal clear to me after learning about a medical condition caused by prolonged opioid use.

Opioid-Induced Endocrinopathy

Opioid-induced endocrinopathy is one of the most common yet least often diagnosed negative consequences of prolonged opioid therapy.

Sustained-action (aka long-acting) opioids used on a daily basis for more than 30 days have a number of negative effects on your endocrine function.

Daily use of opioids can decrease levels of: 

• Gonadal sex hormones
• Growth hormone
• Cortisol
• Dehydroepiandrosterone sulfate (DHEAS)

Note: Any type of opioid can cause endocrine dysfunction. However, the sustained-action opioids (especially methadone) are much more likely to cause significant endocrinopathy than short-acting opioids.

TRT for Opioid-Induced Endocrinopathy

According to medical doctors that specialize in this disorder, “Opioid-induced endocrinopathy should be considered in any patient receiving daily opioid treatment in an amount equivalent to 100 mg of morphine or more. In addition, patients should be asked routinely about symptoms suggestive of sex hormone deficiency before treatment and at regularly scheduled follow-up medical visits.”

Despite these recommendations, the reality is that most of the time, endocrine dysfunction from opioids and using TRT to offset it are rarely talked about.

Most men administering opioids daily aren’t aware of these possibilities, and most opioid-prescribers don’t mention them (either due to ignorance, not wanting to go the extra mile, or other reasons).

If you’re male and have low testosterone from opioids, TRT may help you:

1. Have less side effects from opioids
2. Enhance libido
3. Boost energy and vitality
4. Lift mood
5. Be more adaptable and resilient to stressors
6. Increase muscle mass
7. Decrease body fat

This is by no means a comprehensive list of benefits.

It’s also not a guarantee that you, personally, will experience all or even some of these benefits.

TRT for Men Quitting Opioids

However, 100% of my past male clients on TRT reported that testosterone either noticeably helped — or that it totally changed their life (in a good way!).

Furthermore, close to 100% of my clients that successfully detoxed from opioids and were also on TRT reported noticeable benefits from using testosterone while detoxing.

Testosterone Side Effects and Addiction

At this point, I need to play the devil’s advocate. While TRT has been shown to be a marvelous treatment modality for males on opioids with low “T” — not all males do well on this medication.

Due to biochemical individuality, different people can experience varying effects, side effects, and overall drug efficacy from taking the same exact medication.

Patients on testosterone often report side effects, although usually these are minor. Less commonly, patients report moderate or even severe side effects.

Additionally, testosterone is a Schedule III drug, meaning it has a moderate-to-low potential for both physiological and psychological dependence.

It would be awful for someone to use prescribed testosterone to both offset endocrine issues and help them detox — then start abusing it — become addicted — start buying it illegally — ruin mental and physical health — and be in a worse situation than opioid dependence led to!

Now that I’ve warned you about these potential negative outcomes from using prescribed testosterone, we can move on to the next section.

Mofo

Guys on opioids that want to boost their testosterone (but not with medications) may benefit from using a supplement called Mofo.

Mofo (Male optimization formula w/ organs) is a new product by Ancestral Supplements.

This is one of my favorite supplement brands.

Here are the ingredients in Mofo:

• New Zealand grass-fed bovine:
  • Testicle
  • Prostate
  • Heart
  • Liver
  • Bone marrow

Bovine Testicle is a Natural T-Booster

Taking bovine testicle supplements is a proven way to boost your testosterone naturally.

Bovine testicle is both high in testosterone and high in bioavailability, and typically doesn’t cause side effects, making it the ultimate natural alternative to using synthetic hormones.

When you add these to the fact that you don’t even need a prescription, using Mofo or one of the various other high-quality brands of testicle supplements may be the best option for a lot of guys.

How To Use Mofo or Dr. Ron’s Testicle Supplement

If you choose Mofo by Ancestral Supplements (available on Amazon), the recommended dosage is 6 capsules daily. This is just a recommendation, and some people may benefit from taking less or more.

Another high-quality supplement is Dr. Ron’s Testicle supplement, which contains freeze-dried testicle from New Zealand grass-fed bulls in little capsules.

Often times men on opioids can benefit from using 2-4 capsules or more of this product per day.

Both of these supplements can be taken with or without food.

And hey…

If you think a bull testicle supplement is bizarre…

Just wait until I write about supplementing with things like deer placenta, goat placenta, pearl powder, seahorse, and other products that are not well-known in the U.S. but revered in China.

KEY CONCEPTS:

• Men on opioids should have their testosterone levels checked as prolonged opioid use can destroy healthy T-levels
• If levels come up low and in the qualifying range, they may consider testosterone replacement therapy as an option
• Testosterone is a Schedule III drug and has a moderate-to-low potential for both physiological and psychological dependence
• If they don’t qualify or don’t want to utilize TRT, taking a daily bovine testicle supplement is a natural and safer option (with zero or at least fewer side effects) they might consider
• Regular exercise, good sleep habits, and a healthy diet should be stacked with the use of supplements for optimal results (same for medications!)
• Always consult with your healthcare provider before tying any new supplements as there could be interactions and contraindications with other things you’re taking

-Matt

P.S. Please share this article with anyone you believe would enjoy learning about this topic. Thanks for reading.