{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:46:29Z","timestamp":1789497989574,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Chronic opioid use suppresses hypothalamic\u2013pituitary signalling, leading to hypogonadism and adrenal insufficiency. Whether these abnormalities persist following long\u2010term opioid cessation remains unclear. In particular, data on the female gonadal axis are limited, while other endocrine outcomes are predominantly reported in male cohorts. This study examined endocrine function in a long\u2010term prospective cohort of people with opioid use disorder, comparing those in sustained remission with those continuing opioid use, exploring associations with opioid exposure, sex and depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study using data from the Australian Treatment Outcome Study 18\u201320 year follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Measurements<\/jats:title>\n                    <jats:p>Participants underwent a structured interview and fasting endocrine assessment, including gonadal, adrenal, thyroid, and prolactin measurements. Endocrinopathies were defined using prespecified biochemical and clinical criteria. Prevalence was compared between opioid\u2010free and opioid\u2010using participants. Associations with opioid exposure, sex and depression were examined using Firth logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 123 participants with complete endocrine data, 71 (57.7%) had at least one endocrinopathy. Thirty\u2010five participants (28.4%) were opioid\u2010free. Hypogonadism was markedly less common in opioid\u2010free participants (3.3% vs. 26.7%), and no opioid\u2010free participant had hypocortisolism, compared with 14.8% of those with continuing opioid use. Methadone dose, male sex, and depression were independently associated with hypogonadism. Men prescribed methadone had significantly lower testosterone and luteinising hormone levels. No participant with hypogonadism or hypocortisolism had been previously diagnosed or treated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Opioid\u2010induced 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\u2010associated endocrinopathies and the need for routine screening in opioid agonist treatment settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.70109","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:14:30Z","timestamp":1772957670000},"page":"637-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Endocrinopathies and Their Recovery in a 20\u2010Year Cohort Study of People With Heroin Dependence"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-3342","authenticated-orcid":false,"given":"Chris","family":"Tremonti","sequence":"first","affiliation":[{"name":"St Vincent's Hospital, Sydney, NSW, 2011 Darlinghurst Australia"},{"name":"Sydney Medical School (Central) Faculty of Medicine and Health, University of Sydney NSW 2006 Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Twigg","sequence":"additional","affiliation":[{"name":"Sydney Medical School (Central) Faculty of Medicine and Health, University of Sydney NSW 2006 Sydney Australia"},{"name":"Department of Endocrinology Royal Prince Alfred Hospital Camperdown Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine L.","family":"Mills","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006 Camperdown Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Marel","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006 Camperdown Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maree","family":"Teesson","sequence":"additional","affiliation":[{"name":"The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, NSW 2006 Camperdown Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Haber","sequence":"additional","affiliation":[{"name":"Sydney Medical School (Central) Faculty of Medicine and Health, University of Sydney NSW 2006 Sydney Australia"},{"name":"Drug Health Services, Royal Prince Alfred Hospital, Camperdown NSW 2050 Camperdown Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,24]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30254-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa417"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0270"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz022"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.107823"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.07.015"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.04.010"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgaa499"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(19)30254-2"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2015.01.038"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469-022-01006-6"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0820"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2007.09.025"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.08.005"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001317"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1992.tb02719.x"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-015-0463-4"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.84.10.6079"},{"issue":"5","key":"e_1_2_11_20_1","first-page":"527","article-title":"Evaluation and Management of Orthostatic Hypotension","volume":"84","author":"Lanier J. 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