The Hidden Danger of Amphetamine-Type Stimulants (ATS) and Opioids on Male Reproduction Toxicity: A Narrative Review

New psychoactive substances (NPS) pose a global public health challenge. Its ongoing evolution intensifies drug abuse cases, complicates regulation, and makes comprehensive studies difficult to conduct. Emerging studies indicate that these substances may severely impact spermatogenesis, reproductive hormones and male fertility. This review aims to consolidate existing knowledge on the impact of NPS on male reproduction, identify gaps in the literature, and suggest directions for future research. This comprehensive review examines original, peer-reviewed studies and clinical reports from PubMed, Semantic Scholar, AJOL, and Google Scholar. Data collection spanned from 2014 to 2024, using keywords such as “amphetamine-type stimulants”, “ATS”, “amphetamine”, “stimulants”, “opioids”, “opioid abuse”, “opioid addiction”, “male reproduction”, “male fertility”, and “reproductive toxicity”. The search encompasses illegal drugs, prescription medications, and over-the-counter (OTC) drugs that induce male reproduction toxicity through chronic use or prolonged exposure. Although current studies have limitations, our findings indicate that both illicit and medicinal ATS and opioids negatively impact male reproduction. These substances can diminish sperm quality, disrupt reproductive hormones, and cause sperm DNA damage. This review highlights further study in formulating public health strategies and supplements that mitigate DNA damage caused by these substances.