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Tramadol no less likely than other opioids to result in long-term use
Clinical Question
Are patients who are prescribed tramadol instead of another opioid less likely to continue long-term use?
Bottom line
Given its touted lower risk of abuse, tramadol (Ultram, Ivodol) is perceived as being less likely to result in long-term use. Not so. Patients who receive tramadol following surgery are as likely as patients who receive other short-acting opioids to have prolonged use. Additionally, even though the overall subset is small, patients who take tramadol are more likely to receive chronic opioid treatment 6 months after surgery. 2b
Reference
Study design: Cohort (retrospective)
Funding: Foundation
Setting: Population-based
Synopsis
This study drew on administrative prescribing data of 444,764 patients who were given a short-acting opioid following surgery, Of these patients, 357,884 filled a discharge prescription for an opioid, including hydrocodone (53%), oxycodone (37.5%), and tramadol (4%). The prescription data indicated that 7% of these patients had prolonged use (defined as receiving at least one more prescription in the 90 to 180 days after surgery), and 0.5% had long-term use (defined as receiving an opioid for at least 3 months after the first 180 days following surgery). Patients who were prescribed tramadol were at least as likely as patients given other opioids to have prolonged use and were more likely (0.7% vs 0.5%) to require long-term opioid use (risk ratio 1.41; 95% CI 1.08 - 1.75; P = .013).
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Tramadon't.
The tramadol marketing team deserves some sort of award. They've managed to take a cheap, not very safe, not very effective drug into an expensive drug that's perceived as being safe and effective.