Emergency Department Visits for Drug Misuse or Abuse Involving the Pain Medication Tramadol

Excerpt

Background: Tramadol is an opioid pain reliever for the management of moderate to moderately severe pain in adults. Prescriptions for tramadol increased 88 percent from 23.3 million in 2008 to 43.8 million in 2013. In July 2014, the U.S. Drug Enforcement Agency (DEA) placed tramadol into Schedule IV of the Controlled Substance Act - a designation indicating that tramadol has some potential for abuse. Methods: Data from the 2005-2011 Drug Abuse Warning Network (DAWN) were used to estimate the number of emergency department (ED) visits that involved the misuse or abuse of tramadol. We examined the trends by age and gender, other drugs identified in these ED visits, and the number of visits that resulted in admission to the hospital or transferred to another health care facility. Results: Data from the DAWN shows that the number of visits made to emergency departments (EDs) that involved the misuse or abuse of tramadol increased about 250 percent between 2005 and 2011 (6,255 visits in 2005 to 21,649 in 2011). In 2011, about 70 percent of tramadol-related ED visits involving misuse or abuse involved tramadol combined with at least one other drug or alcohol, with nearly half (47 percent) of those visits involving other pharmaceuticals only. In 2011, the majority of tramadol-related ED visits involving misuse or abuse resulted in the patient being treated and released (60%). The remainder of patients were usually admitted to the hospital or transferred to another health care facility. Conclusion: Although tramadol offers important medical benefits when used appropriately, it can have serious health consequences when taken without medical supervision, in larger amounts than prescribed, or in combination with illicit drugs, alcohol, or other prescription or over-the-counter (OTC) medications. Physicians prescribing tramadol can warn against these dangers and advise patients to only take prescription medication prescribed for them and as directed, the dangers of sharing prescription medications, the importance of preventing others from having access to personal prescription medications, and methods for properly disposing of remaining dosage units once the need for medication has passed.