Emergency Department Visits for Adverse Reactions Involving the Pain Medication Tramadol

Excerpt

Background: Approximately 100 million adults in the United States experience pain that can affect performance of daily tasks, quality of life, and productivity in the workplace. Tramadol is an opioid medication for the management of moderate to moderately severe pain in adults. Prescriptions for this drug increased 88% from 23.3 million in 2008 to 43.8 million in 2013. Methods: Data from the 2005 to 2011 Drug Abuse Warning Network (DAWN) were used to estimate the number of emergency department (ED) visits made for adverse reactions involving tramadol. We examined 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 transfer to another health care facility. Results: Data from 2011 DAWN shows an estimated 54,397 ED visits involving tramadol, 27,421 (50%) of which were attributed to adverse reactions. From 2005 to 2009, the number of estimated ED visits made for adverse reactions involving tramadol increased 145% (10,091 to 25,884 visits), and remained stable in 2010 and 2011 (25,887 and 27,421 visits, respectively). Females accounted for 75% of tramadol-related ED visits (7,604) involving adverse reactions in 2005 and continued to account for the majority of visits through 2011 (19,329). In 2011, although visits made by patients aged 65 or older accounted for 35% of tramadol-related ED visits involving adverse reactions (9,688), they accounted for 52% of the visits that resulted in admissions to the hospital or transferred to another health care facility. Conclusion: When tramadol is combined with other drugs that depress the central nervous system, such as anti-anxiety medications (e.g. benzodiazepines), narcotic pain relievers, or alcohol, the sedative effects of tramadol can be enhanced. This may be especially crucial for older adults, especially females, for whom acute or chronic pain is a common complaint and who often take other prescription medications that may interact with tramadol.