Patients receiving tramadol after surgery have a higher risk of prolonged use of the drug, according to a study published Wednesday in BMJ, formerly known as the British Medical Journal.
Tramadol is classified by the US Drug Enforcement Administration as a controlled substance in Schedule IV, while opioids such as oxycodone and hydrocodone are listed as Schedule II drugs due to the potential for abuse.
Researchers from the Mayo Clinic in Rochester, Minnesota, who conducted the study, used data from OptumLabs Data Warehouse to investigate records of nearly half a million patients who had undergone 20 common operations in the United States from January 1, 2009 to June 30, 201
] The team found that in the approximately 350,000 patients who filled the opioid prescription after surgery, 7% had at least one replenishment 90 to 180 days after surgery, 1% replenished the prescription 180 to 270 days after surgery, categorized them as sustained users and 0.5 % had 10 or more prescription fillings or 120 days added, classifying them as long-term users. Patients in all three categories were likely to receive a prescription for tramadol.
"We found that people who received tramadol were as likely as those who received hydrocodone or oxycodone to continue using opioids beyond the point where the surgery would be expected to be resolved," says senior author Molly Jeffery, scientific research director of the Mayo Clinic Division of Emergency Medicine "This does not link to the idea that tramadol is less common than other opioids." The researchers also found that the use of tramadol has increased during the study period and at 4% it was the third most prescribed opioid in this study. was prescribed most at 51% followed by oxycodone at 38%.
Given the results and the fact that tramadol is not as highly regulated as many other opioids, the researchers said further dialogue on the drug's treatment of DEA is needed.