Increase of high-risk tramadol use and harmful consequences in France from 2013 to 2018: Evidence from the triangulation of addictovigilance data.
Br J Clin Pharmacol
; 88(8): 3789-3802, 2022 08.
Article
en En
| MEDLINE
| ID: mdl-35318713
ABSTRACT
AIMS:
The aim of this paper is to assess recent developments in non-medical tramadol use, tramadol use disorder, illegal procurement and deaths.METHODS:
This study used repeated cross-sectional analysis of data collected nationwide from 2013 to 2018. Analysis was conducted through multisource monitoring of the French Addictovigilance Network of (1) validated reports of high-risk tramadol use, (2) record systems collecting information from toxicology experts investigating analgesic-related deaths (DTA) and deaths related to substance abuse (DRAMES), and pharmacists for forged prescriptions (OSIAP), and (3) survey of drug users, with investigation of patterns of use while visiting addiction-specialised institutions (OPPIDUM).RESULTS:
Despite a plateauing level of tramadol exposure in the French population, the proportion of tramadol reports increased 1.7-fold (187 cases in 2018, 3.2% (95% confidence interval [CI] 2.74-3.63%), versus 1.9% (95% CI 1.49-2.42% in 2013). Trends were similar in OSIAP 11.9% of forged prescriptions in 2018 (95% CI 10.56-13.45%); 1.7-fold increase; in OPPIDUM 0.76% (95% CI 0.55-1.02); 2.2-fold increase; and DRAMES 3.2% of drug abuse-related deaths in 2018 (95% CI 1.89-5.16) versus 1.7% in 2013 (95% CI 0.65-3.84). Tramadol was the primary opioid in analgesic-related deaths in DTA (45% in 2018). Two profiles of high-risk tramadol users were identified (1) patients treated for pain or with tramadol persistence when pain disappeared (mainly women; mean age 44 years), and (2) individuals with non-medical use for psychoactive effects (mainly men; mean age 36 years).CONCLUSION:
The triangulation of the data obtained through addictovigilance monitoring evidenced a recent increase in high-risk tramadol use. These findings have a practical impact on the limitation of the maximal duration of tramadol prescriptions.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tramadol
/
Trastornos Relacionados con Sustancias
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
Br J Clin Pharmacol
Año:
2022
Tipo del documento:
Article
País de afiliación:
Francia