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Study: Tramadol carries higher risk for prolonged use than other opioids

By Tauren Dyson

May 14 (UPI) -- Patients given a so-called "safer" opioid have a higher chance of prolonged use, even though the drug has a low risk of addiction, a new study says.

About 7 percent of patients had at least one opioid prescription refilled between 90 and 180 days after surgery, according to research published Tuesday in BMJ. And those patients were likely to have been prescribed tramadol.

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"This data will force us to reevaluate our post-surgical prescribing guidelines," Cornelius Thiels, a researcher at the Mayo Clinic and study lead author, said in a news release. "And while tramadol may still be an acceptable option for some patients, our data suggests we should be cautious with tramadol as we are with other short-acting opioids."

An additional 1 percent of patients had their prescriptions refilled within 180 and 270 days, the study says. Further findings showed that 0.5 percent had 120 days or more supply, which consists of 10 or more refills.

"We found that people who got tramadol were just as likely as people who got hydrocodone or oxycodone to continue using opioids past the point where their surgery pain would have been expected to be resolved," said Molly Jeffery, scientific director at Mayo Clinic Division of Emergency Medicine and study author. "This doesn't tie to the idea that tramadol is less habit-forming than other opioids."

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The researchers analyzed insurance records for more than 350,000 patients throughout the United States between 2009 and 2018 who had opioid prescriptions filled.

Tramadol is considered a schedule II drug, the highest classified drug with an accepted medical use. It entered the market in 1994 and wasn't considered a controlled drug until 2014.

Still, the researchers think it's time for the Drug Enforcement Agency to start closely monitoring the use of tramadol to prevent its overuse.

"Given that tramadol is not as tightly regulated as other short-acting opioids, these findings warrant attention," Thiels said.

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