A new study has found that tramadol, a less powerful opioid painkiller, carries the same risks of addiction as other opioids.
As doctors have become more aware about the addiction risks of powerful opioids like oxycodone or morphine they have turned to the less powerful opioid painkiller tramadol, which was perceived as safer, especially since is is classified as less dangerous by federal agencies.
However, a new study has found that tramadol carries the same risk of addiction as other opioids.
“What we know now is there really is no safe opioid, and tramadol is not a safe alternative,” lead study author Cornelius Thiels told the CBC. “Tramadol essentially has a similar risk of long-term dependence or long-term opioid use compared to other opioids.”
Thiels led a team of researchers from the Mayo Clinic. The team examine whether people who were prescribed tramadol were still filling opioids prescriptions more than 90 days after surgery. Long-term use of opioids is associated with a vastly increased risk of addiction.
The study, published in the British Medical Journal, concluded, “People receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.”
“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,” Molly Jeffery, one of the researchers, said.
Because it is seen as safer than other opioids, tramadol is scheduled differently, but study authors call for this to change.
“We found that tramadol, a drug that is scheduled at a lower risk level than other common short acting opioids (Schedule IV versus Schedule II for hydrocodone and oxycodone), has a similar or somewhat greater risk of prolonged opioid use after surgery,” they wrote. “Although all factors related to the safety of a drug must be considered, from the standpoint of opioid dependence, the Drug Enforcement Administration and FDA should consider rescheduling tramadol to a level that better reflects its risks of prolonged use.”
The study is important since use of tramadol has increased in recent years.
“Tramadol has seen a surge in use in the past few years, likely due to its perceived benefits, including what physicians may consider a favorable side effects profile and the widespread assumption that is safer and less addictive than other short acting opioids,” study authors wrote. “As a result, tramadol is now among the most commonly prescribed opioids in the US, and it is frequently used by surgeons for the treatment of postoperative acute pain.”