Tramadol for maintenance in opioid dependence: A retrospective chart revie

Siddharth Sarkar, MD, DNB; Rakesh Lal, MD; Mohit Varshney, MD; Yatan Pal Singh Balhara, MD, DNB, MNAMS

doi:10.5055/jom.2017.0408

Authors

Siddharth Sarkar, MD, DNB
Rakesh Lal, MD
Mohit Varshney, MD
Yatan Pal Singh Balhara, MD, DNB, MNAMS

DOI:

https://doi.org/10.5055/jom.2017.0408

Keywords:

harm reduction, maintenance, opioid dependence, tramadol

Abstract

Background and aims: Tramadol is an opioid agonist which can be potentially used for maintenance treatment of patients with opioid use disorders. This chart review presents the characteristics of individuals with an ICD 10 diagnosis of opioid dependence who were maintained on tramadol for a period of at least 6 months.

Methods: Records of patients seeking treatment for opioid dependence from the outpatient clinic of the National Drug Dependence Treatment Centre, Ghaziabad, India were screened. One hundred consecutive patients who received tramadol for more than 6 months were included.

Results: The sample comprised exclusively of males and had a mean age of 40.9 years. The median dose of tramadol at initiation and continuation was 300 mg/ day. Sixty-two patients achieved complete abstinence during the course of treatment. Greater age, longer duration of opioid use, and better follow-up adherence were associated with abstinent status. The rates of abstinence were higher among those presenting with natural opioid use as compared to others (prescription opioid use or heroin use).

Conclusion: Tramadol can be an alternative medication for harm reduction in select group of patients with opioid dependence. Further research is required to strengthen the evidence base of rational use of tramadol for maintenance treatment of patients with opioid dependence.

Author Biographies

Siddharth Sarkar, MD, DNB

Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India

Rakesh Lal, MD

Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India

Mohit Varshney, MD

Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India

Yatan Pal Singh Balhara, MD, DNB, MNAMS

Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India

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