Greater risk of continued use of tramadol post-operatively than with other drugs?

Researchers in the USA have used claims data to assess the risk of persistent opioid use after hospital discharge for patients treated with tramadol alone compared with other short acting opioids. The research used three commonly used definitions of prolonged opioid use: additional opioid use (defined as at least one opioid fill 90-180 days after surgery); persistent opioid use (any span of opioid use starting in the 180 days after surgery and lasting ≥90 days); and the definition using the CONSORT criteria (an opioid use episode starting in the 180 days after surgery that spans ≥90 days and includes either ≥10 opioid fills or ≥120 days’ supply of opioids). This huge study assessed 444 764 patients who met the inclusion criteria, 357 884 filled a discharge prescription for one or more opioids after surgery. The most commonly drugs were hydrocodone (53.0%), short-acting oxycodone (37.5%) and tramadol (4.0%). The unadjusted risk of prolonged opioid use after surgery was 7.1% (n=31 431) with additional opioid use, 1.0% (n=4457) with persistent opioid use, and 0.5% (n=2027) meeting the CONSORT definition. Use of tramadol alone was associated with a 6% increase in the risk of additional opioid use relative to people receiving other short acting opioids. Given the widespread use of tramadol, the implications of usage patterns of the drug need to be taken on board in the light of these findings. Read more here