Iatrogenic tramadol addiction

Prabhat Chand, Naveen Jayaram, Pratima Murthy


Tramadol, either alone or in combination with paracetamol, is a commonly prescribed opioid analgesic in routine clinical practice. It has reportedly low abuse potential. There are, however, a few reports of tramadol misuse among health care professionals and persons with a family history of addiction. We describe the clinical profile of three women developing addiction to tramadol. In all these cases tramadol was initially prescribed for pain by the physician. Physicians should not only prescribe tramadol cautiously and for a limited time period but also be trained in identifying misuse (self‑use, over the counter procuring, using for mind altering
properties) and dependence (craving, withdrawal symptoms etc.).


Addiction, Opioid, Tramadol

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Gutstein HB, Akil H. Opioid analgesics. In: Brunton LL, Lazo JS,

Parker KL, editor. Goodman and Gilman’s the Pharmacological Basis

of Therapeutics. 11th ed. New York: McGraw‑Hill; 2006. p. 547‑590.

Stoehr JD, Essary AC, Ou C, Ashby R, Sucher M. The risk of tramadol

abuse and dependence: Findings in two patients. JAAPA 2009;22:31‑2,


Skipper GE, Fletcher C, Rocha‑Judd R, Brase D. Tramadol abuse and

dependence among physicians. JAMA 2004;292:1818‑9.

Wesson DR, Ling W. The clinical opiate withdrawal scale (COWS).

J Psychoactive Drugs 2003;35:253‑9.

McDiarmid T, Mackler L, Schneider DM. Clinical inquiries. What is

the addiction risk associated with tramadol? J Fam Pract 2005;54:72‑3.

Liu ZM, Zhou WH, Lian Z, Mu Y, Ren ZH, Cao JQ, et al. Drug

dependence and abuse potential of tramadol. Zhongguo Yao Li

XueBao 1999;20:52‑4.

Yates WR, Nguyen MH, Warnock JK. Tramadol dependence with no

history of substance abuse. Am J Psychiatry 2001;158:964.

Larance B, Ambekar A, Azim T, Murthy P, Panda S, Degenhardt L,

et al. The availability, diversion and injection of pharmaceutical

opioids in South Asia. Drug Alcohol Rev 2011;30:246‑54.

Chand PK, Murthy P. Megadose lorazepam dependence. Addiction


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