Jorgensen compares claims that tramadol is low risk to those made by American companies now facing thousands of lawsuits alleging misleading campaigns touting the safety of opioids unleashed the U.
Stefano Berterame, a chief at the International Narcotics Control Board, said there is a critical difference: The crisis is not as deadly as the American one, which began with prescription opioids and transitioned to heroin and fentanyl. Tramadol does not as routinely cause the respiratory depression that leads to overdose death. But it is mostly afflicting poor nations, where overdose statistics are erratic, he said, so the true toll of tramadol is unknown.
It has since tracked most opioids. Its easy availability also leads to confusion about what tramadol even is, experts say. In many countries, it is thought to be a mood enhancer or treatment for depression and post-traumatic stress.
Some take it to improve sexual stamina or endure grueling labor. Grunenthal synthesized tramadol in the s, as the company was embroiled in scandal over its marketing of the sedative thalidomide, which caused extreme birth defects in thousands of babies whose mothers took it. Tramadol was initially believed to have a low risk of abuse because initial trials studied injected tramadol, the most potent route for most opioids.
But researchers later found that tramadol releases a far more powerful dose taken orally because of how it is metabolized by the liver. In , the WHO, which assesses medications and recommends scheduling, noted reports of dependence.
A committee has reviewed the drug numerous times since, recommended it remain under surveillance but declined to add international regulation. It is used extensively not because it is a particularly good medication, he said.
The most effective opioid is morphine, but morphine is strictly controlled and countries in crisis fear abuse. The WHO is analyzing whether any other drug could take its place but have so far found none.
Meanwhile, Forte said, the agency is working with battered nations to ferret out counterfeits. The medication long ago lost its patent protection. It is now manufactured by many companies and sold under some brand names. Grunenthal markets it as Tramal as well as Zaldiar, tramadol combined with paracetamol.
Grunenthal also sells other opioids and is expanding around the world. The Associated Press this year revealed executives were swept up in an Italian corruption case alleging they illegally paid a doctor to promote the use of opioids.
The company has campaigned to keep tramadol unregulated. Spokesman Stepan Kracala said regulation would not necessarily curtail illicit trade and could backfire: Some desperate pain patients turn to the black market if no legal options exist.
The country enacted strict regulation in and a later survey found some suffering from cancer using counterfeit tramadol for relief. The Mayo Clinic hospital in Minnesota worked to reduce opioids prescribed post-surgery as the American epidemic escalated, said surgeon Cornelius Thiels. Doctors there started shifting patients to tramadol because it was billed as safer. But Thiels and his colleagues analyzed prescription data and were surprised to find patients prescribed tramadol were just as likely to move on to long-term use.
At one stage, this led scientists to believe that it occurred naturally in the pincushion tree — although it has subsequently been shown that plants are incapable of producing it. Egypt has a particular problem with tramadol. It is a prescription drug in the UK and a Schedule IV controlled substance in the US, but in Egypt, any opioid, including tramadol and codeine, is a controlled substance.
Consequently, bringing it into the country without prior permission, especially in large quantities Laura Plummer had tablets , will land you in trouble. The Egyptian authorities have come down hard on people in possession of significant amounts of tramadol, and the courts dish out stiff punishments — possibly even the death penalty. Nevertheless, tramadol is popular in Egypt and is misused widely.
Indeed, besides it being a recreational drug, many people — especially from the poor working class — take tramadol to give them more energy, to work for longer or to hold down two jobs. It has been a particularly serious problem in places such as Gaza , where addiction has led to an illegal trade in tramadol, often smuggled in through underground tunnels. This has led the government to take a particularly hard line on it. So if you are going to take drugs abroad, even your own medications, you should check carefully how they are viewed at your destination.
A legal drug in one country could lead to a very long prison sentence — or even worse — in another. Michael Hooten, M. This research was funded by the Mayo Clinic Robert D. Center research focuses on transforming clinical practice. Researchers seek to discover new ways to improve health; translate those discoveries into evidence-based, actionable treatments, processes and procedures; and apply this new knowledge to improve patient care.
Materials provided by Mayo Clinic. Note: Content may be edited for style and length. Science News. The team found that , filled a prescription for opioids after surgery. Story Source: Materials provided by Mayo Clinic. ScienceDaily, 14 May Mayo Clinic. Historically 'safer' tramadol more likely than other opioids to result in prolonged use.
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