Tramadol Abuse and the Opioid Epidemic

TRAMADOL ABUSE AND THE OPIOID EPIDEMIC

Opioids are drugs that are used as painkillers and therefore prescribed by doctors. These drugs are classified as ‘prescription-only medicines’. However, misuse and abuse of opioids has become an increasing phenomenon in North America And Europe according to the World Health Organization¹. While opioid abuse is undoubtedly most prevalent in North America, other countries across the world are increasingly grappling with similar problems. Ghana is no exception. The country is currently battling a tramadol and codeine abuse problem.

What is Tramadol?

Tramadol is a synthetic opioid medicine for relief of moderate to severe pain. Frequent use of tramadol may make it habit-forming. Tramadol abuse, mostly among men, has been reported in the country. The drug is sometimes mixed with energy drinks or alcoholic beverages or taken on its own as a sexual enhancer. Other reasons for the reported abuse is to help workers stay awake. This has been cited in some professional drivers who embark on long distance trips. Tramadol is being used in unapproved doses, higher than recommended. Tramadol was however not designed for these purposes and its safety cannot be guaranteed. There have been some reported cases of deaths among young people in Ghana who have abused the tramadol.

What is Codeine?

Codeine is an opioid used to treat mild to moderate pain but is a common component of cough mixtures because of its ability to suppress coughs. Codeine-containing cough mixtures are highly abused in Ghana for their euphoria effects. They are usually taken alone or mixed with carbonated drinks.

The new trend of abuse however happens to be mixing both substances – tramadol and codeine-containing cough mixtures.

How did this happen?

Late in the 1990s, big pharmaceutical companies managed to convince the medical community that opioid pain relievers were not addicting and prescription rates of such drugs shot up significantly in North America. The subsequent diversion and abuse of these drugs brought to bear their addicting potential. This led to increasing death and substance use disorders relating to abuse of opioids.

So what is being done about it?

North America has come to terms with the increasing abuse of opioids and has dubbed it the ‘Opioid Crisis’. In response to that, the U.S. Department of Health and Human Services (HHS) is focusing its efforts on five major priority areas²:

1. Improving access to treatment and recovery services
2. Promoting use of overdose-reversing drugs
3. Strengthening our understanding of the epidemic through better public health surveillance
4. Providing support for cutting-edge research on pain and addiction
5. Advancing better practices for pain management

What is Ghana doing about it?

There have been widespread efforts by the Foods and Drugs Authority (FDA) and the Pharmaceutical Society of Ghana (PSGH) to sensitize the public about abuse of such drugs and potential consequences. The perception of good feeling produced by these drugs leads to abuse which can lead to long term effects³.

Potential side effects of abusing tramadol and Codeine-Containing Cough Mixtures include

1. Confusion
2. Loss of consciousness
3. Brain damage
4. Respiratory depression
5. Liver disease
6. Kidney disease
7. Increased suicidal tendencies
8. Death

The FDA is also restricting access to tramadol and Codeine-containing Cough Mixtures which is, in fact, a long overdue measure. The only outstanding issue will then be preventing the influx of unregistered opioids onto the market through back-channels or unmanned ports in the country. We will, as a country, also need to increase access to treatment and rehabilitation services for people already addicted to drugs of abuse.

 

Related sources:

PSGH calls for measures to check tramadol abuse (PSGH, September 2017)