Tox Tuesday: Tramadol

Drugs2_blogA painkiller that has become more popular in recent years also is facing increasing restrictions.

Tramadol is used to alleviate moderate to severe pain. It is an opiate agonist, which works by altering the way the body senses pain, according to Medline Plus. It is similar to the painkiller codeine, and is used to treat fibromyalgia, cancer pain and musculoskeletal pain. Like many other prescription drugs, tramadol can be habit forming and relatively easy to obtain.

Officials in the United Kingdom are considering banning the drug following the finding of the Advisory Council on the Misuse of Drugs (ACMD) earlier this year, which recommended the drug be defined as a class C substance and listed in schedule III of the Misuse of Drugs Regulations 2001. The ACMD report outlines an increase in the prescribing of tramadol, from 5.9 million in September of 2005 to 11.1 million by September 2012. Likewise, deaths related to tramadol use also have risen, from 83 in 2008 to 154 in 2011. In 2012, deaths rose to 175, The Guardian reports.

“The majority of tramadol-related deaths are where it has been obtained through non-prescribed means,” the ACMD’s February 2013 advice on tramadol reads.

It currently is controlled to varying degrees in Australia, Sweden, Norway, Ireland and Germany as well as in some U.S. states, including Arkansas, Kentucky and New York.

Tramadol can cause a myriad of side effects including nausea, vomiting, hallucinations, agitation, fever, loss of coordination, fainting, dizziness and elevated heart rate. Seizures can occur in up to 15 percent of overdose cases and are more common than with other opiod use, ACMD notes. Tramadol also impedes serotonin reuptake in the brain, which can lead to serotonin syndrome, a potentially fatal illness characterized by high body temperature, a breakdown of skeletal muscles and blood clots.

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