Dr. Bob's Psychopharmacology Tips

Potential of tramadol to cause addiction

Date: Wed, 27 Mar 1996 12:29:30 -0800 (PST)
From: "H. Westley Clark" <carter@itsa.ucsf.EDU>
Subject: Potential of tramadol to cause addiction

I just received in the mail the notice from Ortho-McNeil detailing the revised prescribing information about tramadol.

There have been 115 spontaneous domestic reports of drug abuse, dependence, withdrawal, or intentional overdose. McNeil is making it clear that patients with histories of addiction or dependence on opiods should not receive tramadol.

From: ClarkCA@aol.com
Date: Thu, 13 Feb 1997 17:34:40 -0500 (EST)
Subject: Potential of tramadol to cause addiction

Even though it is being touted as a non-addictive alternative to opiates for chronic pain, the PDR clearly states that the drug has the potential to cause physiological addiction, craving, drug seeking, and tolerance.

I have seen two patients who came in addicted to Ultram (tramadol) with classic withdrawal symptoms when they discontinued the drug. Both had a history of polysubstance dependence well known to their primary care doctors -- who told them Ultram was safe for their chronic pain from orthopedic injuries. They both had been clean and sober for years and now found themselves with addiction, craving, and drug seeking behaviors again.

I tried to refer one of them to an outpatient treatment program with a slow detox plan, but the insurance company would not authorize it, saying that the patient could not possibly be addicted to Ultram! It was a battle to get care for both of these patients. They feel duped by their doctors and the company who manufactures and advertises Ultram as non-addictive!

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