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“DEA-classified ‘safe’ pain med might be riskier than you think”

“We found that people who got tramadol were just as likely as people who got hydrocodone or oxycodone to continue using opioids past the point where their surgery pain would have been expected to be resolved,” said senior author Molly Jeffery, PhD, scientific director, Division of Emergency Medicine Research, Mayo Clinic, Rochester, MN. “This doesn’t tie to the idea that tramadol is less habit forming than other opioids.”

Greater risk with tramadol

For this observational study, the researchers reviewed administrative claims data from patients nationwide who underwent 20 common surgeries between January 2009 and June 2018, and found that 357,884 had filled a prescription for opioids after surgery.

Of these patients:

  • 7% had at least one opioid refill 90-180 days after surgery (which the researchers defined as “additional use”)
  • 1% refilled their prescription 180-270 days after surgery (defined as “persistent use”)
  • 0.5% had 10 or more prescription fills or ≥ 120 days’ supply (defined as “long-term use”)

In all three categories, patients were more likely to be prescribed tramadol than another short-acting opioid: 6% more likely for “additional use” patients, 47% more likely for “persistent use” patients, and 41% more likely for patients on “long-term use.”

The researchers wrote: “Our study suggests that tramadol carries a similar or somewhat greater risk of transitioning from acute to prolonged use compared with other short-acting opioids.”

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