Therapeutic experience with tramadol for opioid dependence: A prospective observational study from India.

Introduction: Opioid use disorder (OUD) is a chronic relapsing disorder with significant mortality, morbidity, and public health challenges. In India, tramadol is frequently used for the treatment and management of OUDs.

Methodology: A prospective observational study was performed to evaluate 3-month outcomes in outpatients with OUD on treatment with tramadol at a tertiary care addiction treatment facility in North India. One hundred and sixty newly registered patients fulfilling the inclusion and exclusion criteria were recruited and assessed on Maudsley Addiction Profile to evaluate changes in days and the amount of substance use and associated complications at 1-, 2-, and 3-month follow-up.

Results: This study also showed a treatment retention rate of 14 percent with an abstinence rate of 34 percent at the end of the third month. The mean number of days of illicit opioid use in retained population decreased from 29.3 (±3.5) days from baseline to 12.5 (±10.9) days at 1 month, 5.0 (±7.2) days at 2 months, and 4.3 (±6.8) days at 3 months. Repeated measures analyses showed significant change in the days of illicit opioid use on treatment with tramadol over 3 months (p = 0.01).

Conclusion: This study leads the way in showing tramadol as an important medication for use in OUDs to provide for maintenance therapy for longer durations. This has major implications in low- and middle-income countries, especially in Asia and Africa, where tramadol is more easily available.