Shahid Beheshti University of Medical Sciences, Department of Epidemiology, Tehran, Iran; Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Addict Behav. 2014 Jan;39(1):333-7. doi: 10.1016/j.addbeh.2013.09.013. Epub 2013 Sep 14.
Tramadol hydrochloride is a common prescription pain reliever that is structurally similar to morphine and codeine with its analgesic effects identified as a mu-receptor agonist. Due to its opioid-like stimulant effects, the potential for tramadol misuse is a public health concern. As such, the aim of this investigation is to estimate the prevalence of tramadol misuse in a sample of Iranian adolescents and to assess the relationship between tramadol misuse and other substance use.
This is the first phase of a prospective survey examining the prevalence of adolescent smoking status, substances use and related factors in Ilam city, Iran. Grade 10 male and female students (n=2000) were recruited using multistage sampling. Self-administered multiple-choice questionnaires were conducted with data analysed using cross tabulations and logistic regression models.
The prevalence of lifetime tramadol misuse was 4.8% (7.6% males; 1.8% females). Adjusted odds ratios and confidence intervals for lifetime tramadol misusers reporting substance use during the past month were 2.2 (1.1-4.4) for alcohol, 5.0 (1.5-21.9) for cannabis, 8.9 (2.7-29.4) for ecstasy, 0.5 (0.03-7.0) for methamphetamine and 2.3 (0.7-7.4) for opium.
Tramadol could be a related factor or co-factor for adolescent alcohol, cannabis and ecstasy use. We recommend future longitudinal studies to investigate the possible role of tramadol as a gateway drug in the development of substance abuse.
盐酸曲马多是一种常见的处方止痛药，其结构与吗啡和可待因相似，其镇痛作用被确定为μ-受体激动剂。由于其类似阿片类兴奋剂的刺激作用，曲马多滥用的潜在风险是一个公共卫生问题。因此，本研究旨在估计伊朗青少年中曲马多滥用的流行率，并评估曲马多滥用与其他物质使用之间的关系。
这是一项前瞻性调查的第一阶段，该调查旨在检查伊朗伊拉姆市青少年吸烟状况、物质使用及相关因素的流行率。采用多阶段抽样法招募了 10 年级的男女生（n=2000）。采用自填式多项选择题问卷调查，采用交叉表和逻辑回归模型进行数据分析。
终生曲马多滥用的流行率为 4.8%（男性为 7.6%；女性为 1.8%）。报告过去一个月内物质使用的终生曲马多滥用者的调整后比值比和置信区间分别为：酒精 2.2（1.1-4.4）；大麻 5.0（1.5-21.9）；摇头丸 8.9（2.7-29.4）；冰毒 0.5（0.03-7.0）；鸦片 2.3（0.7-7.4）。
曲马多可能是青少年酒精、大麻和摇头丸使用的相关因素或共同因素。我们建议未来进行纵向研究，以调查曲马多作为滥用物质的门户药物的可能作用。
