Sarkar Siddharth, Varshney Mohit, Patil Vaibhav, Lal Rakesh
Department of Psychiatry, National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India.
J Neurosci Rural Pract. 2017 Aug;8(Suppl 1):S98-S101. doi: 10.4103/jnrp.jnrp_422_16.
Although tramadol has been used in the management of acute withdrawal in patients with opioid dependence, its use for maintenance treatment as a harm reduction approach has not been assessed systematically. This case series describes patients with opioid dependence who were treated with tramadol for long-term maintenance.
Patients with opioid dependence who received treatment at the National Drug Dependence Treatment Centre of All India Institute of Medical Sciences, New Delhi, were included in the study. Patients who received at least 6 months of tramadol and had follow-up adherence of more than 80% were included in the case series.
A total of 25 cases were included, all of whom were males. The types of opioids being taken at the time of initiation of tramadol were natural opiates (poppy husk and raw opium), followed by heroin. The median dose of tramadol at initiation and maintenance was 300 mg/day. Nineteen patients were able to achieve complete abstinence to other opiates on tramadol.
Tramadol may be an effective option in the long-term management of patients with opioid dependence. Further studies are required for establishing the efficacy of tramadol for agonist management of patients with opioid dependence.
尽管曲马多已被用于阿片类药物依赖患者的急性脱毒治疗，但其作为一种减少伤害方法用于维持治疗尚未得到系统评估。本病例系列描述了接受曲马多长期维持治疗的阿片类药物依赖患者。
纳入在新德里全印度医学科学研究所国家药物依赖治疗中心接受治疗的阿片类药物依赖患者。接受至少6个月曲马多治疗且随访依从性超过80%的患者纳入该病例系列。
共纳入25例病例，均为男性。开始使用曲马多时所服用的阿片类药物类型为天然阿片（罂粟壳和生鸦片），其次是海洛因。开始和维持治疗时曲马多的中位剂量为300毫克/天。19例患者在使用曲马多时能够完全戒除其他阿片类药物。
曲马多可能是阿片类药物依赖患者长期管理的有效选择。需要进一步研究以确定曲马多对阿片类药物依赖患者激动剂管理的疗效。
