Sarkar Siddharth, Lal Rakesh, Varshney Mohit, Balhara Yatan Pal Singh
Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India.
J Opioid Manag. 2017 Sep/Oct;13(5):329-334. doi: 10.5055/jom.2017.0401.
Tramadol is an opioid agonist which can be potentially used for maintenance treatment of patients with opioid use disorders. This chart review presents the characteristics of individuals with an ICD 10 diagnosis of opioid dependence who were maintained on tramadol for a period of at least 6 months.
Records of patients seeking treatment for opioid dependence from the outpatient clinic of the National Drug Dependence Treatment Centre, Ghaziabad, India were screened. One hundred consecutive patients who received tramadol for more than 6 months were included.
The sample comprised exclusively of males and had a mean age of 40.9 years. The median dose of tramadol at initiation and continuation was 300 mg/day. Sixty-two patients achieved complete abstinence during the course of treatment. Greater age, longer duration of opioid use, and better follow-up adherence were associated with abstinent status. The rates of abstinence were higher among those presenting with natural opioid use as compared to others (prescription opioid use or heroin use).
Tramadol can be an alternative medication for harm reduction in select group of patients with opioid dependence. Further research is required to strengthen the evidence base of rational use of tramadol for maintenance treatment of patients with opioid dependence.
曲马多是一种阿片类激动剂，可潜在用于阿片类物质使用障碍患者的维持治疗。本图表回顾展示了国际疾病分类第10版诊断为阿片类物质依赖且接受曲马多维持治疗至少6个月的个体特征。
对印度加济阿巴德国家药物依赖治疗中心门诊寻求阿片类物质依赖治疗的患者记录进行筛查。纳入连续100例接受曲马多治疗超过6个月的患者。
样本仅包括男性，平均年龄为40.9岁。起始和持续使用曲马多的中位剂量为300毫克/天。62例患者在治疗过程中实现完全戒断。年龄较大、阿片类物质使用时间较长以及随访依从性较好与戒断状态相关。与其他情况（处方阿片类物质使用或海洛因使用）相比，自然阿片类物质使用者的戒断率更高。
曲马多可作为特定阿片类物质依赖患者减少伤害的替代药物。需要进一步研究以加强曲马多合理用于阿片类物质依赖患者维持治疗的证据基础。
