Basu Aniruddha, Mahadevan Jayant, Ithal Dhruva, Selvaraj Sowmya, Chand Prabhat Kumar, Murthy Pratima
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian J Pharmacol. 2018 Jan-Feb;50(1):44-46. doi: 10.4103/ijp.IJP_21_17.
Tapentadol is a centrally acting opioid analgesic which has partial opioid agonistic and norepinephrine reuptake inhibitor action similar to its nearest congener and tramadol though with a relatively higher μ-affinity. It has abuse potential, is a scheduled drug, yet currently is not known to be an opioid widely misused in India. However, under the current drug abuse legislation in India, where common prescription opioids such as dextropropoxyphene have been banned, tapentadol may take the center stage of pharmaceutical opioid abuse in the near future. We present a series of two cases where the opioid use started with codeine, dextropropoxyphene, and buprenorphine but moved on to tapentadol and tramadol due to ease of access and cost. These cases highlight the potential of tapentadol in replacing dextropropoxyphene as the widespread prescription opioid of abuse and also emphasize the current controversies regarding opioid control policies in India.
曲马多是一种中枢性阿片类镇痛药，具有部分阿片激动作用和去甲肾上腺素再摄取抑制作用，与其最接近的同类药物曲马多类似，但具有相对较高的μ亲和力。它具有滥用潜力，是一种管制药物，但目前在印度尚不知其为广泛滥用的阿片类药物。然而，根据印度现行的药物滥用立法，右旋丙氧芬等常见的处方阿片类药物已被禁止，曲马多可能在不久的将来成为药物性阿片类药物滥用的焦点。我们报告了一系列两例病例，阿片类药物的使用始于可待因、右旋丙氧芬和丁丙诺啡，但由于易于获取和成本较低，后来转向了曲马多和曲马朵。这些病例凸显了曲马多取代右旋丙氧芬成为广泛滥用的处方阿片类药物的可能性，也强调了印度目前关于阿片类药物控制政策的争议。
