Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu , Oulu, Finland.
Department of Psychiatry, Oulu University Hospital , Oulu, Finland.
J Psychoactive Drugs. 2020 Apr-Jun;52(2):162-168. doi: 10.1080/02791072.2019.1671638. Epub 2019 Sep 24.
We investigated the association between tramadol use, co-morbid substance use disorders and hepatitis in former adolescent psychiatric inpatients. The study sample consisted of 508 adolescents, admitted to psychiatric inpatient care between 13 and 17 years of age. Follow-up information of tramadol prescriptions, substance use disorders and hepatitis were obtained from the Finnish national health care registers. The users of prescription tramadol were categorized as follows: single users (one tramadol purchase), mild users (2-5 purchases) and heavy users (≥6 purchases). About one tenth (11.0%, n = 56) of study participants were tramadol users. Heavy users of tramadol had mothers with psychiatric problems ( = .039), and a diagnosis of substance use disorder ( < .001) in adolescence. Heavy use of tramadol was predicted with adolescent substance use disorder (OR = 8.31, 95%Cl 2.10-32.91, = .003) and with mother´s psychiatric problems (OR = 5.85, = .003). Hepatitis C (n = 54, 10.6%) associated with mild and heavy tramadol use ( < .001). Comorbid diagnosis of opioid dependence prevailed among heavy tramadol users (.001). Tramadol should only be prescribed to adolescents after careful evaluation. Particular caution is required in adolescents with a history of substance use disorders.
我们调查了曲马多使用、合并物质使用障碍与前青少年精神科住院患者肝炎之间的关系。研究样本包括 508 名青少年，他们在 13 至 17 岁之间被收治到精神科住院治疗。处方曲马多、物质使用障碍和肝炎的随访信息从芬兰国家卫生保健登记处获得。处方曲马多的使用者分为以下几类：单一使用者（一次曲马多购买）、轻度使用者（2-5 次购买）和重度使用者（≥6 次购买）。大约十分之一（11.0%，n=56）的研究参与者为曲马多使用者。曲马多重度使用者的母亲有精神问题（=0.039），并且在青少年时期被诊断出物质使用障碍（<0.001）。青少年物质使用障碍（OR=8.31，95%Cl 2.10-32.91，=0.003）和母亲的精神问题（OR=5.85，=0.003）可预测曲马多的重度使用。丙型肝炎（n=54，10.6%）与轻度和重度曲马多使用相关（<0.001）。曲马多重度使用者中合并诊断出阿片类药物依赖症的情况居多（=0.001）。曲马多只能在仔细评估后开给青少年使用。对于有物质使用障碍史的青少年，尤其需要谨慎。
