ArticleBritish journal of clinical pharmacology2022
Increase of high-risk tramadol use and harmful consequences in France from 2013 to 2018: Evidence from the triangulation of addictovigilance data.
Article in British journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Psychoactive prescription drug use and misuse in patients on opioid agonist treatment.British journal of clinical pharmacology · 2026Article
- Contribution of Addictovigilance data to assess adverse-events linked to psychoactive substances in children and adolescents.British journal of clinical pharmacology · 2025Article
- Ten-year analgesic utilization patterns and economic implications in Portugal.British journal of clinical pharmacology · 2025Article
- Abuse and misuse of tramadol in patients with non-oncologic pain in a region of Southern Europe.Journal of pharmaceutical policy and practice · 2025Article
- Prevalence and patterns of substance use in West Africa: A systematic review and meta-analysis.PLOS global public health · 2024Article
- Trends in Fatal Poisoning Among Drug Users in France From 2011 to 2021: An Analysis of the DRAMES Register.JAMA network open · 2023Article
- Increase of high-risk tramadol use and harmful consequences in France from 2013 to 2018: Evidence from the triangulation of addictovigilance data.British journal of clinical pharmacology · 2022Article
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10 authors.
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Abstract
aimsThe aim of this paper is to assess recent developments in non-medical tramadol use, tramadol use disorder, illegal procurement and deaths.
methodsThis study used repeated cross-sectional analysis of data collected nationwide from 2013 to 2018. Analysis was conducted through multisource monitoring of the French Addictovigilance Network of: (1) validated reports of high-risk tramadol use, (2) record systems collecting information from toxicology experts investigating analgesic-related deaths (DTA) and deaths related to substance abuse (DRAMES), and pharmacists for forged prescriptions (OSIAP), and (3) survey of drug users, with investigation of patterns of use while visiting addiction-specialised institutions (OPPIDUM).
resultsDespite a plateauing level of tramadol exposure in the French population, the proportion of tramadol reports increased 1.7-fold (187 cases in 2018, 3.2% (95% confidence interval [CI]: 2.74-3.63%), versus 1.9% (95% CI: 1.49-2.42% in 2013). Trends were similar in OSIAP: 11.9% of forged prescriptions in 2018 (95% CI: 10.56-13.45%); 1.7-fold increase; in OPPIDUM: 0.76% (95% CI: 0.55-1.02); 2.2-fold increase; and DRAMES: 3.2% of drug abuse-related deaths in 2018 (95% CI: 1.89-5.16) versus 1.7% in 2013 (95% CI: 0.65-3.84). Tramadol was the primary opioid in analgesic-related deaths in DTA (45% in 2018). Two profiles of high-risk tramadol users were identified: (1) patients treated for pain or with tramadol persistence when pain disappeared (mainly women; mean age 44 years), and (2) individuals with non-medical use for psychoactive effects (mainly men; mean age 36 years).
conclusionThe triangulation of the data obtained through addictovigilance monitoring evidenced a recent increase in high-risk tramadol use. These findings have a practical impact on the limitation of the maximal duration of tramadol prescriptions.
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