Clinical characteristics distinguishing tramadol-using adolescents from other substance-using adolescents in an out-patient treatment setting

A Holmstedt,M.O Olsson,A Håkansson

doi:10.1016/j.abrep.2020.100272

A Holmstedt, M.O Olsson + Show 1 more

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https://doi.org/10.1016/j.abrep.2020.100272

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Abstract

BackgroundNon-medical Prescription Opioid Use (NMPOU) has increased worldwide during the last decades, and specifically, tramadol misuse may represent a novel pattern of substance use among adolescents. The present study aims to analyze characteristics distinguishing tramadol-using adolescents from other substance-using adolescents seeking out-patient treatment. MethodsThis is a cross-sectional study of treatment-seeking patients between 13 and 24 years of age in an out-patient facility for substance use problems in Malmö, Sweden. A total of 526 treatment-seeking adolescents at an out-patient treatment center were included. Data on substance use, treatment history and socio-demographic variables were extracted through a semi-structured interview method aimed specifically for adolescents with alcohol or drug problems (Ung-DOK). Lifetime tramadol users were compared to non-users, and also, primary tramadol users were compared to remaining subjects. ResultsThirty-one percent (n = 162) were tramadol users (lifetime prevalence). In logistic regression, the tramadol group showed a significantly increased risk of tobacco use, problematic lifetime cocaine, benzodiazepine and amphetamine use, and were more likely to report contacts with the judicial system, and less likely to report contacts with child or adult psychiatry, and more likely to have parents born outside the Scandinavian countries. In logistic regression, primary tramadol use was negatively associated with frequent cannabis use. ConclusionsTramadol use appears to be a novel pattern among treatment-seeking adolescents. They showed a significantly increased risk of initiation of other illicit drugs and criminal behaviour, despite less contact with psychiatric care. More attention may be needed to this relatively novel pattern of opioid use.

Highlights

Non-medical Prescription Opioid Use (NMPOU) has increased worldwide during the last decades, and tramadol misuse may represent a novel pattern of substance use among adolescents
Lifetime tramadol use was significantly associated with age, occupation last three months, one or both parents born outside Scandinavia, ever being convicted, regular use of tobacco, a lifetime history of anxiety or distress, no ongoing contact with child or adult psychiatry, lifetime problematic use of cocaine, ecstasy, amphetamine, and benzodiazepines, as well as frequent cannabis use
Tramadol use remained significantly associated with having one or both parents born outside Scandinavia, ever being convicted, regular use of tobacco, absence of ongoing contact with child or adult psychiatry, and lifetime problematic use of cocaine, amphetamine, and benzodiazepines (Table 2)

Summary

Introduction

Non-medical Prescription Opioid Use (NMPOU) has increased worldwide during the last decades, and tramadol misuse may represent a novel pattern of substance use among adolescents. Conclusions: Tramadol use appears to be a novel pattern among treatment-seeking adolescents. They showed a significantly increased risk of initiation of other illicit drugs and criminal behaviour, despite less contact with psychiatric care. During the last decades adverse consequences from non-medical prescription opioid use (NMPOU) have increased dramatically, such as in the United States, causing widespread public health problems (Cheng & DeBeck, 2017; Manchikanti et al, 2012; Saha et al, 2016). In several European countries, non-heroin opioids represent the most common form of opioid use (Centre, 2018)

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