Abstract
Background Nonmedical prescription opioid use (NMPOU) is a growing problem and tramadol has been suggested as an emerging problem in young treatment-seeking individuals. The aim of the present study was to investigate, through hair analysis, NMPOU in this group and, specifically, tramadol use. Methods In a study including 73 treatment-seeking adolescents and young adults at an outpatient facility for young substance users, hair specimens could be obtained from 59 subjects. Data were extracted on sociodemographic background variables and psychiatric diagnoses through MINI interviews. Results In hair analysis, tramadol was by far the most prevalent opioid detected. Thirty-two percent screened positive for opioids, and of those, all but one were positive for tramadol. Ninety-eight percent reported problematic cannabis use. Significantly more opioid-positive patients also screened positive for other (noncannabis) drugs, compared to nonopioid users. Sixty-four percent fulfilled criteria of DSM-IV psychiatric disorders, other than substance use disorders according to MINI. Fifty-three percent met the symptom criteria count of ADHD above cut-off level. Conclusion In the present setting, tramadol, along with high rates of cannabis use, may represent a novel pattern of substance use among young treatment-seeking subjects with problematic substance use and high rates of concurrent psychiatric problems.
Highlights
Nonmedical prescription opioid use (NMPOU) is defined as the consumption of an opioid medication that is not prescribed to a user or is consumed in a manner not intended by the prescriber
Out of 59 correctly obtained baseline hair analyses, 19 (32%) specimens were positive for prescription opioids
To the best of our knowledge, this study provides the first example of a clinical application of hair analysis for drug detection in a population of adolescents and young adults
Summary
Nonmedical prescription opioid use (NMPOU) is defined as the consumption of an opioid medication that is not prescribed to a user or is consumed in a manner not intended by the prescriber (such as tampering, snorting, or injecting). The question of tramadol misuse has been addressed in the Middle East and Africa [13,14,15,16], as a problem drug among adolescents and young adults. In many settings, such as the one studied here, cannabis is still the most frequently used illicit drug among adolescents both in population-based surveys [17, 18] and in treatment-seeking samples [19], and tramadol, primarily a prescription drug, has been described to be associated with more traditional illicit drugs, including cannabis. Tramadol, along with high rates of cannabis use, may represent a novel pattern of substance use among young treatment-seeking subjects with problematic substance use and high rates of concurrent psychiatric problems
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