Abstract
The increase in the prescription of opioid medications has resulted in a wildfire of misuse of opioids, both for medical and non-medical reasons, with over 1.7 million people in the United States (US) suffering from distinct disorders owing to opioid use. While various medications, such as methadone, buprenorphine, and naloxone, among others, have been used in treating opioid withdrawal symptoms, concerns of the potential abuse of these drugs, the cost of procurement, legislations, and prescription policies have risen. In recent times, tramadol has been considered a viable replacement for some of these treatment regimes. Tramadol is a synthetic analgesic that acts centrally, possessing opioid-like effects due to the binding of its metabolite with the mu (µ)-opioid receptor, yet with low potential for abuse. Several clinical studies conducted in the past ten years have identified the effects of tramadol in opioid withdrawal cases. The results showed that it exhibits better efficacy and tolerance with fewer side effects in specific clinical scenarios as compared to existing available detox management. We aim to examine the properties of tramadol in opioid withdrawal through this systematic review of clinical studies on humans.
Highlights
BackgroundThe use of opioids dates back to more than 5000 years, occurring as natural extracts of the poppy plant, 'Papaver somniferum,' and it can be synthesized [1,2]
The researchers noted that these findings suggest tramadol as a useful treatment option for low-level opioid dependence or mild to moderate opioid withdrawal and along the lines with the findings of Lanier and Threlkeld [35,38]
Comparison study conducted by Chawla et al to assess the efficacy between buprenorphine and tramadol in the detoxification of opioid dependent subjects, involving 62 subjects aged 20-45 years, showed that mean scores on subjective opioid withdrawal scale (SOWS), objective opiate withdrawal scale (OOWS) and visual analog scale (VAS) list, were significantly lower for the buprenorphine group on the second and third day than for the tramadol group
Summary
The use of opioids dates back to more than 5000 years, occurring as natural extracts of the poppy plant, 'Papaver somniferum,' and it can be synthesized [1,2]. The researchers noted that while the results provide a positive signal of clinical efficacy, there was no clarity as to whether the differences observed were substantial enough to be clinically effective They agreed that findings suggest that optimal repeated dosing of tramadol for the treatment of opioid withdrawal may be within the maximum analgesic range dose of ER 300 mg or less than 600 mg if above it required [40]. Comparison study conducted by Chawla et al to assess the efficacy between buprenorphine and tramadol in the detoxification of opioid (heroin) dependent subjects, involving 62 subjects aged 20-45 years, showed that mean scores on SOWS, objective opiate withdrawal scale (OOWS) and VAS list, were significantly lower for the buprenorphine group on the second and third day than for the tramadol group. Our findings of the systematic review of clinical studies are shown in Table 2 [33,34,35,37,39,40,41,42,43]
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