Abstract
BackgroundThe misuse of tramadol has become a major aspect of the wider substance use challenge in recent years and is evolving into a health crisis at an alarming rate. However, literature on motivations for non-medical purpose tramadol use among commercial vehicle operators remains inadequate. The aim of this study was to document the motivations for non-medical purposes tramadol use in Kumasi. Such an understanding could inform policy direction to regulate non-medical purposes tramadol use in Ghana.MethodsWe conducted this exploratory qualitative study with 23 purposively selected commercial vehicle drivers (15) and assistants (8) in Kumasi, Ghana. Data for the study were collected through in-depth face-to-face interviews between June 2018 and March 2019. Using a thematic analytical approach, the interviews were coded and analysed.ResultsMultiple motivations for non-medical purposes tramadol use were found including those related to: (1) sexual; (2) psychological; (3) physical; and (4) economic factors. Participants also reported three main inter-linking categories of perceived tramadol adverse effects: (1) physical; (2) psychological; and (3) social effects. Although participants indicated no plans for stopping their non-medical use of tramadol any time soon, strong willingness was voiced for supporting officials in finding and dealing with non-medical purpose tramadol sellers.ConclusionNon-medical purposes tramadol use was associated with a confluence of factors, ranging from enhanced sexual performance to economic reasons. Based on the findings of the study and the dependence and addictive potentials of tramadol, there is the need for psychoeducational programmes for persons who misuse tramadol and enhancement of operational capacities of regulatory agencies.
Highlights
The misuse of tramadol has become a major aspect of the wider substance use challenge in recent years and is evolving into a health crisis at an alarming rate
Study design and context Considering the exploratory nature of the study, a qualitative approach was adopted to present a deeper understanding of motivations for non-medical use purposes of tramadol in Kumasi, Ghana
This study offers a useful understanding of varied reasons for using tramadol for non-medical purposes among commercial vehicle drivers and assistants in Kumasi, Ghana
Summary
The misuse of tramadol has become a major aspect of the wider substance use challenge in recent years and is evolving into a health crisis at an alarming rate. Literature on motivations for non-medical purpose tramadol use among commercial vehicle operators remains inadequate. The aim of this study was to document the motivations for non-medical purposes tramadol use in Kumasi. Prior to its United States (US) approval in 1995, tramadol was marketed in Europe for approximately 20 years with little evidence of misuse [1]. Zosel et al [12] investigated more than 16,000 identified cases of adolescent (age 13–19 years) prescription drug misuse in the United States between 2007 and 2009, where the most frequent opioids were Hydrocodone (32%), Oxycodone (15%), and tramadol (11%). Among 73 treatment-seeking adolescents and young adults at an outpatient facility for young people who use substances in Malmö, Sweden, tramadol was the most prevalent opioid detected in hair analysis (31% of cases) [13]. Tjäderborn et al [14] found that tramadol was the third most common pharmaceutical drug among young drug-impaired drivers with mixed substance use
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