Tramadol Addiction Research Articles

Effects of Tramadol Addiction on Brain of Adult Male Albino Rats and Role of lofexidine during Withdrawal Period: A Biochemical, Histopathological and Immunohistochemical Study

Background: Tramadol is a synthetic opioid analgesic commonly prescribed for moderate to severe pain, becoming abused more popular among teens in most countries. In addition to the euphoric and mood-enhancing effects sought by tramadol abusers, taking this drug for nonmedical purposes, abusing tramadol can lead to tolerance and dependence. Abusers who continue to take tramadol long enough and at high enough doses will eventually develop a physical dependence on the drug and experience unpleasant, or even dangerous, symptoms of withdrawal if they stop taking the medication. Objective: To study the biochemical, histopathological and immunohistochemical changes of repeated administration of tramadol on the brain cells of male albino rats and role of duration of addiction in the damaging effects produced, and to prove if there is a role for lofexidine in the treatment of tramadol addiction in withdrawal period and detect the changes after recovery period and withdrawal of tramadol .Materials and methods: 100 adult male albino rats were randomly divided into equal 5groups: Group I: (20 rats) Control group: including those given normal feeding. Group II: (20 rats) Tramadol treated group for one month. Group III: (20 rats) Tramadol treated group for 2 months. Group IV: (20 rats) Tramadol treated for one month then given lofexidine for another month during withdrawal. Group V: (20 rats) Tramadol treated for one month and left for another month for recovery. Animals were observed for any behavioral changes throughout the research and recorded. At the end of the experiment animals were scarified by cervical dislocation under inhalation anesthesia, autopsy was done and the brain specimens were obtained, prepared for biochemical study for dopamine level and others preserved for histopathological and immunohistochemical study with their specific procedures. Results: Repeated Tramadol administration resulted in rats behavioral changes( restlessness, irritability defensive aggressive reactions) and produced decreased dopamine levels and significant brain damage in the histopathological and immunohistochemical study that increased with increased period of intake (The maximum damage was recorded in group III with two months tramadol administration, varying degrees of recovery after stoppage of intake were noted in Group V and more improvement by Lofexidine treatment in Group IV). Conclusions: Repeated Tramadol administration causes degenerative changes on the rat brain which increased with increasing the period of this administration. Some improvement was detected after stoppage and more improvement with Lofexidine treatment in withdrawal period.

Study of risk factors for pulmonary tuberculosis among diabetes mellitus patients

People with diabetes mellitus (DM) are at high risk of developing tuberculosis (TB) than those without. People with diabetes are more likely to fail treatment and to die during treatment compared to those without diabetes. Aim of the workThe aim of the current study was to study the risk factors for pulmonary tuberculosis among diabetic patients in comparison to patients with DM alone. Methods160 patients were grouped into two groups, the first group, 80 patients (DM-TB) group, and the second group, 80 patients, diabetics with chest diseases other than TB. All patients were subjected to meticulous history taking, clinical examination, radiological examination, and laboratory investigations. All data were statistically analyzed. ResultsIn this study the mean age of the DM-TB group was 52.90±11.12years and 54.57±9.84years for DM group. There was no statistically significant difference in gender, smoking, and DM treatment compliance between the two groups. There was a highly statistically significant difference in body mass index (BMI), Hashish, Banjo and Tramadol addiction, poor glycemic control, lower hemoglobin levels, platelet count, erythrocyte sedimentation rate and lower serum protein and albumin. Bilateral affection was found in 45% and 21.5% in lower lobe in DM-TB. ConclusionFrom the current work it could be concluded that the factors determinant of pulmonary tuberculosis among diabetics are weight loss, decreased BMI, drug addiction, uncontrolled diabetes, higher rates of HbA1c, increased insulin requirements, anemia, higher ESR, higher platelet count and decreased serum proteins and albumin.

Latarjet Procedure for Anterior Shoulder Instability Due to Tramadol-Induced Seizures

Background: Seizures, commonly due to epilepsy, are known to cause shoulder instability. Tramadol addiction has recently been found to induce seizures in patients who exceed the recommended dose. Because of the easy accessibility and low cost of tramadol, an increasingly alarming phenomenon of tramadol abuse has been demonstrated in recent years. Purpose/Hypothesis: The purpose of this multicenter study was to investigate shoulder instability resulting from tramadol-induced seizure (TIS) as well as to recommended management for such shoulder instability. The hypothesis was that TIS leads to anterior shoulder dislocations with major bony defects, which favors bony reconstructive procedures as a suitable method of treatment. Study Design: Case series; Level of evidence, 4. Methods: This prospective case series study was conducted on 73 patients (78 shoulders) who presented with anterior shoulder dislocations and a clear history of tramadol abuse. The mean age of the patients was 26.8 years, and the mean number of dislocations was 14. The mean duration of addiction was 17 months, with a mean dose of 752 mg of tramadol hydrochloride per day. Glenoid and humeral bone loss ranged from 15% to 35% and from 15% to 40%, respectively. The mean follow-up period was 28 months. All patients underwent an open Latarjet procedure. Results: Postoperative mean Rowe score and American Shoulder and Elbow Surgeons score at final follow-up (24 months) improved significantly from 20 to 84 and from 44 to 91, respectively (P < .05). The patient satisfaction rate reached 95%, and the mean period of return to work was 12.8 weeks. Five patients (9%) had postoperative seizures due to relapse of the tramadol abuse, but only 3 patients (5%) had redislocations with nonunion or breakage of the graft or hardware. Conclusion: Tramadol addiction has evolved as an important cause of seizures that can result in shoulder dislocation. Anterior shoulder instability with TIS occurs mainly with higher levels of addiction and results in significant humeral and/or glenoid bone defects. The Latarjet procedure is recommended for these patients, after control of addiction, and provides 95% satisfaction at midterm follow-up.

Does Tramadol Increase the Severity of Nicotine Dependence? A Study in an Egyptian Sample

In Egypt, tramadol abuse is increasing, especially among youths and the middle- aged. Tobacco smoking is a worldwide health problem responsible for more deaths and disease than any other noninfectious cause. To investigate if there is a relationship between tramadol and nicotine dependence. 48 tramadol addicts completed a demographic sheet, drug use questionnaire, and the Fagerstrom Test for Nicotine Dependence (FTND). Numbers of cigarettes smoked were recorded every week or two weeks at follow-up or by phone calls, and the FTND was completed again five weeks after abstinence. All participants underwent full psychiatric assessment, plus a urine toxicology screening at first visit, and once again during follow-ups. All subjects of the study were cigarette smokers. The mean numbers of cigarettes smoked per day were 13, 31.8, 20.2, and 14.3 during the phase before tramadol taking, addiction phase, two weeks and five weeks after stopping tramadol. The mean FTND score dropped from 6.67 during the tramadol addiction phase to 4.31 only five weeks after stopping tramadol. Tramadol increases the severity of nicotine dependence. The relation seems to be bi-directional, so increased cigarette smoking also increases tramadol intake.

Tramadol Dependence in a Tunisian Patient with No Previous Substance Misuse History

Introduction Tramadol is an atypical, centrally acting, synthetic, analgesic. Its anti-nociceptive effects are mediated by a combination of μ-opioid agonist effects, and norepinephrine and serotonin reuptake inhibition. Initially, tramadol was said to have a low-abuse potential. However, its abuse liability and diversion were soon recognized, with several reports on physical dependence. Methods A case report and review of literature by a research on medline database. Key words: 'Tramadol”, 'opiate dependence”, 'tramadol withdrawal”, 'tramadol addiction” Case Report Mr. L.M. is a 24 year-old man without past history of substance abuse. In 2012, he underwent leg surgery after gunshot wounds. He was started on Tramadol treatment for his pain. He progressively increased Tramadol dosage and was taking 250mg to 750mg intravenous injections per day. He tried several times to stop taking Tramadol but each time his developed nausea, muscle aching, dysphoric mood and insomnia. His withdrawal symptoms had bad impact on his daily life and resulted in family life breakdown. Discussion Tramadol has long been considered to have a very low abuse potential. According to the US Food and Drug Administration, the rate of addiction was 1 in 100,000 during the last 18 months period of surveillance. Most of the cases had been in patients with a prior history of substance abuse. This case shows that Tramadol addiction may also occur in patients with no psychiatric or substance abuse history.

Posterior capsular release and coracoid transfer for cases of neglected locked anterior shoulder dislocation in tramadol addicts

Introduction Neglected locked anterior shoulder dislocation is a rare condition as the injury is easily detectable. The humeral head is engaged against the anterior glenoid rim with a large Hill-Sachs defect. Due to the time lapse, there is additional soft tissue tightness. Our hypothesis is that Latarjet procedure combined with posterior capsular release will provide a stable shoulder with less limitation of external rotation in such cases.

PRELIMINARY STUDY FOR THE EFFECT OF TRAMADOL ADDICTION ON FUNCTIONAL AND STRUCTURAL INTEGRITY OF RENAL PROXIMAL TUBULES AMONG ADDICTED EGYPTIANS

Experimental animals and human post-mortem studies concerning renal effects of tramadol addiction showed histopathological changes in proximal tubules. This study investigates early changes in function and structure of proximal tubules to tramadol addiction. The study included 44 males (G1 = 23 controls, G2 = 21 tramadol addicts). The measured urinary parameters were: urinary alpha-1-microglobulin (U.1-m), urinary leucine aminopeptidase (U.LAP), urinary N-acetyl--D-glucosaminidase (U.NAG). Urinary tramadol (U.Tr) was measured in G2. In G2, levels of U.1-m, U.LAP and U.NAG were increased in comparison with G1. These changes were insignificant. U.Tr did not show any correlation with any parameter in G2. Tramadol addiction may affect proximal tubules. This study is a Preliminary assessment for the subclinical renal effects of tramadol.

2856 – Tramadol dependence in a patient with no previous substance history

Tramadol, initially introduced in Germany in 1977, is a synthetic analgesic and appears to have a dual mechanism of action; a weak μ-opioid receptor agonism and a reuptake inhibition of serotonin and noradrenaline. It is marketed in Tunisia since 2001. Generally, Tramadol is considered to have a very low risk of dependence and abuse, but rare cases of tramadol dependence have been described in patients without prior substance abuse history. We describe one such case in a relatively young, otherwise healthy patient. Mr AR, a 47-year-old man, presented to get help with tramadol addiction. He had no previous history of illicit drug use, did not smoke cigarettes or drank alcohol. Mr AR was started on tramadol treatment about 2 years earlier for back pain. He did have better pain control with tramadol, but he gradually started taking more and more. Ultimately, his pain resolved but he was unable to stop taking tramadol: he was taking up to 1700 mg/d of tramadol and had made multiple efforts to stop. When he stopped taking tramadol, he had dysphoria, muscle cramps, anxiousness, restlessness, and a sensation of insects crawling all over his body. His withdrawal symptoms were severe enough to interfere with his work and family life. Tramadol dependence is very rare but can happen in a patient without substance abuse history. We, as medical practitioners, should be open to the possibility of tramadol dependence and should resort to optimal and judicious use of such a substance.

Severe Tramadol Addiction in a 61 Year-Old Woman without a History of Substance Abuse

We describe here the first case of Tramadol addiction and withdrawal in an elderly female patient in apparently good physical health. We report successful treatment with mirtazapine and clonidine. We believe that patients must be advised to take Tramadol regularly and to stop gradually especially after long treatment periods; moreover physicians must consider the potential physical dependence when they prescribe Tramadol for pain. Hence, we are observing some patients who continue to take Tramadol in order to achieve a feeling of well-being, even though their pain is controlled after disease regression. Finally, the establishing of an evidence-based Tramadol detoxification protocol would be highly desirable.

Tramadol Dependence With No History of Substance Abuse

Tramadol Dependence With No History of Substance Abuse