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Heroin Addiction and Related Clinical Problems: 2020, 22, N5 (pages: 13 - 18)

Tramadol as the Most Prescribed Opioid Analgetic Medication in Slovenia in Recent Years

Kostnapfel T., Korošec A., and Kastelic A.

Summary: Background: There is a variety of options available for the treatment of chronic pain. Tramadol is an opioid analgesic licensed for use in moderate to severe pain. A single dose of a weak opioid, possibly combined with paracetamol, has greater analgesic efficacy than paracetamol alone. Aim: The aim of the present study was to analyse the trends in prescriptions of tramadol as a monocomponent drug (ATC group N02AX02) and in combination with paracetamol (ATC group N02AJ13) in Slovenia between 2006 and 2018. Methods: Anonymised data from the Slovenian "Outpatient Prescription Database" were used based on the WHO Anatomical-Therapeutic-Chemical methodology. Compiled data were processed by means of descriptive statistics and tested for linear trend. Results: In Slovenia, the number of tramadol (N02AX02) prescriptions significantly decreased, and the number of tramadol/paracetamol (N02AJ13) prescriptions increased between 2006 and 2017, with a decrease in 2018. The percentage of people who received at least one tramadol (N02AX02) and tramadol/paracetamol (N02AJ13) prescription per year differed according to gender. Conclusions: While tramadol is recognised as having lower abuse and respiratory depression potential compared to opioid agonists, it is not without risks. Increasing public awareness, not only doctors' but patients' as well, would be necessary to reduce the possibilities for potential misuse, abuse, addiction and opioid-related overdoses, through stricter implementation of national and international guidelines and recommendations.