Tramadol - Substance Use Disorder

Dr Helen Fulcher, Goodfellow GP Advisor talks with Northland general practitioner and addiction medicine specialist Dr Alistair Dunn about the prescription drug tramadol and the substance use disorder that can be associated with it’s use.

Topics covered include:

  • What does tramadol use disorder look like?
  • How do you define substance use disorder or addiction?
  • Is this a significant problem for our communities here in New Zealand?
  • Who has the potential to develop tramadol use disorder?
  • What alternatives are there for treating chronic non-malignant pain?
  • What can we do to help patients with tramadol dependance?


This MedTalk was recorded in September 2018



Peer group discussion points

1. Tramadol misuse covers a spectrum ranging from recreational use through to full addiction.

  • What are some indicators of drug-seeking behaviour that you need to be aware of?
  • Has anyone been in the situation they have suspected drug-seeking behaviour relating to Tramadol? What were the factors that alerted you to a potential problem?

2. Pressure to prescribe can be a common experience in primary care. When thinking about drugs of misuse there are some specific strategies or planned responses that can be used if under pressure to prescribe.

  • Discuss within the group the strategies that were mentioned in the MedTalk and reflect on how useful they might be.
  • What other strategies have people used or attempted to use when under pressure to prescribe Tramadol/drugs of misuse? How successful were these?

3. Tramadol is commonly prescribed in primary care. The first prescription of Tramadol has been shown to have implications regarding potential future development of dependence with the number of days of the first prescription being the important risk factor.

  • If you were to prescribe Tramadol, discuss in the group some of the prescribing strategies which can reduce your prescribing risk

4. Non-pharmacological strategies are important for the ongoing management of chronic non-malignant pain.

  • Are there any techniques or resources you use in practice to help your patients with chronic non-malignant pain?
  • Do you think these techniques or resources are effective in the populations you see with chronic non-malignant pain?

5. Reflecting on the MedTalk and the peer group discussion you have had, what could you do differently (if anything) in your practice to improve the prescribing of Tramadol?

This MedTalk is supported by

Date Published: 
Friday, September 28, 2018

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This presentation is intended for qualified health practitioners professional development and should not be relied upon for any other purpose. Any opinions offered are those of the presenter or other speaker and do not necessarily represent the views of Goodfellow Unit.