Tramadol Effective for Management of Opioid Withdrawal

July 12, 2017

CHICAGO -- July 12, 2017 -- Tramadol extended-release (ER) suppressed withdrawal more than clonidine and was comparable to buprenorphine for the management of opioid withdrawal symptoms in patients with opioid use disorder in a residential research setting, according to a study published online by JAMA Psychiatry.

Opioid use disorder is a public health problem that has contributed to unprecedented levels of overdose deaths. Detoxification is a widely used treatment for opioid use disorder; however, failing to adequately manage opioid withdrawal symptoms can contribute to people leaving treatment.

Clonidine and buprenorphine are widely used to manage opioid withdrawal. Tramadol hydrochloride is a promising alternative option for effective opioid use disorder treatment.

Kelly E. Dunn, PhD, Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues conducted a randomised clinical trial in a residential research setting with 103 patients, mostly men, with opioid use disorder. During a 7-day taper, clonidine, buprenorphine or tramadol hydrochloride ER were used.

Results showed tramadol ER suppressed withdrawal more than clonidine and was comparable to buprenorphine during a residential tapering program.

The study noted some limitations, including a primarily male sample and a lack of specific information regarding past 30-day use of other illicit drugs and alcohol.

“These data suggest that tramadol ER is a promising and valuable medication for the management of opioid withdrawal in patients undergoing treatment for opioid use disorder,” the authors wrote. “Future studies should evaluate whether relapse varies following supervised withdrawal with tramadol ER versus other medications and whether tramadol ER can be used to transition patients to naltrexone treatment.”

SOURCE: JAMA Psychiatry

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