| opioid therapy

Scheduling and Prescribing: Tramadol for Postsurgical Pain

Research Shows Slightly Higher Risk of Extended Use in Opioid

Newswise — Surgical patients receiving the opioid tramadol have a somewhat higher risk of prolonged use than those receiving other common opioids, new Mayo Clinic research finds. However, the Drug Enforcement Administration (DEA) classifies tramadol as a Schedule IV controlled substrance, meaning it's considered to have a lower risk of addiction and abuse than Schedule II opioids, such as oxycodone and hydrocodone. The study was published on Tuesday, May 14 in The BMJ.

"This data will force us to reevaluate our postsurgical prescribing guidelines," says lead author Cornelius Thiels, D.O., a general surgery resident in Mayo Clinic School of Graduate Medical Education. "And while tramadol may still be an acceptable option for some patients, our data suggests we should be as cautious with tramadol as we are with other short-acting opioids."

The Mayo team of physicians and researchers used the OptumLabs Data Warehouse to examine the records of 444,764 patients who underwent 20 common surgeries across the U.S. between Jan. 1, 2009, and June 30, 2018. The OptumLabs Data Warehouse contains de-identified administrative claims data, including medical claims and eligibility information from a large national U.S. health insurance plan, as well as electronic health record data from a nationwide network of provider groups.

The team found that 357,884 filled a prescription for opioids after surgery.

Among them:

  • 7% had at least one refill 90–180 days after surgery, which was defined by the team as additional use.
  • 1% refilled their prescription 180–270 days after

Read the full press release.

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