Tramadol is a highly prescribed drug because of its effectiveness. However, its consumption carries the risk of addiction. How do you know if you are dependent on tramadol? How to succeed in weaning? Dr. Sarah Coscas, addictologist, answers our questions.
In 2019, the National Agency for the Safety of Medicines warned about the French consumption of opioids, grouping together drugs and medicines with the same effects as opium. Tramadol came first, its consumption doubled between 2004 and 2017.
“There is an explosion of addictions to opiates through analgesics, which we see clinically”begins Dr. Sarah Coscas, addictologist. “Tramadol is one of the opiates, by definition very addictive substances. Any person can quickly have withdrawal signs in 2 to 3 weeks if the treatment is stopped badly..”
What are the symptoms of tramadol addiction?
The first sign of an addiction is loss of control. The person can no longer do without tramadol, the prescribed number of tablets is no longer respected. “Another very important element is the increase in doses, called the phenomenon of tolerance, because hasAfter a while, the treatment no longer works”, resumes Dr. Coscas. “The person gradually loses interest in daily activities, there may also be depression.
Another sign of addiction: the onset of pain. “These are pains linked to lack even though the initial pain is no longer there. The other signs are tremors, sweating, feeling hot and cold, runny nose, or even diarrhea.”
The notion of duration is also taken into account in addiction, according to the specialist. For example, taking tramadol for a few weeks, following an operation, is not worrying. If it continues, it becomes.
Dr. Coscas recommends that physicians include an end date for each prescription and notify patients. The latter have been obliged since 2020 to renew their prescription every 3 months, to limit the risk of abuse.
Read also : Tramadol, a risky drug
What factors increase the risk of addiction?
“Having or having had another addiction increases the risk of addictionsays Dr. Coscas.
Just like a psychiatric history, such as depressive or anxiety disorders, or misuse, with an incorrectly prescribed medication, for mild pain.”
The longer the intake, the higher the doses, the greater the risk.
Can children become addicted?
Tramadol can be prescribed for children over 3 years old, for pain that is severe or not relieved by paracetamol or ibuprofen.
According to Dr. Coscas, “children rather suffer from a behavioral addiction, to screens for example. But an addiction is potentially possible.”
“TO outside the hospital, with the exception of sickle cell crises or serious and extremely painful pathologies, opioids are not used (Editor’s note: tramadol is a weak morphine, less powerful than morphine)”, reassures Professor Robert Cohen, pediatrician. “Tramadol cannot be given before the age of 3, and 80% of our consultations concern children under the age of 3.”
The health authorities warn above all about the risk of overdose, sometimes fatal, in children, but not about that of dependence. However, adolescents are concerned by the risk of abuse, dependence or voluntary increase in doses.
Read also : Five things to know about tramadol in children
How is tramadol addiction treated?
When tramadol is stopped abruptly, it exposes to withdrawal symptoms and a rebound effect. In other words, the pain increases temporarily when the treatment is stopped. It is therefore recommended to reduce the doses, in a accompanied and progressive manner, at the rate of a reduction of 5 to 10% every one to 4 weeks, depending on the patient.
Symptomatic treatment can be offered in the event of withdrawal signs, such as paracetamol or phloroglucinol. Non-drug care is preferred, with treatments to improve comfort, such as relaxation, hot baths when there is muscle pain, hypnosis.
“Cognitive and behavioral therapy is done in first intention., continues the addictologist. “It is based on motivational interviews. We also work on the false beliefs that maintain addiction, such as sleeping well with tramadol, when there is no deep sleep, when you are knocked out and when there are disorders. of memory.”
According to the review Prescribe“weaning requires strong patient motivation and justifies prolonged support”.
In the event of repeated weaning failures or if the doses or intakes continue to be increased, a substitution treatment, such as buprenorphine, may possibly be proposed, in a medical setting.
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