HEALTH – It is the most consumed opioid in France. But from April 15, 2020, the prescription of tramadol will be limited to a maximum of three months instead of one year. This announcement fromDrug agency Wednesday 15 January aims to limit the risk of misuse.
This measure should also help to avoid reproducing the current health catastrophe in the United States, where opioids obtained by prescription caused 17,087 deaths in 2016.
Tramadol, like codeine, are weak opioids, prescription since July 2017. On the contrary, morphine, oxycodone and fentanyl are strong opioids, classified as narcotics, available on secure prescriptions.
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Outside of drug users, people who take weak opioids tend to be women, with a median age of 62.
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In 2015, almost 10 million patients received at least one prescription for opioids. Tramadol is “indicated only for the treatment of moderate to severe pain, but should not be prescribed for the treatment of migraine”.
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In addition, it should be prescribed for the shortest possible period and the dose should be reduced gradually before stopping, to avoid withdrawal syndrome. It is advisable to consult again if the pain is not sufficiently or quickly relieved by the treatment.
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70,000 deaths in the United States in 2017
In France, tramadol is the first opioid analgesic cited in a 2018 survey on problematic uses both among drug users but also in the general population for the treatment of pain.
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He is also the first involved in deaths related to taking painkillers, in front of morphine, and second most common pain reliever found on falsified prescriptions presented in pharmacies, behind codeine.
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In the United States, since the 1990s, there have been an increasing number of opioid overdoses. These painkillers are prescribed, especially for cancer patients, but they are also bought illegally. In 2017, 70,000 deaths are attributed to an overdose of this type of medication, thus estimated in September the French Ministry of Health.
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It is also believed to be the number one killer of Americans under 55, in car accidents, guns and cancer, reports France Inter.
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Overdoses in the United States even precipitated the first major decline in life expectancy since the AIDS epidemic in the early 1990s. An American born in 2017 could expect to live 78.6 years on average, compared to 78.9 years. in 2014, according to a report published in October 2019. This translates to almost four months less.
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Dependence is observed with signs of withdrawal occurring even when taken at recommended doses and over a short period, leading to persistent taking by patients who no longer have pain.
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“Tramadol is not the most potent opioid, but the risks of addiction are the same regardless of the opioid (including codeine),” said Nathalie Richard, deputy director of painkillers and narcotic drugs, at the AFP. It also exposes you to the risk of seizures.
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Avoid addiction
The situation in France is incommensurate with this health catastrophe, but it is all the more necessary to remain vigilant about these products.
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At the same time, we must continue to treat pain and there is always a favorable risk / benefit ratio for tramadol, subject to proper use, according to Nathalie Richard.
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This is why after three months, continuing treatment with tramadol (oral), alone or in combination with other molecules (paracetamol in Ixprim for example), will require a new prescription.
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“To renew the prescription, the patient will have to return to the doctor, this will reassess the pain, if he does not take too much and risks becoming addicted,” explains Nathalie Richard. “There are still doctors and pharmacists who do not know it is an opioid,” she said.
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The number of hospitalizations related to the use of opioid drugs almost tripled (+ 167%) between 2000 and 2017, while the number of deaths jumped 146% between 2000 and 2015, with “at least four deaths per week” , according to an ANSM report made public in February 2019.
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See also on The HuffPost: How are homeopathic medicines made?
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