Although tramadol is increasingly used to manage non-cancer pain, few safety studies have compared it with other opioids in actual practice conditions. A new study, published in JAMA, provides evidence that tramadol is associated with an increased risk of mortality and adverse clinical outcomes, and highlights the need for future research on its safety.
The population-based cohort study on 368,960 participants reviewed a new dispensation of tramadol, compared with codeine. The international research team prespecified eight outcomes that had been previously correlated to the opioid use including: all-cause mortality, cardiovascular events, fractures, constipation, delirium, falls, opioid abuse/dependence, and sleep disorders within one-year after the first dispensation. Codeine was used as the comparator as both tramadol and codeine are weak opioids, prescribed for addressing similar pain and illness.