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Does the product, a common painkiller implicated in the disqualification of a cyclist in the last Tour de France, present a risk for patients who use it?
On August 17, Colombian cyclist Nairo Quintana was disqualified from the last Tour de France. The reason ? A positive test for tramadol, a painkiller banned by the International Cycling Union since 2019. The drug is an analgesic from the opioid family that fights pain by acting directly on its perception by the brain. In fact, it would “hide” the pain of the athlete, which can be considered as cheating or, at least, a certain level of doping. But what about non-athletic users? Are the prescription and use of tramadol also problematic?
Tramadol, an effective painkiller
Tramadol is therefore an opioid analgesic, prescribed in the management of moderate to severe pain in adults, especially as a second-line treatment, when taking conventional analgesics such as paracetamol is not enough to relieve the patient. It is generally prescribed against certain acute and chronic forms of pain such as low back pain, headaches or joint pain. Its use is considered safe, provided that the prescribed doses and durations are respected. Remember that, since January 2021, the prescription of tramadol-based drugs must not exceed 12 weeks of use. If the patient is still in pain beyond that, reassessment and a new prescription should be considered by the physician.
Euphoric effects, diversions of use… Many limits to its use
However, this is not the first time that tramadol has been mentioned in the news. Indeed, the painkiller is regularly reported, in particular by the French Observatory of Analgesic Medicines (OFMA) for problematic consequences.
Risky side effects
Like all opioids, tramadol exposes you to several adverse effects: nausea, dizziness, vomiting, constipation, sweating, headache, drowsiness. Some, more rare, can induce a risk: hallucinations, mental confusion, sleep disorders, slow heart rate, increased blood pressure. An overdose can also lead to death.
A dependency effect
Due to its euphoric effect, tramadol also induces a fairly rapid risk of dependence, as well as withdrawal which can prove to be difficult or violent for the patient with a resumption of pain.
Too frequent diversion of use
Indeed, according to an OpinionWay survey for the OFMA carried out in April 2022, a quarter of French people taking tramadol admit to prolonging its use for a purpose other than an analgesic effect (anxiety, sleep, stimulant, etc.) without knowing the risks.
Proper use of opioids
As a reminder, taking medication and in particular opioids is never harmless and must comply with regulated use:
- Always respect the dosage indicated on the prescription, the intake and the duration of treatment that corresponds to your situation;
- If the pain is still strong, do not increase the doses yourself but consult your doctor again;
- Do not suddenly stop your treatment but consult your doctor or pharmacist to gradually reduce the doses.
- Finally, do not divert the use of a drug for a purpose other than its initial indication.