Sunday, December 22, 2013

Killing Pain: Tramadol the 'Safe' Drug of Abuse Published: Dec 22, 2013 By John Fauber, Reporter, Milwaukee Journal Sentinel/MedPage Today

For years following spine surgery, Anthony Fort suffered.
And like many with his condition, the 46-year-old gospel singer and former construction worker used a combination of medications to alleviate his pain.
But as he took more drugs, including narcotic painkillers, Fort was often groggy when awake. When he slept, he gurgled and snored so loudly that his fiancee recorded it so she could convince him he was using too much medication.
On May 18, 2011, he didn't wake up.
According to the Milwaukee County Medical Examiner Office he died of an accidental overdose of opioids.
Tramadol, a "Safe" Pain-Killer
Included in the mix were drugs well-known for their abuse and overdose potential -- hydrocodone and methadone -- and one that the medical world long had thought posed little threat: tramadol.
But doctors -- and the FDA, the agency charged with regulating drug safety -- may have gotten it wrong.
Recent research shows that tramadol has greater potential to be abused and to cause overdoses than was believed when it first appeared on the U.S. market in 1995.
Journal Sentinel/MedPage Today investigation found that the FDA failed to heed a key piece of research indicating tramadol had the potential to be abused. Instead, the agency recommended not putting tramadol under the Controlled Substance Act. Restrictions on prescribing it are no more stringent than for Lipitor or Viagra.
The Controlled Substance Act places drugs into five progressively restrictive categories based on their abuse potential. At the top of the list are drugs such as heroin. At the other, are some cough medicines with limited amounts of codeine.
In approving tramadol, the FDA decision was based largely on research in which the drug was injected. The FDA also weighed evidence from Europe, where tramadol had been on the market for years.
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