Citation

Sørensen AMS, Petersen J, Christensen MB, Schelde AB, Andersen JT, Jimenez Solem E, Petersen TS. Basic Clin. Pharmacol. Toxicol. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Nordic Pharmacological Society, Publisher John Wiley and Sons)

DOI

10.1111/bcpt.13741

PMID

35538919

Abstract

Tramadol is a commonly used opioid with a potential of addiction and abuse. Using Danish nationwide registers, we aimed to 1) characterise opioid poisonings, 2) assess the 30-day mortality following morphine, oxycodone, and mixed poisonings compared to tramadol poisonings, and 3) assess the development in tramadol poisonings during a 12-year period. Poisonings were identified from 2006 to 2017. A Cox proportional hazards regression model was used to estimate adjusted hazard ratios (aHRs) along with 95% confidence intervals (CIs) for 30-day mortality following morphine, oxycodone, or mixed poisonings compared to tramadol poisonings. We identified 7,718 opioid poisonings among 6,365 patients. Patients with a tramadol poisoning were younger and had less comorbidities than patients with a morphine, oxycodone, or mixed poisoning. Within 30 days, a total of 205 patients died. The 30-day mortality risk was higher following morphine (aHR 3.2, 95% CI 2.0-5.1), oxycodone (aHR 2.1, 95% CI 1.2-3.6), and mixed poisonings (aHR 1.6, 95% CI 1.0-2.7) compared to tramadol poisonings. The annual number of tramadol poisonings increased from 233 in 2006 to 501 in 2013 and declined to 348 in 2017. In conclusion, despite a lower mortality risk compared to other opioid poisonings, physicians should consider the poisoning and abuse risks when prescribing tramadol.

Language: en

Keywords

epidemiology; mortality; opioids; intoxications; poisonings