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Speaker 1: There are a little bit of a few concerns about

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Speaker 1: the prescription of tramadol and whether it's being abused. More

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Speaker 1: than two hundred and seventy thousand people would prescribe tramadol

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Speaker 1: last year, with an increase of fourteen percent from five

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Speaker 1: years ago. It is commonly prescribed before or after surgeries.

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Speaker 1: It can actually be quite addictive after prolonged use. Plus

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Speaker 1: there are concerns of a usage in the workplace, with

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Speaker 1: recent testing finding that tramadol made up three point one

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Speaker 1: percent of opioid detections by the Drug Detection Agency. Doctor j.

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Speaker 1: Gong is with me on this, hij jodo hea, How

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Speaker 1: are you well? Thank you? Why are we seeing this increase?

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Speaker 2: Well, I think there's a number of reasons. I think

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Speaker 2: from my research in the pass around surgery, tramada was

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Speaker 2: definitely seeing as a very commonly prescribed medication after surgery.

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Speaker 2: It could be that a lot of clinicians and prescribers

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Speaker 2: may prefer tramada over some much stronger opioids like morphine

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Speaker 2: or oxy codo, And there might be some perceived ideas

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Speaker 2: around because it's a weaker opioid, if not as maybe

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Speaker 2: as addictive and maybe in the long run you might

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Speaker 2: not you know, also have as much side effect.

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Speaker 1: Yeah, are all of those assumptions correct or incorrect?

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Speaker 2: Well, what we've shown, what we've shown past research is

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Speaker 2: that yesda tramada is not without is on problem without

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Speaker 2: the risk of long term use either. So it's not

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Speaker 2: really true that just because it's weak, it doesn't mean

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Speaker 2: it's sort of safer. And also I think it's quite

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Speaker 2: important to emphasize that, you know, immediately after surgery is

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Speaker 2: quite important for patients to have really good pain relief,

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Speaker 2: and tramadah being the drug that it is, because it

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Speaker 2: requires our body to sort of transform it to sort

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Speaker 2: of work as a proper sort of ophud pain relief,

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Speaker 2: not everybody may yet the same degree of pain relief

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Speaker 2: that they should get with trevidall. And in terms of

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Speaker 2: side effect, you know, tremada is also quite known to

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Speaker 2: cause nausea as well. And I know that in the

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Speaker 2: report that you guys talked about just before was sort

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Speaker 2: of a workplace, you know, one of the things that

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Speaker 2: I've why I've been seeing just after just after you

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Speaker 2: guys call me about just looking at the rate so

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Speaker 2: that there is a particular type of formulation of opure

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Speaker 2: tablets that's been prescribed a lot more these days, which

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Speaker 2: is called a long acting tablet, and that could be

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Speaker 2: you know, that could be you know, seeing as somebody

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Speaker 2: taking at nighttime and then potentially the levels persised in

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Speaker 2: their body maybe for longer, and perhaps you know, into

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Speaker 2: when they go to the work the next day.

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Speaker 1: Oh, I see what you're saying. Look, does this kind

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Speaker 1: of thing become more problematic when you've got long waiting

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Speaker 1: lists for surgery because people who would you know, if

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Speaker 1: you could get them into surgery and out the other side,

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Speaker 1: they wouldn't be on it as long. But if they're

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Speaker 1: trying to manage their pain and the lead up to

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Speaker 1: surgery for a long time is where you really start

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Speaker 1: getting addiction problems.

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Speaker 2: Yeah. I mean we I haven't looked at that in

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Speaker 2: terms of how waiting list affects sort of opused. But

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Speaker 2: in one of our sort of another research project where

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Speaker 2: we looked at surveys of patients how they use ocure,

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Speaker 2: there definitely was a signal of sort of a few

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Speaker 2: one or two patients that did kind of say, oh,

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Speaker 2: you know, I'm now having to use opia much longer

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Speaker 2: because I waited for surgery, and if you think about it,

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Speaker 2: you know, long term pain conditions like osteoarthritis for example,

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Speaker 2: you know we're waiting for a knee hip replacement. It

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Speaker 2: could it could mean that you might be on pay

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Speaker 2: reief for longer and you might need to have stronger

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Speaker 2: paying releaf thing your normal parasitcome or intufirmetry, and you

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Speaker 2: might need that travedol. So perhaps that could be a

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Speaker 2: contributing factor. But again that's not something that I've looked

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Speaker 2: at myself. Jay.

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Speaker 1: If somebody is concerned about this and doesn't want to

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Speaker 1: get addicted to something so it doesn't want to take traviital,

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Speaker 1: is there an alternative that they could ask for.

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Speaker 2: I mean, there are some other alternatives, but it really

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Speaker 2: depends on the pain, the type of pain, because pain

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Speaker 2: is quite complex and it's quite variable for people to

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Speaker 2: a person to person. I mean, I think, well, I

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Speaker 2: think for the best thing would be to contact the

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Speaker 2: health providers. There might be other alternatives, so definitely contact

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Speaker 2: the GP if you're very concerned. And also if you've

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Speaker 2: been taking tremidall for a long time, you know the

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Speaker 2: painters are getting better, it might mean that there's something

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Speaker 2: else going on. As well.

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Speaker 1: Hmmm, that's a very good point, Jay, Thanks very much,

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Speaker 1: doctor j. Gong, who's a lecturer in clinical practice at

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Speaker 1: Aukland University School of Pharmacy.

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