Dr Jay Gong: UOA School of Pharmacy lecturer on the concerns tramadol could be getting over-prescribed

There's concerns tramadol could be getting over-prescribed, with more patients being given the painkiller.

Pharmac data shows more than 270,000 people were prescribed the drug last year - an increase of 14 percent since 2019.

UOA School of Pharmacy lecturer Dr Jay Gong says healthcare providers likely prefer prescribing tramadol over stronger painkillers.

"There might be some perceived ideas around it - because it's a weaker opioid, it's maybe not as addictive and maybe in the long run, you might not have as much side effects."

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Episode Transcript

Speaker 1 (00:00):
There are a little bit of a few concerns about
the prescription of tramadol and whether it's being abused. More
than two hundred and seventy thousand people would prescribe tramadol
last year, with an increase of fourteen percent from five
years ago. It is commonly prescribed before or after surgeries.
It can actually be quite addictive after prolonged use. Plus
there are concerns of a usage in the workplace, with
recent testing finding that tramadol made up three point one

(00:22):
percent of opioid detections by the Drug Detection Agency. Doctor j.
Gong is with me on this, hij jodo hea, How
are you well? Thank you? Why are we seeing this increase?

Speaker 2 (00:33):
Well, I think there's a number of reasons. I think
from my research in the pass around surgery, tramada was
definitely seeing as a very commonly prescribed medication after surgery.
It could be that a lot of clinicians and prescribers
may prefer tramada over some much stronger opioids like morphine
or oxy codo, And there might be some perceived ideas
around because it's a weaker opioid, if not as maybe

(00:55):
as addictive and maybe in the long run you might
not you know, also have as much side effect.

Speaker 1 (01:01):
Yeah, are all of those assumptions correct or incorrect?

Speaker 2 (01:06):
Well, what we've shown, what we've shown past research is
that yesda tramada is not without is on problem without
the risk of long term use either. So it's not
really true that just because it's weak, it doesn't mean
it's sort of safer. And also I think it's quite
important to emphasize that, you know, immediately after surgery is

(01:26):
quite important for patients to have really good pain relief,
and tramadah being the drug that it is, because it
requires our body to sort of transform it to sort
of work as a proper sort of ophud pain relief,
not everybody may yet the same degree of pain relief
that they should get with trevidall. And in terms of
side effect, you know, tremada is also quite known to

(01:48):
cause nausea as well. And I know that in the
report that you guys talked about just before was sort
of a workplace, you know, one of the things that
I've why I've been seeing just after just after you
guys call me about just looking at the rate so
that there is a particular type of formulation of opure
tablets that's been prescribed a lot more these days, which
is called a long acting tablet, and that could be

(02:09):
you know, that could be you know, seeing as somebody
taking at nighttime and then potentially the levels persised in
their body maybe for longer, and perhaps you know, into
when they go to the work the next day.

Speaker 1 (02:22):
Oh, I see what you're saying. Look, does this kind
of thing become more problematic when you've got long waiting
lists for surgery because people who would you know, if
you could get them into surgery and out the other side,
they wouldn't be on it as long. But if they're
trying to manage their pain and the lead up to
surgery for a long time is where you really start
getting addiction problems.

Speaker 2 (02:40):
Yeah. I mean we I haven't looked at that in
terms of how waiting list affects sort of opused. But
in one of our sort of another research project where
we looked at surveys of patients how they use ocure,
there definitely was a signal of sort of a few
one or two patients that did kind of say, oh,
you know, I'm now having to use opia much longer

(03:00):
because I waited for surgery, and if you think about it,
you know, long term pain conditions like osteoarthritis for example,
you know we're waiting for a knee hip replacement. It
could it could mean that you might be on pay
reief for longer and you might need to have stronger
paying releaf thing your normal parasitcome or intufirmetry, and you
might need that travedol. So perhaps that could be a

(03:23):
contributing factor. But again that's not something that I've looked
at myself. Jay.

Speaker 1 (03:28):
If somebody is concerned about this and doesn't want to
get addicted to something so it doesn't want to take traviital,
is there an alternative that they could ask for.

Speaker 2 (03:36):
I mean, there are some other alternatives, but it really
depends on the pain, the type of pain, because pain
is quite complex and it's quite variable for people to
a person to person. I mean, I think, well, I
think for the best thing would be to contact the
health providers. There might be other alternatives, so definitely contact
the GP if you're very concerned. And also if you've

(03:58):
been taking tremidall for a long time, you know the
painters are getting better, it might mean that there's something
else going on. As well.

Speaker 1 (04:04):
Hmmm, that's a very good point, Jay, Thanks very much,
doctor j. Gong, who's a lecturer in clinical practice at
Aukland University School of Pharmacy.

Speaker 2 (04:12):
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