Tramadol is an opioid-like analgesic drug used to treat moderate-severe acute pain, but the risk and effects of prolonged use of tramadol are known. The objective of this study is to evaluate the risk of prolonged use of tramadol compared with other short-acting opioids. 

This is an observational study of administrative claims data that included a total of 444,764 opioid-naive patients undergoing elective surgery. The primary outcome of the study was the risk of persistent opioid use after discharge in patients treated with tramadol versus patients treated with other short-acting opioids. 

Out of 444,764 patients, 357,884 filled a discharge prescription for one or more opioids. The most commonly prescribed opioid was hydrocodone (53%), followed by oxycodone (37.5%), and tramadol (4.0%). The prolonged unadjusted use after surgery was 7.1% with additional opioid use and 1.0% with persistent opioid use. The prescription of tramadol alone was associated with a 6% increase in additional opioid use relative to other short-acting opioids.

The research concluded that participants who receiving tramadol alone after surgery had similar risks of prolonged opioid use compared with other short-acting opioids. Therefore, tramadol could be an addiction-developing drug, and the providers should use caution when prescribing tramadol in episodes of acute pain.