title: The non-medical use of tramadol in the UK: findings from a large community sample.
abstract: BACKGROUND
  Prescription drug misuse has become a public health problem in several developed countries. In the UK, there has been no increase in people seeking treatment for prescription drug dependence, but there has been a progressive rise in fatal overdoses involving tramadol.
  
  
  OBJECTIVE
  To explore the source, motivations for use and patterns of use of tramadol in the UK.
  
  
  METHODS
  We conducted anonymous online survey of drug use and related behaviours as part of an ongoing drug trend monitoring initiative. We included questions assessing the patterns of use, source and function of tramadol.
  
  
  RESULTS
  UK Survey respondents (n = 7360) were predominantly young (mean age 29), and 90% reported being employed or studying. Less than 1% reported past-year use of heroin or methadone, but about 1/3 reported past-year use of cocaine. 326 (5% of respondents) reported having used tramadol in the preceding year, usually obtained by prescription but in 1/3 of cases from a friend; rarely from a dealer or from the internet. Most used the drug for pain relief, but 163 respondents (44%) reported using tramadol for reasons other than pain relief - particularly, using it to relax, to sleep, to get high or to relieve boredom. Nineteen per cent took doses higher than prescribed, and 10% reported difficulty discontinuing. Twenty-eight per cent combined tramadol with alcohol or other drugs to enhance its effect.
  
  
  CONCLUSIONS
  Misuse and sharing of tramadol, supplied by prescription, was common.
authors.affiliation: Kings Health Partners, Kings College London, London, UK; Insitute of Psychiatry, Kings College London, London, UK; Global Drug Survey, London, UK.
authors.forename: A R
authors.initials: AR
authors.lastname: Winstock
authors.forename: R
authors.initials: R
authors.lastname: Borschmann
authors.forename: J
authors.initials: J
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063487:Prescription Drug Misuse / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014147:Tramadol / Q000627:therapeutic use*; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol