title: Adolescent tramadol use and abuse in Egypt.
abstract: BACKGROUND
  Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has not been well studied in Egypt. The aim of this study was to estimate the prevalence and associated correlates of tramadol use and abuse among school students in Egypt.
  
  
  METHODS
  A total of 204 students, aged 13-18 years, from six schools in Zagazig, Egypt, were screened for tramadol use using The Drug Use Disorders Identification Test and a urine screen for tramadol.
  
  
  RESULTS
  The prevalence of tramadol use was 8.8% among school students and the average age at onset of tramadol use was 16.5 ± 1.1. Some 83% of the users were using tramadol alone while the rest (17%) were using a combination of tramadol, alcohol, and cannabis. Two-thirds of these students started with tramadol as the first drug after the onset of tobacco smoking. Over one third of tramadol users had drug-related problems and 6% had dependence. There was a significant association between tramadol use and older age, male gender, and smoking. Drug-related problems were negatively correlated with age at onset of tramadol use.
  
  
  CONCLUSIONS
  Tramadol use was common among adolescents and over one third of tramadol users had drug-related problems. Population-based longitudinal studies are needed to investigate tramadol use and the possible role of tramadol as a gateway drug in the development of substance abuse in Egypt.
authors: Department of Psychiatry, Faculty of Medicine, Zagazig University , Egypt.
authors: Medhat M
authors: MM
authors: Bassiony
authors: Ghada M
authors: GM
authors: Salah El-Deen
authors: Usama
authors: U
authors: Yousef
authors: Yasser
authors: Y
authors: Raya
authors: Mohamed M
authors: MM
authors: Abdel-Ghani
authors: Hayam
authors: H
authors: El-Gohari
authors: Samar A
authors: SA
authors: Atwa
mesh_terms: D000293:Adolescent; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D015995:Prevalence; D014147:Tramadol
chemical_list: D014147:Tramadol
keywords: Adolescent; Egypt; tramadol abuse; tramadol use