A claims analysis of the utilization of tramadol for acute pain in patients prescribed buprenorphine/naloxone for opioid use disorder

J Opioid Manag. 2018 Nov/Dec;14(6):407-413. doi: 10.5055/jom.2018.0473.

Abstract

Objective: To determine the prevalence of tramadol prescribing among commercially insured adults receiving medication-assisted therapy (MAT) with buprenorphine/naloxone.

Design: The authors conducted a cross-sectional descriptive study to evaluate the use of tramadol among patients prescribed buprenorphine/suboxone for MAT.

Setting: This study utilized data from 2010 to 2013 Optum® Clinformatics® Data Mart. This cohort is an administrative health claims database from a large national insurer. These data included pharmacy and medical care utilization and information describing patient enrollment.

Patients/participants: Patients were 12-64 years of age and had complete and available medical, pharmacy, and administrative records in the Optum Clinformatics Data Mart during the study period.

Main outcome measures: Patients who received at least one paid claim for buprenorphine/naloxone from 2010 to 2013 and also received at least one overlapping pharmacy dispensing for tramadol were identified for analysis. The authors determined if the concurrent buprenorphine/naloxone and tramadol dispensings were from the same or a different prescriber.

Results: In this analysis of 18,734 US commercially insured patients receiving MAT with buprenorphine/naloxone, the authors identified 1,198 (6.4 percent) patients who received at least one overlapping dispensing for tramadol during a 4-year period spanning 2010-2013. Among these patients, 266 (1.42 percent) were co-prescribed buprenorphine/naloxone and tramadol from the same provider.

Conclusions: These results suggest that the use of tramadol among patients receiving buprenorphine/naloxone is not uncommon. Further study is warranted to further determine the benefits and risks associated with the use of tramadol for pain management among patients prescribed buprenorphine/naloxone.

MeSH terms

  • Acute Pain* / drug therapy
  • Adolescent
  • Adult
  • Analgesics, Opioid
  • Buprenorphine
  • Buprenorphine, Naloxone Drug Combination / administration & dosage*
  • Buprenorphine, Naloxone Drug Combination / adverse effects
  • Child
  • Cross-Sectional Studies
  • Drug Utilization*
  • Female
  • Humans
  • Insurance Claim Review*
  • Male
  • Middle Aged
  • Naloxone
  • Opioid-Related Disorders* / prevention & control
  • Tramadol* / adverse effects
  • Tramadol* / supply & distribution
  • Tramadol* / therapeutic use
  • Young Adult

Substances

  • Analgesics, Opioid
  • Buprenorphine, Naloxone Drug Combination
  • Naloxone
  • Tramadol
  • Buprenorphine