Tramadol Prescription over a 4-Year Period in the USA

  • Luisa M. BigalEmail author
  • Kristen Bibeau
  • Stephanie Dunbar
Hot Topics in Pain and Headache (N Rosen, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hot Topics in Pain and Headache


Purpose of Review

Deaths associated to tramadol, a synthetic opioid, are rising globally. Herein, we characterize prescription patterns of tramadol relative to other opioids in the USA from 2012 to 2015, by geographic region and physician specialty.

Recent Findings

Data on opioid was obtained using Truven Health Analytics MarketScan for the years 2012–2015. Inclusion criteria included subjects living in the USA with ages from 12 to 64 years. Patterns of prescription of tramadol were contrasted with other prescription opioids including hydrocodone, codeine, oxycodone, oxymorphone, methadone, and fentanyl. Between 2012 and 2015, prescriptions for tramadol increased by 22.8%. The absolute rate of prescription varies considerably per region, with tramadol representing nearly 20% of opioid prescriptions in the South, which, in turn, represents nearly 50% of all prescriptions in the USA. Significant differences were seen when comparing prescribers of tramadol with other opioids (p < 0.0001). Tramadol was more frequently prescribed by family practice (40% vs. 32%) and internal medicine physicians (19% vs. 16%). Family medicine, internal medicine, and non-physician prescribers responded by 67.2% of all tramadol prescriptions in 2015. The proportion of patients receiving tramadol from non-physician prescribers increased by 56% between 2012 and 2015 (p < 0.001) IOM.


Tramadol prescriptions rates have continuously increased both nationally and throughout all US regions. Important differences exist among regions and physician specialties. These results may be helpful in the creation of regional policies to monitor reasons for this increase and to avoid excessive use of tramadol.


Tramadol Opioids Prescription rates Prescription patterns 


Compliance with Ethical Standards

Conflict of Interest

Luisa M. Bigal conducted this study as part of a paid internship at Teva Pharmaceuticals. Kristen Bibeau is a full-time employee at Incyte Corporation and was a full-time employee at Teva at the time of data collection. Stephanie Dunbar is a full-time employee at Teva.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Luisa M. Bigal
    • 1
    Email author
  • Kristen Bibeau
    • 2
  • Stephanie Dunbar
    • 3
  1. 1.Global Health and International Comparative GovernmentDuke UniversityDurhamUSA
  2. 2.Global Health Outcomes and Real-World Evidence GenerationIncyte PharmaWilmingtonUSA
  3. 3.Biometrics and Data SciencesTeva PharmaceuticalsNorth WalesUSA

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