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Tramadol deaths soar as overall drug deaths fall

The number of deaths involving prescription painkiller tramadol in England and Wales has more than doubled in four years, as the overall number of people dying from drug poisoning dropped 11 per cent

The number of deaths involving prescription painkiller tramadol in England and Wales has more than doubled in four years, as the overall number of people dying from drug poisoning dropped 11 per cent.

Deaths involving tramadol rose from 83 in 2008 to 175 in 2012, according to figures released by the Office for National Statistics (ONS) on Wednesday (August 28). 

The ONS said the rise could be linked to a 35 per cent increase in prescriptions for tramadol over the past five years and the Home Office is consulting on whether the painkiller should be reclassified as a class C drug to deter its use.

Overall drug deaths have fallen, despite spike in tramadol-related poisoning

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Tramadol faces reclassification after surge in deaths

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Deaths involving both legal and illegal drugs in England and Wales fell last year to 2,597, compared with 2,928 in 2008.

Deaths involving methadone, heroine and morphine and other opiates, including codeine, fell between 2008 and 2012. Last year 182 people died after taking paracetamol compared with 260 in 2008.  

However, the number of deaths from antidepressants has rocketed 22 per cent since 2008 to 468 last year. 

Tricyclic antidepressants (TCAs) were involved in more deaths than any other type of antidepressant. However, deaths caused by TCAs fell 53 per cent, from 497 in 1998 to 233 last year.

Most deaths were among men - although numbers fell 18 per between 2008 and 2012. The number of women dying from drug poisoning rose to 891 in 2012.

Accidental poisonings accounted for most deaths, although just under half of female drug-poisoning deaths were suicide, the ONS said.

The surge in deaths involving tramadol prompted the Advisory Council on the Misuse of Drugs to call in February for it to be placed under tighter control.

The Home Office has suggested that by reclassifying the drug it would still be available on prescription for patients who need it, but would mean access "will be appropriately restricted." The consultation ends on October 11.

What adivice do you offer to prevent overdose or poisoning?

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I've dispensed prescriptions for 224 tramadol and sometimes 224 x 2 to cover holidays..

C W, Dispensing assistant

Any theories on why the death count is so high?

Inappropriate prescribing? Poor patient counselling by the prescriber/pharmacist?

If a considerable amount of deaths were suicide related, then it would make sense to reduce the quantity supplied. I was told that one reason behind restricting sales of paracetamol was due to a fall in paracetamol related suicides after restricting sales.

A K, Community pharmacist

A bit too sensationalist headline for my liking to be honest. Yes, 175 deaths are quite a few, but by comparison to other figures it is not as much. And in my opinion, majority of those deaths will be illigally obtained supply.

In so far the reclassification of tramadol to high schedul CD, that is completely uncalled for. If it is required to be kept under lock in the safe, most pharmacies will have to invest into big CD cabinets as the supply of tramadol kept in many a pharmacy is massive. I would urge all pharmacists to answer the consulation. It is completely not practical to store tramadol in CD cabinets or have it on 28 day prescription limit.

In my opinion what would go a far way is if GPs start thinking a bit more before dishing tramadol in hundreds to each patient a few times a month. Maybe some strict guideline would do. Tramadol is a very good tool for fighting the pain and limiting access to patients who use it correctly will not help anybody.

Gareth Rowe, Community pharmacist

Agree with this. It would be a logistical nightmare and if handwriting requirements were brought in for tramadol too it would be another burden on pharmacists to have to monitor and get incorrect scripts sorted out. If it becomes that much of a problem maybe they could be prescribed weekly to limit the amount kept at home.

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