In Patients Undergoing Treatment for Opioid Addiction, is Tramadol more Effective than Buprenorphine in Maintaining Patient Comfort during the First 3 to 5 Days after Last Opioid Exposure? A Systematic Review

Opioid use disorder has emerged as a global healthcare crisis.  Buprenorphine is has become the standard treatment.  Unfortunately, buprenorphine has a relatively high failure rate, as well as a lengthy course of treatment.  Several other medications have been studied to either augment or replace buprenorphine in the treatment of opioid use disorder.  Due to limited available research on the use of tramadol in managing opiate withdrawal, researchers included randomized double-blind studies, randomized open-label studies, and retrospective cohort studies in this review.  A total of six studies met the criteria set for inclusion in this study. A total of 462 participants were included in the six studies. The participants in the studies met the DSM-5 criteria for opiate use disorder or the ICD 10-DCR criteria for opiate use disorder.The findings of this systematic review are inconclusive. Five of the six studies indicate that tramadol does show some effectiveness in managing mild opiate withdrawal symptoms but is less effective than buprenorphine in managing more acute, severe symptoms.  Due to the limited amount of information and research available regarding the use of tramadol for opiate withdrawal symptom management, the researchers for this systematic review cannot definitively report tramadol is more effective than buprenorphine. The researchers believe further research into the efficacy of tramadol use in opiate withdrawal is indicated.