Nonmedical use of tramadol among secondary school students in Benin, Africa

Bio-Sya, Assad; Gandjo, Henri Joël; Klikpo, E; Kouglenou, Odile; Agbanlinsou, Arnaud; Damien, Georgia; Allabi, Aurel Constant

doi:10.1080/00952990.2021.1955897

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…Physical and psychological reasons are factors related to a person’s bodily function or psychological health. They refer to physical and psychological reasons, such as relief of pain, reducing stress, euphoria, protection against the cold, treatment for analgesic activities, combat fatigue, tiredness, staying awake, feeling more potent than usual, alleviating fear, pleasure-seeking and habits, prevention of withdrawal symptoms, craving or compulsive urges, mood improvement and increasing sexual performance (premature ejaculation/erectile dysfunction), and a sense of well-being [ 17 , 18 , 39 , 43 , 44 , 46 , 49 , 55 , 63 , 72 , 81 , 89 ]. Social reasons are factors related to a person’s social environment, including relationships, peer influences/pressure, influence of friends or partners, experimentation, novelty-seeking behaviour, and attempts to escape from troubles or stress in one’s social environment [ 39 , 43 , 60 , 81 , 109 ].…”

Section: Resultsmentioning

confidence: 99%

“…Economic reasons relate to a person’s financial situation or work life. They involve the need or desire to improve one’s economic status, maintain or increase productivity at work, assist in continuing work, performance enhancement, have more motivation, or address other work-related issues [ 18 , 39 , 42 , 46 , 49 , 89 , 109 ]. They also include situations where someone takes tramadol because it is more affordable or accessible than other options.…”

Section: Resultsmentioning

confidence: 99%

“…Lack of parental control, familial tension, and having a friend or family member who uses drugs are additional risk factors [ 46 , 49 ]; 3) substance use and a history of abuse increase the risk of NMU of tramadol. Those who smoke or have a history of substance misuse are especially vulnerable, with a five times greater likelihood of misuse [ 39 , 79 , 89 , 111 ]; 4) psychological factors, such as adverse childhood experiences, sociosexual behaviours and desires, and posttraumatic addiction, have been linked with NMU of tramadol [ 102 ].…”

Section: Resultsmentioning

confidence: 99%

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Prevalence and health consequences of nonmedical use of tramadol in Africa: A systematic scoping review

Boun,

Omonaiye,

Yaya

2024

PLOS Glob Public Health

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Tramadol is a widely prescribed painkiller around the world. As a synthetic opioid, it offers a valuable substitute for morphine and its derivatives in African countries. However, the adverse health effects of tramadol use resulting from illicit trafficking, like those caused by fentanyl and methadone in North America, have not been well-documented in Africa. This scoping review aims to shed light on the nature and scope of the nonmedical use (NMU) of tramadol in Africa and its associated health consequences. To carry out our scoping review, we used Arksey and O’Malley’s (2005) five-step approach for exploratory analysis and followed Joanna Briggs Institute guidelines for scoping reviews to ensure systematic and replicable studies. We then searched six databases: Medline, Global Health (EBSCO), Scopus, Web of Science, the African Journals online database, and for grey literature via Google Scholar without any time restriction. The articles were imported into Covidence and reviewed by two independent researchers. Eighty-three studies on NMU of tramadol’s prevalence or health consequences were selected from 532 titles/abstracts screened, including 60 cross-sectional and six qualitative studies from 10 African countries. Findings from the included studies highlighted five distinct groups significantly affected by the NMU of tramadol. These groups include: 1) young adults/active populations with varying degrees of prevalence ranging from 1.9% to 77.04%, 2) professionals, where drivers exhibit a relatively high prevalence of tramadol NMU, ranging from 7.2% to 35.1%, and commercial motorcyclists, with a prevalence of 76%, 3) patients, who have a high rate of tramadol NMUs, with prevalence rates ranging from 77.1% to 92%, 4) academics, with a considerable rate of tramadol misuse among substance-using undergraduates (74.2%) and substance-using high school students (83.3%), and 5) other individuals impacted in various ways. The health consequences are classified into four distinct types: intoxication, dependence syndrome, withdrawal syndrome and other symptoms. Despite providing a comprehensive global overview of the phenomenon described in the African literature, this systematic scoping review’s main limitations stem from the relatively limited exploration of various consequences of the NMU of tramadol, notably those of a social and economic nature. Our review shows that tramadol misuse affects diverse populations in Africa. The prevalence of misuse varies within sub-populations, indicating the complexity of the issue. Professional and academic groups have different rates of misuse across regions. This highlights the need for targeted interventions to address unique challenges contributing to tramadol misuse. Future studies should focus on the social and economic costs of abuse on households to better understand the impact on well-being. Systematic review registration: Open Science Framework: https://osf.io/ykt25/.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Prevalence and health consequences of nonmedical use of tramadol in Africa: A systematic scoping review

Boun,

Omonaiye,

Yaya

2024

PLOS Glob Public Health

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“…Of the total articles, 24 studies were from western sub‐Saharan Africa [5, 32–53], 15 studies were from southern sub‐Saharan Africa [54–68] and 12 studies were from eastern sub‐Saharan Africa [6, 69–79]. Two studies were conducted in multiple regions [11, 80] (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Cannabis use in sub‐Saharan Africa: A systematic review and meta‐analysis

et al. 2023

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Background and Aims: The most available data on the prevalence of cannabis use come from population surveys conducted in high-income countries in North America, Oceania and Europe. Less is known about the prevalence of cannabis use in Africa. This systematic review aimed to summarize general population-level cannabis use in sub-Saharan Africa since 2010.Methods: A comprehensive search was conducted in PubMed, EMBASE, PsycINFO and AJOL databases in addition to Global Health Data Exchange and grey literature without language restriction. Search terms related to 'substance', 'Substance-Related Disorders' and 'Prevalence' and 'Africa South of the Sahara' were used. Studies that reported cannabis use in the general population were selected, while studies from clinical populations and high-risk groups were excluded. Prevalence data on cannabis use in the general population of adolescents (10-17 years) and adults (≥ 18 years) in sub-Saharan Africa were extracted. Results:The study included 53 studies for the quantitative meta-analysis and included 13 239 participants. Among adolescents, the life-time, 12-month and 6-month prevalence of cannabis use were 7.9% [95% confidence interval (CI) = 5.4-10.9%], 5.2% (95% CI = 1.7-10.3%) and 4.5% (95% CI = 3.3-5.8%), respectively. The corresponding lifetime, 12-month and 6-month prevalence of cannabis use among adults were 12.6% (95% CI = 6.1-21.2%), 2.2% (95% CI = 1.7-2.7%, with data only available from Tanzania and Uganda) and 4.7% (95% CI = 3.3-6.4%), respectively. The male-to-female life-time cannabis use relative risk was 1.90 (95% CI = 1.25-2.98) among adolescents and 1.67

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“…Tramadol is a synthetic opioid widely used as an analgesic for alleviating moderate to medium-intensity pain, whose potency is estimated to be around one-tenth that of morphine and is considered relatively safe for dependency. There has been a growing concern of widespread non-medical consumption of tramadol in West Africa (Alhassan, 2022; Bio-Sya et al , 2021; Dumbili et al , 2021; Fusieni et al , 2019; Nelson and Alichie, 2022; Peprah et al , 2020). For example, a cross-sectional survey among young people in Ghana found that over half of the respondents had used tramadol for non-medical purposes.…”

Section: Introductionmentioning

confidence: 99%

Tramadol control measures and supply for health-care services: findings from Ghana and other West African countries

Ane

2023

DHS

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Purpose This paper aims to explore the role of tramadol in pain management and the impact of regulatory measures on supply and medical access in Ghana and other African countries. Design/methodology/approach The study adopted an exploratory design and qualitative methods to explore the perspectives of different actors, including officials of regulatory agencies, law enforcement agents, health-care providers and non-medical tramadol users. Data were collected through individual and group interviews, and transcripts were subjected to thematic analysis. Findings Findings show that tramadol fills a critical gap in treating pain across Ghana in areas with an acute shortage of opioid analgesics due to scheduling-related barriers. This was partly due to porous borders allowing for an influx of tramadol into the countries. The study further found that most tramadol purchases in Ghana and other West African countries were made from market traders rather than from health-care settings and were mainly generic medicines categorised as “substandard/spurious/falsely-labelled/falsified/counterfeit medical products” within the World Health Organization standards. Research limitations/implications Although the findings are instructive, there were some limitations worth noting. The study encountered several limitations, especially with the non-medical users, because the environment is highly criminalised, People who use drugs were unwilling to avail themselves for fear of law enforcement officers’ harassment. Obtaining ethical clearance had its own bureaucracy – challenges that delayed the study time frame. Practical implications Placing tramadol under the list of internationally controlled substances would create barriers to access to effective pain medications, particularly by the poor, and encourage victimisation of users by law enforcement authorities. Originality/value The study is based on empirical research on tramadol use and regulation in African countries, contributing to knowledge in an under-researched subject area on the continent. The comparative approach further adds value to the research.

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Nonmedical use of tramadol among secondary school students in Benin, Africa

Cited by 7 publications

References 16 publications

Prevalence and health consequences of nonmedical use of tramadol in Africa: A systematic scoping review

Prevalence and health consequences of nonmedical use of tramadol in Africa: A systematic scoping review

Cannabis use in sub‐Saharan Africa: A systematic review and meta‐analysis

Tramadol control measures and supply for health-care services: findings from Ghana and other West African countries

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