Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: We would like to raise some
issues regarding the Research Letter on tramadol abuse and dependence among
physicians by Dr Skipper and colleagues.1 First,
the authors refer to hundreds of spontaneous tramadol-related reports to MEDWATCH, and Brinker et al2 note
that reports of tramadol abuse continue after one would expect a decline in
reporting. However, the independent steering committee (ISC) monitoring tramadol
is involved in active case finding, without which the reports would have declined.
In the most recent period (2002-2004), data from the ISC master database,
which is composed of all abuse- or dependence-related reports to the company
plus those obtained through case finding, indicate a total of 216 reported
cases of abuse or dependence. Of these, 146 (67%) were generated by the ISC.
In 2004, only 5 of 28 cases were spontaneous reports.
Adams EH, Dart RC, Knisely JS, Schnoll SH. Tramadol Abuse and Dependence Among Physicians. JAMA. 2005;293(16):1977-1978. doi:10.1001/jama.293.16.1977-a