Background/purpose Tramadol abuse has become a crisis in Egypt and many other Middle Eastern countries Tramadol abuse is associated with sexual dysfunction and male infertility, according to recent animal and human studies The objective of this study was to compare tramadol abuse patients and healthy controls regarding free testosterone and prolactin levels and semen analysis Methods Sixty patients with opiate use disorders attributed to tramadol (OUD-T) based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnostic criteria and 30 healthy controls were included in the study Sociodemographic and clinical data and urine, blood, and semen samples were collected from patients and controls for assessment Results Compared with controls, OUD-T patients had higher prolactin and lower free testosterone levels Patients with OUD-T were more likely to have lower sperm count and higher abnormal motility and forms of sperms compared with controls Conclusions Patients with OUD-T were found to be more likely to have lower free testosterone levels and lower sperm counts and vitality, and higher prolactin levels and sperm abnormal forms compared with controls

Free Testosterone and Prolactin Levels and Sperm Morphology and Function Among Male Patients With Tramadol Abuse: A Case-Control Study.

Background and objectives Many studies investigated the association between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) but none focused on the association between ADHD and nonmedical prescription opioids such as tramadol. The objective of this study was to assess the prevalence, correlates, and consequences of co-occurrence of ADHD and tramadol use among adults. Methods This study included 122 Egyptian adults with opioid use disorders attributed to tramadol (N = 122). Participants were recruited from the psychiatric outpatient clinic and inpatient unit of Zagazig University Hospital, Egypt. ADHD and SUDs were assessed by using the Adult ADHD Self-Report Scale (ASRS-v 1.1) and SCID-I criteria of DSM-5, respectively. All participants were screened for drugs by urinalysis. Results Forty percent of the participants used tramadol alone, whereas the remaining used it with other substances, such as alcohol (51.6%) and cannabis (48.4%). Thirty-eight cases (31%) had adult ADHD and most of them had inattentive or mixed types. Adults with tramadol use and ADHD were more likely to have a younger age of onset of tramadol use, use a higher dose of tramadol, and use it for a longer duration than those with tramadol use without ADHD. Conclusions and discussion ADHD in adults with tramadol use is common and is associated with early-onset, high dose, and long duration of tramadol use. Scientific significance This is the first study to investigate the co-occurrence of ADHD and tramadol misuse among adults.

Prevalence, correlates, and consequences of attention-deficit/hyperactivity disorder in a clinical sample of adults with tramadol use in Egypt

The purpose of this study was to estimate the prevalence of psychiatric and personality disorders among industrial workers with substance use disorders and to investigate the association between this comorbidity and drug-related problems. A total of 353 industrial workers were included in the study. Sociodemographic and clinical data were collected from participants. Compared to controls, workers with substance use disorders were about 19 and 8 times more likely to have psychiatric and personality disorders, respectively. Anxiety (35.4%) and mood disorders (29.2%) were the most common psychiatric disorders among substance use workers. The most common personality disorders among substance use workers included antisocial and borderline (24.6% and 16.9%, respectively). There was a significant association between drug-related problems/dependence and psychiatric (χ2 = 14.04; p < 0.001) and personality disorders (χ2 = 18.74; p < 0.001). Psychiatric and personality disorders are common among substance use workers and are associated with drug-related problems.

Association Between Dual Diagnosis and Drug-Related Problems in Workplace in Egypt: A Case-Control Study

Background: Evidence for the association between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) is common. However, little research has investigated this relationship among adolescents using nonmedical prescription opioids, particularly tramadol.Objective: To estimate the prevalence and correlates of ADHD among adolescents with tramadol misuse and without conduct disorder (CD).Methods: This study included 122 Egyptian adolescents (100% male) with opioid use disorders attributed to tramadol. The diagnosis of SUDs, ADHD, and CD (to exclude) was based on the SCID-I criteria of the DSM-IV-TR. Drug-related problems were assessed using the Drug Use Disorders Identification Test (DUDIT). All adolescents were screened for drugs by urinalysis.Results: Thirty-eight percent of adolescents with tramadol misuse had ADHD. Adolescents with tramadol misuse and ADHD were more likely to have a younger age of onset of smoking, substance use, and tramadol misuse than adolescents without ADHD.Conclusions: ADHD is common among adolescents with tramadol misuse. There is an association between ADHD and young age of onset of tramadol misuse and drug-related problems.

Current attention-deficit/hyperactivity disorder and nonmedical prescription opioid use attributed to tramadol among male adolescents without conduct disorder in Egypt.

Tramadol and venlafaxine share similar pharmacological characteristics that may allow for overlapping therapeutic indications for them. The objective of this study was to compare the efficacy of venlafaxine and naltrexone in the treatment of tramadol abuse. This comparative trial included 95 patients with tramadol abuse who were detoxified for 2 weeks. Twenty-eight participants underwent the maintenance phase, while the remaining participants (n = 67) dropped out. The patients were randomized to use 50 mg/day of naltrexone or 225 mg/day of venlafaxine for 8 weeks. All participants were interviewed using SCID-I (DSM-IV-TR) criteria for diagnosing substance use and other psychiatric disorders. The proportion of relapsed patients was comparable between the naltrexone and venlafaxine groups (29.4% vs. 30.4%, P = 0.9). However, participants in the venlafaxine group stayed in treatment longer than participants in the naltrexone group, and the difference was significant (22.9 ± 7.89 days vs. 16.9 ± 3.4 days, P = 0.01). Only psychiatric comorbidity was found to be significantly associated with retention in treatment (80% vs. 22%, P = 0.005). Venlafaxine is as effective as naltrexone in preventing relapse in patients with tramadol abuse. Venlafaxine was more effective than naltrexone in treatment retention.

A comparative study of the efficacy of venlafaxine and naltrexone for relapse prevention in patients with opioid use disorder attributed to tramadol.

Background and Objective: Substance abuse in the workplace is a major public health problem. The objectives of this study are to: (1) to determine the prevalence and associated risk factors of substance abuse, drug-related problems, and drug dependence among industrial workers; (2) to identify patients' views of the pros and cons of their drug use and their treatment readiness; and (3) to assess the severity of substance abuse according to the Addiction Severity Index (ASI) scale in substance users. Subjects and Methods: A total of 353 industrial workers from 5 factories in 10th of Ramadan city in Egypt were included in the study. The participants were interviewed to collect sociodemographic and clinical data using the Structural Clinical Interview for DSM-IV-Axis I (SCID-I), the Drug Use Disorder Identification Test (DUDIT), DUDIT-Extended version and the Addiction Severity Index (ASI). The participants were screened for drug abuse by urine analysis. Results: The prevalence rates of smoking and substance abuse were 27.6% and 18.3%, respectively. The most commonly abused drugs were tramadol (66.2%), cannabis (55.4%), and alcohol (38.5%). Compared with controls, smokers and substance users were more likely to be males and were older. Smokers were 7 times more likely to use substances. Substance dependence was associated with a younger age of substance use onset and alcohol abuse. Conclusions: Smoking and substance abuse are common among industrial workers. Tramadol and cannabis are the most commonly abused substances. Smoking, older age, and male sex are correlates of substance abuse. Alcohol abuse is associated with dependence.

Substance Use Disorders Among Industry Workers in Egypt

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Substance Use Disorders Among Industry Workers in Egypt