Tramadol versus Tapentadol for Short-term Detoxification in Patients with Opioid Use Disorders: A Retrospective Observational Study in Outpatient Settings

Introduction: Tramadol has shown promise in managing opioid abuse and offers a good alternative to usual opioid detoxification strategies. Tapentadol, a novel opioid analgesic with more potency than Tramadol, is indicated for use in chronic pain. Due to a similar mechanism of action to Tramadol, Tapentadol has been employed as an off-label agent to overcome opioid withdrawal. This retrospective study aimed to compare the effectiveness of Tramadol and Tapentadol in detoxifying patients with opioid use disorder (OUD) who cannot undergo Buprenorphine detoxification for various reasons. Methodology: A retrospective analysis was conducted on outpatient records of 200 OUD patients who underwent detoxification using either Tramadol or Tapentadol. Socio- demographic and clinical information were gathered using a standardized form. Outcomes were assessed at 4 weeks, and compared using chi-square and t-test. Results: The study included participants with an average age of 28 years, predominantly with a history of Heroin use (90%), mainly through the intravenous (IV) route (51.4%) or chasing method (48.1%), with an average heroin usage of 1000 mg. Tramadol tablets were administered to 58.3% of participants, while Tapentadol tablets were given to 41.2%, with a median dose of 300 mg. At the end of 4 weeks, dropout rates were 72.6% for Tramadol and 82.1% for Tapentadol, while maintenance rates were 16.3% and 14.2%, respectively. Statistical analysis showed no significant difference in outcomes between the two groups. Conclusion: The study found no significant difference in the detoxification outcomes between Tramadol and Tapentadol in OUD patients.