Impact of the Raqeeb narcotic controlling system on tramadol prescriptions in surgical patients: A pre-post implementation study

Background: Tramadol hydrochloride, a Schedule III opioid, is the primary take-home narcotic for postoperative pain in Saudi Arabia, with a misuse prevalence of 11.4%-20%. On February 1, 2024, the Saudi Food and Drug Authority implemented the Raqeeb electronic monitoring system for real-time prescription tracking to curb abuse while maintaining legitimate access. Objectives: To evaluate Raqeeb's impact on tramadol prescribing in surgical patients and compare outcomes with international prescription drug monitoring programs (PDMPs). Methods: -tests and chi-square tests. Results: = 0.012). Repeat prescriptions remained stable (33% vs. 29%). Conclusion: Raqeeb achieved a 43% reduction in tramadol prescriptions among surgical patients-exceeding typical PDMP postoperative reductions (5%-30%)-with a shift toward older patients and chronic indications, without apparent barriers to legitimate access.