Tramadol painkiller could be banned from public sale, say ministers

Public consultation launched on making tramadol a class C drug after links to deaths and growing concerns around its misuse

Home Office ministers are proposing to ban from public sale a widely used prescription painkiller, tramadol, that has been linked to 154 deaths in 2011 through its non-medical use.

Tramadol, which is a synthetic opioid similar to codeine, is used in the treatment of moderate to severe pain, and is available online and easily obtainable without a prescription.

The Home Office crime prevention minister, Jeremy Browne, said he was launching a public consultation on making tramadol a class C drug following evidence of growing concerns around its misuse and harms from the Advisory Council on the Misuse of Drugs (ACMD) – an expert group that makes recommendations to ministers on drug classification.

The medical use of tramadol has nearly doubled over the past eight years and more than 11m doses of the drug are prescribed every day in England. Ministers intend to list it in schedule III of the misuse of drugs regulations 2001 to emphasise that the drug will remain legally available to prescribers.

The ACMD report to ministers said the symptoms of a tramadol overdose include rapid heart beat, high blood pressure, vomiting and seizures. Side-effects can include hallucinations, agitation, fever, overactive reflexes, nausea, vomiting, loss of co-ordination and a raised heart rate.

The official drug advisers also said tramadol had been mentioned in 154 death certificates in 2011. Figures from the national programme of substance abuse deaths show that the drug was implicated as the "sole agent" in 23 deaths in 2010 and a further 109 where it was mentioned on the death certificate.

The 2011 Street Drug Trends survey also identified a rise in tramadol use in 16 out of the 20 areas across Britain that it investigated.

Browne said: "While tramadol will continue to be available under prescription for those that need it, placing it in a schedule will mean access to the drug will be appropriately restricted."

The move to ban the public sale of tramadol comes as drug charities highlighted the number of suspected ecstasy-related deaths in Britain recently.

Seven deaths in Scotland have been linked to a batch of fake ecstasy pills, as have a further five across Greater Manchester, Merseyside and Derbyshire.

DrugScope, the drugs information charity, said the common factor appeared to be the presence of an ecstasy-like drug, PMA, in the tablets.

The charity said it was rare to have so many drug-related deaths in such clusters. "It has been suggested that tighter controls on the key chemical used to make ecstasy have prompted underground chemists to switch to legal chemicals used to make PMA. But such controls have been in place for many years while ecstasy pills containing PMA are nothing new. And where batches of extra-strong drugs have caused deaths and hospital admissions, this usually takes place in a very localised area for a short period of time," said the charity.

Martin Barnes, chief executive of DrugScope said: "With the festival season under way, those who are using ecstasy need to be extra vigilant. There is no way of knowing whether or not a pill contains PMA - the safest option is not to use a drug at all.

"Apart from not taking the risk in the first place, the most sensible advice is not to take repeat doses in the belief that the pills aren't working. PMA takes longer to have an effect than ecstasy, but the outcome can be far more serious.

"Additionally, don't get overheated; keep hydrated with sips of water – no more than a pint an hour, don't mix with other drugs especially alcohol and get help immediately if you start to feel unwell."


Alan Travis, home affairs editor

The GuardianTramp

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