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Medicolegal Aspects Concerning Tramadol Abuse. The New Middle East Youth Plague: An Egyptian Overview 2010

Abstract

Marwa M Fawzi

An increasingly alarming phenomenon of tramadol drug abuse has been demonstrated in the Egyptian community in the last four years. Although the issue of drug abuse is not a newcomer to the Egyptian society, tramadol has been associated with a wide range of drug abuse and its illegal drug transactions had made it easily accessible and readily provided at cheap costs despite of its being a scheduled drug. The alleged usages of tramadol had also contributed greatly to its popularity and massive use especially among Egyptian youth as a remedy for premature ejaculatory function and for extended orgasm and increase sexual pleasure as promoted through many online drug stores and media. Aim of the work: To study the impact of tramadol increasing rates of drug abuse on the observed association with forms of aggression and accidents. Patients and methods: This study was carried out on the patients who presented to Poison Control Center of Ain Shams University Hospitals, Egypt in the year 2010 presented with trauma with suspected associated drug toxicity for toxicological assessment. RESULTS: Number of studied cases was 640 with the adult population showing a higher prevalence (67.9%). The prevalence was higher in males (77.2%). Abuse form of drug intake was the highest (50.8%). The oral route of intake is the highest (96.8%). Patients abusing tramadol presented with any clinical finding denoting involvement in an act of violence or giving history of it (36.3%), forms of accidents whether road traffic accidents (18.7%), acts of violence as fights and domestic violence (33%) and accidental fall and unintentional self-induced injuries (48.3%).The most frequent forms of injuries were cerebral edema (55.9%) and the least being inter cerebral hemorrhage (5%) both diagnosed both clinically and as a CAT SCAN brain finding. Whilst as forms of injuries were lacerated wounds (38.9%), contusions (35.3%), abrasions (31.3%), cerebral concussion (22%), and bone fracture (17.8%), and polytrauma (11%). Conclusions: The significantly notable increasing violence forms are closely related to drug abuse. Tramadol's prevalence is the mostly noted due to its wider availability and cheaper prices than other types of abused drugs. Recommendations: Drug screening for tramadol should be added to all forms of basic toxicological screening. Especially in cases of patients involved in violent crimes and road traffic accidents, also for those applying for drivers' license fitness program. Keywords: Abuse-Tramadol-Egypt-Youth-Violence.