The opioid tramadol is not regulated like almost every other opioid. Now addiction is spreading through the developing world.
The man-made opioid tramadol was touted as able to relieve pain with little risk of abuse. Unlike other opioids, it was unburdened by international controls. But now countries are asking international authorities to intervene.
“This is a huge public health dilemma,” said Dr. Gilles Forte, the secretary of the World Health Organization’s committee that recommends how drugs should be regulated. Tramadol is available in war zones and impoverished nations because it is unregulated. But it is widely abused for the same exact reason. “It’s a really very complicated balance to strike.”
Tramadol is so pervasive in Cameroon scientists a few years ago believed they’d discovered a natural version in tree roots. But it was not natural at all: Farmers bought pills and fed them to their cattle to ward off the effects of debilitating heat. Their waste contaminated the soil, and the chemical seeped into the trees.
“We know that opioids are some of the most addictive drugs on the face of the planet, so the claim that you’ve developed one that’s not addictive, that’s an extraordinary claim, and extraordinary claims require evidence. And it just wasn’t there,” said Jorgensen. “We’ve all been cheated, and people are angry about that.”
Tramadol’s exemption means authorization isn’t required as the drug moves across borders. Its easy availability also leads to confusion about what tramadol even is, experts say. In many countries, it is thought to be a mood enhancer or treatment for depression and post-traumatic stress. Some take it to improve sexual stamina or endure grueling labor.
The WHO is analyzing whether any other drug could take its place but have so far found none. Meanwhile, Forte said, the agency is working with battered nations to ferret out counterfeits. The company has campaigned to keep tramadol unregulated. It funded surveys that found regulation would impede pain treatment and paid consultants to travel to the WHO to make their case that it’s safer that other opioids.
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