Thinking of you, Lizz Bowker

https://edsinfo.wordpress.com/2015/06/04/tramadol-causes-spike-in-emergency-room-visits/#comment-3592

http://www.dailymail.co.uk/health/article-2305936/Tramadol-When-safe-option-painkiller-turns-lethal.html

Lizz, 57, a mother of three, died from an accidental overdose of the opioid painkiller tramadol, which she’d been taking for the previous year for back pain and leg ulcers.  She had taken just two more tablets than her usual daily dose of eight 50mg tablets. ‘She’d been sorting out her weekly pill box and I think she just got confused and took two doses,’ says John, who was married to Lizz for 38 years.

Tragically, her death is by no means an isolated case and highlights the dangers associated with a drug too often regarded as the ‘safer’ option.  Tramadol is an increasingly commonly prescribed painkiller — prescriptions have almost doubled in the past seven years, from 5.9 million in 2006 to 11.1 million in September 2012. Its popularity has soared partly because it’s cheap — now available as a non-branded generic drug, it costs the NHS £1.99 for 100 tablets.

Fears about other painkillers have also made tramadol an attractive option…

Tramadol is regarded by many doctors as a weaker opioid. But in fact it has the same risks of overdose as with morphine…

This dual action makes interactions with other drugs more likely — the risk is if the patient is taking medications or other substances with a sedative effect on the central nervous system, because this can affect breathing and, in some cases, lead to death. So tramadol should not strictly be used if you’re taking sleeping tablets, tranquilisers, and antidepressants, other painkillers that act on the brain, or are under the influence of alcohol.

But despite these well-known interactions, some patients end up being prescribed tramadol as well as sleeping pills and antidepressants, as often pain, mood and sleep problems go together. Deaths from tramadol overdose have soared from just one in 1996 to 154 in 2011. More than 500 people died from tramadol overdoses between 2006 and 2011…

‘Although there’s evidence to show tramadol works well in the short term for conditions such as post-operative pain, the evidence for long- term benefit is disappointing.’ …