Evaluation of abuse and dependence in addiction monitoring systems: tramadol as an example

The objective of this paper is to present an evaluation of the potential for abuse of and dependence on a drug from the data obtained from the different pharmacoepidemiological tools used by the French network for evaluation and information on pharmacodependence and addiction monitoring taking the example of tramadol. Comparison of the data from spontaneous reports with surveys in specific populations and with evaluations of indicators of diverted uses does not highlight a major problem of tramadol abuse and dependence in terms of public health, but stresses the importance of paying attention to the signal. This example of addiction monitoring of tramadol illustrates the interest of comparing results obtained from different validated sources. The implementation of repeated observational programs of abuse of and dependence on psychoactive drugs is an important aid to health authorities to define the content of the information to be delivered or regulatory decisions to reduce these problematic uses.