Tapentadol as a drug of abuse - A preliminary report

Tapentadol is a dual action opioid analgesic with emerging data on abuse and diversion.

This study describes tapentadol abuse, clinical presentation, and treatment patterns.

We reviewed patients seeking help for tapentadol use (2017-2023) at a South Indian tertiary hospital. We collected data on sociodemographics, clinical profiles, and treatment, including buprenorphine dose and dose limiting side effects.

Of 933 opioid use disorder cases, 228 involved tapentadol. Most (89%) initiated opioid use with tapentadol, and 93% injected dissolved tablets. 80% were diagnosed with opioid dependence. Over half required inpatient treatment. 75% received buprenorphine, but tolerability was poor. The median first day dose was 0.8 mg (IQR = 0.4-2), and the maintenance dose was 4 mg (IQR = 2-8), with nausea being the main side effect.

We can conclude that Tapentadol is prone to abuse and dependence. These patients have poor buprenorphine tolerability and receive low maintenance doses. Further research is needed on effective opioid agonist treatment for tapentadol dependence.