Document Type


Date of Original Version



Pharmacy Practice


Objective: To determine the prevalence of tramadol prescribing among commercially insured adults receiving medication assisted therapy (MAT) with buprenorphine/naloxone.

Design: We conducted a cross-sectional descriptive study to evaluate the use of tramadol among patients prescribed buprenorphine/suboxone for MAT.

Setting: This study utilized data from 2010 to 2013 Optum Clinformatics Data Mart (OptumInsight, Eden Prairie, MN). This cohort is an administrative health claims database from a large national insurer. This data included pharmacy and medical care utilization and information describing patient enrollment.

Patients, Participants: Patients were 12 to 64 years of age and had complete and available medical, pharmacy and administrative records in the Optum Clinformatics Data Mart during study period.

Main Outcome Measures: Patients who received at least one paid claim for buprenorphine/naloxone from 2010 to 2013 and also received at least one overlapping pharmacy dispensing for tramadol were identified for analysis. We determined if the concurrent buprenorphine/naloxone and tramadol dispensings were from the same or a different prescriber.

Results: In this analysis of 18,734 U.S. commercially insured patients receiving MAT with buprenorphine/naloxone, we identified 1,198 (6.4%) patients who received at least one overlapping dispensing for tramadol during a four-year period spanning 2010 through 2013. Among these patients, 266 (1.42%) were co-prescribed buprenorphine/naloxone and tramadol from the same provider.

Conclusions: These results suggest that the use of tramadol among patients receiving buprenorphine/naloxone is not uncommon. Further study is warranted to further determine the benefits and risks associated with the use of tramadol for pain management among patients prescribed buprenorphine/naloxone.