Tramadol and Cycling: Is It the End of a “Painful” Relationship? An Insight From 60,802 Doping-Control Samples From 2012 to 2020

in International Journal of Sports Physiology and Performance

Click name to view affiliation

Thomas ZandonaiDepartment of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain
Neuropharmacology on Pain and Functional Diversity (NED), Institute of Health and Biomedical Research of Alicante (ISABIAL Foundation), Alicante, Spain
Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy

Search for other papers by Thomas Zandonai in
Current site
Google Scholar
PubMed
Close
https://orcid.org/0000-0002-7606-9675*
,
Ana M. PeiróDepartment of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, Elche, Spain
Neuropharmacology on Pain and Functional Diversity (NED), Institute of Health and Biomedical Research of Alicante (ISABIAL Foundation), Alicante, Spain
Pain Unit, Department of Health of Alicante, General Hospital, Alicante, Spain
Clinical Pharmacology Unit, Department of Health of Alicante, General Hospital, Alicante, Spain

Search for other papers by Ana M. Peiró in
Current site
Google Scholar
PubMed
Close
https://orcid.org/0000-0002-2385-3749
,
Caterina CovelliLaboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy

Search for other papers by Caterina Covelli in
Current site
Google Scholar
PubMed
Close
,
Xavier de la TorreLaboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy

Search for other papers by Xavier de la Torre in
Current site
Google Scholar
PubMed
Close
https://orcid.org/0000-0001-8037-6750
, and
Francesco BotréLaboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
REDs—Research and Expertise on Anti-Doping Sciences, Institute of Sport Science (ISSUL), University of Lausanne, Lausanne, Switzerland

Search for other papers by Francesco Botré in
Current site
Google Scholar
PubMed
Close
https://orcid.org/0000-0001-5296-8126
Restricted access

Purpose: To assess the prevalence of tramadol use among athletes from 2012 to 2020. Methods: All urine samples were collected from national and international in-competition doping-control tests that took place in Italy between 2012 and 2020. The analysis of the samples was performed by gas chromatography coupled with mass spectrometry with electronic ionization and acquisition in selected ion monitoring. The cutoff tramadol concentration was >50 ng/mL. Results: Of the 60,802 in-competition urine samples we analyzed, 1.2% (n = 759) showed tramadol intake, with 84.2% (n = 637) of these coming from cyclists and 15.8% (n = 122) from other sports. In cycling, a strong and significant negative correlation was found (r = −.738; P = .003), showing a decrease of tramadol use compared with the other sports. Conclusions: The decrease in tramadol prevalence in cycling in the last years may be due to (1) the deterrent action of antidoping regulations and (2) the fact that tramadol may not have any actual ergogenic effect on performance.

  • Collapse
  • Expand
  • 1.

    Wilson N, Kariisa M, Seth P, Smith H, Davis NL. Drug and opioid-involved overdose deaths—United States, 2017–2018. MMWR Morb Mortal Wkly Rep. 2020;69(11):290297. doi:10.15585/mmwr.mm6911a4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. Trends and geographic patterns in drug and synthetic opioid overdose deaths-United States, 2013–2019. MMWR Morb Mortal Wkly Rep. 2021;70(6):202207. doi:10.15585/mmwr.mm7006a4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Peprah P, Agyemang-Duah W, Appiah-Brempong E, Akwasi AG, Morgan AK. “With tramadol, I ride like a Jaguar”: a qualitative study of motivations for non-medical purpose tramadol use among commercial vehicle operators in Kumasi, Ghana. Subst Abus Treat Prev Policy. 2020;15(1):49. doi:10.1186/s13011-020-00292-4

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Miotto K, Cho AK, Khalil MA, Blanco K, Sasaki JD, Rawson R. Trends in tramadol: pharmacology, metabolism, and misuse. Anesth Analg. 2017;124(1):4451. doi:10.1213/ANE.0000000000001683

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Baltazar-Martins JG, del Mar Plata M, Muñoz-Guerra J, Muñoz G, Carreras D, Del Coso J. Prevalence of tramadol findings in urine samples obtained in competition. Drug Test Anal. 2019;11(4):631634. doi:10.1002/dta.2575

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Zandonai T, Escorial M, Peiró AM. Codeine and tramadol use in athletes: a potential for abuse. Front Pharmacol. 2021;12:661781. doi:10.3389/fphar.2021.661781

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Xie J, Strauss VY, Martinez-Laguna D, et al. Association of tramadol vs codeine prescription dispensation with mortality and other adverse clinical outcomes. J Am Med Assoc. 2021;326(15):15041515. doi:10.1001/jama.2021.15255

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Strano Rossi S, de la Torre X, Botrè F. A fast gas chromatography/mass spectrometry method for the determination of stimulants and narcotics in urine. Rapid Commun Mass Spectrom. 2010;24(10):14571466. doi:10.1002/rcm.4542

    • Search Google Scholar
    • Export Citation
  • 9.

    Salamin O, Garcia A, Gonzalez-Ruiz V, et al. Is pain temporary and glory forever? Detection of tramadol using dried blood spot in cycling competitions. Drug Test Anal. 2020;12(11–12):16491657. doi:10.1002/dta.2923

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Holgado D, Zandonai T, Zabala M, et al. Tramadol effects on physical performance and sustained attention during a 20-min indoor cycling time-trial: a randomised controlled trial. J Sci Med Sport. 2018;21(7):654660. doi:10.1016/j.jsams.2017.10.032

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Bejder J, Andersen AB, Bonne TC, et al. Tramadol does not improve performance or impair motor function in trained cyclists. Med Sci Sport Exerc. 2019;52(5):11691175. doi:10.1249/MSS.0000000000002217

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Zandonai T, Holgado D, Ciria L, et al. Novel evidence on the effect of tramadol on self-paced high-intensity cycling. J Sports Sci. 2021;39(13):14521460. doi:10.1080/02640414.2021.1877440

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 1039 1039 667
Full Text Views 36 36 22
PDF Downloads 52 52 27