Under pressure, Punjab to relook at curbs on sale of opioid painkillers

Chandigarh: Under pressure from psychiatrists, the Punjab government is reconsidering its decision of restrictions on sale and distribution of opioid painkillers tramadol and tepentadol.

The restriction was imposed by food and drug administration (FDA), Punjab, to check widespread misuse of both the medicines by drug addicts. However, the psychiatrists fear that restriction will have a negative impact on the drug de-addiction programme.

The issue was taken up by Association of Psychiatrists (AOP) in the meeting of health department with psychiatrists on Friday. Doctors were of view that the restriction will prove disastrous for the treatment of opioid dependence in the state where there are close to 7.5 lakh opioid users and about 2.5 lakh dependent undergoing treatment.

The authorities were appraised that both the medicines were being used for treatment of many opioid-use disorder patients who could not access buprenorphine or other substitute treatments due to limited availability. Supporting their contention, psychiatrists referred to guidelines issued by Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, in 2014 for treatment of opioid dependence in which tramadol has been listed as a treatment of opioid users.

According to sources, Dr P D Garg, head of department of psychiatry, Government Medical College, Amritsar, who attended the meeting as government expert, endorsed the view expressed by private psychiatrists.

An official of FDA who attended the meeting said they had, in recent months, made huge seizures of these painkillers, prescribed by doctors for post-surgery pain or other chronic pain. Representatives of AOP offered unconditional support to FDA to promote judicious and scientific use of these medicines by psychiatrists and the public.

Principal secretary (health) Anurag Aggarwal, who chaired the meeting, asked Dr Garg to give his recommendation on the issue so that appropriate step could be taken.

It was after seizing lakhs of tramadol tablets in the run up to the last assembly elections in Punjab that the Narcotics Control Bureau had approached the Union government to restrict the sale of the painkiller. The Centre brought it under the NDPS Act in August 2018 and Punjab took more than six month to implement the new rules by amending its own norms. Now, the state is planning to undo the changes.