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103 A history of chronic tramadol abuse was found in 34 tramadol controlled medication tramadol 50 mg round white pill tramadol nursing implications In the United States, tramadol was introduced in 1994 on the market as medicine to treat pain . In an analysis of tramadol poisonings (n=401 from March 2008 ultram to March 2009; 266 mild and excluded; 135 included in the study; confirmation by blood analyses) in Iran, the investigators found 70 cases of intentional intoxications and 40 cases of recreational abuse (euphoria intention) .
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Data of the first postmarketing surveillance program started shortly after the introduction of tramadol showed that the reported rate of tramadol abuse (rated as positive, possible and alleged) was 1-3 cases per 100,000 ultram patients in the first three years (1995-1998) . 23 The majority of abuse cases (97%) concerned individuals with ultram a history of substance abuse .

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