Contributing factors, social effects and rehabilitation of the non-medical use of tramadol: a scoping review

Non-medical tramadol use is a global public health issue, yet evidence on its contributing factors, social effects, and rehabilitation remains fragmented. This scoping review synthesised this evidence and identified gaps in the literature. The review followed the JBI methodology for scoping reviews and PRISMA-ScR reporting guidance. Searches across 11 databases identified relevant literature. Included sources involved individuals with a history of non-medical tramadol use and examined contributing factors, social consequences, or rehabilitation approaches. Quantitative, qualitative, mixed-methods studies, and opinion pieces were included, while studies on prevalence, pharmacological interventions, and secondary evidence were excluded. Findings were narratively synthesised. Among the 68 included sources, most were related to Africa (74%), with evidence focusing on initiation (n = 21), continued use (n = 28), intrapersonal (n = 26), interpersonal (n = 13), and societal effects (n = 6), and rehabilitation (n = 15). Important gaps remain regarding societal impacts, rehabilitation outcomes, and underrepresented populations. More qualitative and multidisciplinary research is needed to understand contextual drivers and lived experiences and inform prevention and treatment strategies.