Assessment of Non-Medical Use of Tramadol among University Students

Assessment of Non-Medical Use of Tramadol Among University Students
Menoufia Nursing Journal, Vol. 4, No. 1, May 2019, p. 119

This study explores attitudes toward non-medical use of tramadol among university students. Key sentiments expressed include:

A lack of belief that tramadol increases physical activity or improves mood.
Optimism that the state can address and eliminate the misuse of tramadol in the coming years, despite viewing current governmental efforts as ineffective.
Concern over the negative societal impact of tramadol, such as accidents and crimes associated with its abuse.
No personal desire to experiment with tramadol or belief that it induces happiness.
Feelings of sadness when friends or others misuse tramadol or when its abuse is widespread in Egyptian society.

Participants highlighted the importance of raising awareness about tramadol addiction, actively supporting awareness campaigns, and encouraging friends struggling with tramadol dependency to seek treatment. They expressed interest in learning more about prevention and treatment strategies for tramadol addiction.

Scoring System:
Attitudes were assessed using a scoring system with three levels:

Agree = 2 points
Sometimes agree = 1 point
Disagree = 0 points

The total attitude score was calculated by summing responses to all questions, then converting the score into a percentage. The total score of 34 represented 100%, with the following categories:

Positive attitude: ≥ 80%
Negative attitude: < 80%

Content Validity and Reliability
The content validity of the data collection tools was ensured by a review from five Community Health Nursing experts, who confirmed that the tools were relevant to the study’s topic. Unnecessary details were removed following their recommendations. Reliability was assessed, resulting in a reliability coefficient of 0.61 for knowledge and 0.76 for attitude.

Ethical Considerations
Approval and informed oral consent were obtained from all participants after the study’s purpose was explained to ensure their trust and cooperation. Participants were assured that all information would remain confidential and used solely for the study. They were also given the freedom to withdraw from the study at any point without providing a reason.

Pilot Study
A pilot study was conducted with 32 students, who were later excluded from the main study. This pilot was used to evaluate the clarity, applicability, and time requirements of the data collection tools, which took approximately 20–30 minutes to complete. The findings from the pilot study guided necessary modifications to the tools.

Statistical Design
Data were entered and analyzed using SPSS version 20. Descriptive statistics, including frequency and percentage for qualitative data, and mean and standard deviation for quantitative data, were applied. The chi-square test was used to assess significance, and correlation coefficients tested relationships. Statistical significance was classified as:

P-Value > 0.05: Not significant
P-Value < 0.05: Significant
P-Value < 0.001: Highly significant

Findings
The study revealed that over one-third of students had good knowledge regarding the non-medical use of tramadol. This aligns with findings from Heydarabadi et al. (2014), who reported similar results. However, it contrasts with Gebreslassie et al. (2013), who found that more than half of students in North Ethiopia, particularly medical science students, had good knowledge due to their awareness of drug abuse consequences.

Further analysis showed:

Over half of the fathers of students had less than a secondary education.
More than one-third of the mothers of students who tried tramadol had a secondary education.
A positive association was observed between students' total knowledge, attitude scores, and their characteristics.

This finding disagrees with Ghoreishi (2017), who reported that more than two-thirds of male university students in Kuwait had good knowledge but a negative attitude toward tramadol abuse. The discrepancy may highlight the role of knowledge in shaping attitudes and influencing behaviors to prevent tramadol misuse.
Findings
The study revealed that more than three-quarters of students demonstrated a positive attitude toward tramadol. This contrasts with the findings of a study by Deressa & Azazh (2011) at Addis Ababa University in Ethiopia, which reported that over half of students had a negative attitude toward substance abuse. The disparity may be attributed to cultural differences.

Conclusion
The majority of students had never tried tramadol, with more than three-quarters reporting good psychological health and no signs of distress. Most students were in good health, and over one-third demonstrated strong knowledge about the non-medical use of tramadol. However, despite their knowledge, more than three-quarters expressed a negative attitude toward the non-medical use of the drug.

The study also identified statistically significant relationships between trying tramadol and certain family characteristics, such as parental education and monthly income. However, no significant relationship was found between tramadol use and place of residence. A positive correlation was observed between students’ overall knowledge and their attitudes.

Recommendations

Implement health education programs for students to raise awareness about the non-medical use of tramadol, its side effects, precautions, and prevention.
Provide awareness campaigns across all faculties to educate students about the dangers of tramadol abuse.
Conduct further research on educational health programs targeting tramadol abuse among university students.
Expand research efforts to focus on the non-medical use of tramadol in Egypt to protect students from addiction.