الفهرس 
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Abstract
The magnitude of the problem of substance use in Egypt has been growing lately. Substance use disorders (SUDs) have been associated with depression and suicide, as well as impulsivity and specific personality traits (Shahin et al., 2018).
Alcohol, cocaine, and opiate dependent suicide attempters also show higher ratings of personality traits such as introversion and neuroticism compared to substance dependent patients who did not attempt suicide (Roy. 2014).
Among all used drugs, tramadol, a centrally acting analgesic, was the most heavily used illicit drug in the last decade, considered by some as youth plague not only in Egypt but also in the neighboring. According to the Ministry of Health report on drug addiction in Cairo, 1.4 million people were addicted to drugs, particularly heroin and/or tramadol (Bassiony et al., 2018).
United Nation reported that middle east and north Africa regions were among highest areas of tramadol/opiate abuse over the world (Farag et al., 2018).
According to the Ministry of Health report on drug addiction in Cairo, 1.4 million people were addicted to drugs, particularly heroin and/or tramadol (Viney, 2017).
Rationale and Aim
This study hypothesized that the rate of occurrence of suicide is probably to be high among tramadol addicts.
In consequence this study was aiming at assessing suicidal probability among tramadol addicts and it’s relation with each of severity of addiction and personality disorder.
Methodology
This cross sectional descriptive study was done in outpatient clinic of Institute of Psychiatry Ain Shams University hospitals among tramadol addicts age ranging from 18-60.
The participants were 72 of tramadol addicts included would fill out a short pre-designed sheet regarding socio-demographic data. Followed by Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Clinical Interview for DSM-VI Personality Disorders, Suicide probability scale and Addiction severity index.
All data gathered were recorded, tabulated and transferred on Statistical Package for Social Sciences (SPSS) using personal computer and the suitable statistical parameters were used. Results were displayed to answer questions raised in the hypothesis of this study.
Results
On demographic characteristics, our study demonstrated that the mean age of the patients was 25.694 years. It also showed that 77.78% of the sample were males, 55.56% were married. Most of them from Urban (61.11%). Overall, most of the studied group were educated, 47.22% scholastic and 22.22% of high education. It showed as well 19.44% of the sample reported previous suicidal attempts and 16.67% reported positive family history of addiction. Among the sample the majority’s motive of tramadol abuse was as a power for work 30.56% followed by pleasurable effects 22.22%. majority of the sample 72.22% took tramadol as among other substances.
By the application of Suicide Probability Scale (SPS) it was significant in 32 cases (44.44%) of the sample. And was positively related with each of the following:
Legal domain on addiction severity index, as 75% of cases showing considerable legal problem were severe as regards probability of suicide.
Among tramadol addicts with antisocial personality disorder 85.71% were having severe probability of suicide.
Those with longer duration of addiction (6-23) years were with severe probability of suicide.
Among tramadol addicts with severe suicidal probability 31.25% married, 56.25% reported family history of addiction and 85.71% reported past history of suicide.
Conclusion
Suicidal probability is significant among tramadol addicts and positively related with each of the following being single, with antisocial personality disorder, having positive family history of addiction, reporting past history of suicide and long duration of addiction.
Recommendations
Careful and systematized psychiatric assessment should be done for these cases, along with including a protocol for suicide prevention in those susceptible group to be included in the rehabilitation programs.
It’s recommended to have more research that can explain the occurrence of suicide among tramadol addicts.