الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Abuse of prescription opioids and its health outcomes has turned into a major public health issue in different parts of the world in recent years. Though the scope of the problem and the type of opioids vary across different regions.
Tramadol is a synthetic opioid analgesic for acute and chronic pain mediates its analgesic effect through acting on opioid receptors and nor-epinephrine serotonin reuptake inhibition.
In general opioid use disorder is chronic relapsing disorder in the beginning through activation of the brain reward neurocircuites increasingly engages anti-reward neurocircuits that drive adverse emotional states and relapse.
However treatment of opioid use disorder could be successful if appropriate treatment used.
Medications demonstrated to be effective for OUD are methadone (a full opioid agonist), buprenorphine (a partial agonist), and naltrexone (an opioid antagonist) Methadone and buprenorphine act by suppressing opioid withdrawal symptoms and attenuating the effects of other opioids. Naltrexone blocks the effects of opioid agonists.
Long acting naltrexone treatment has been announced as a viable option for the treatment of relapse after opioid withdrawal based on operant conditioning theory. Operant theory occur with extended release naltrexone suggest that the patients stop seeking opioids as episodes of opioid use are no longer reinforcing.
This study was conducted on 50 patients diagnosed as tramadol use disorder.
The results reveal that 28% of patients have a problem which needs treatment according to the addiction severity index before the treatment while after the treatment 40% of them has slight problem and treatment not probably needed.
Also, our study demonstrated that long acting naltrexone decrease significantly the relapse P < 0.0001according to the addiction severity index.
Fifty six present of our patients have moderate cognitive impairment before treatment while after the treatment 68% of them have mild cognitive impairment.
According to Wechsler adult intelligence scale 38% of the patients have low average IQ before the treatment and after the treatment 60% have average IQ.