NBA player’s suspension drives online conversation about tramadol, a prescription opioid

Conversations also debated the purpose of overdose prevention centers and highlighted the importance of medication for opioid use disorder.

On February 20, the NBA suspended a player after he tested positive for the banned prescription opioid tramadol, leading to online conversation about the drug. Plus, posts debated the effectiveness of overdose prevention centers and opioid use disorder treatment centers that offer methadone.

In response, communicators may share information about the risks of prescription opioids like tramadol, explain how overdose prevention centers and other harm reduction interventions save lives, and highlight how medication for OUD works.

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What’s trending nationally in reproductive health conversation:

On February 20, the NBA suspended Milwaukee Bucks player Bobby Portis Jr. for 25 games after he tested positive for tramadol, an opioid medication that the NBA has banned. Portis’s agent said that the player had intended to take an approved pain medication for an elbow injury and accidentally took tramadol instead. News of Portis’s suspension led to an uptick in online conversation about tramadol across platforms. Some comments on posts sharing articles about the suspension called tramadol a “migraine pill,” with some arguing that the NBA should allow its use and that it should not be classified as an opioid. Others expressed support for the NBA’s ban on tramadol, noting that it may help prevent athletes from developing OUD.

On February 17, articles reported that a congressperson from New York urged the U.S. attorney general to shut down two New York City overdose prevention centers, which provide a space where people can use pre-obtained drugs in a supervised environment. Overdose prevention centers are different from syringe services programs (SSPs), which may offer tools like vaccinations and sterile syringes to reduce the spread of infectious diseases. However, both overdose prevention centers and SSPs are types of harm reduction programs that help people who use drugs live healthier lives and connect people to treatment when they are ready. The congressperson claims—without evidence—that the centers encourage drug use and “attract crime.” An X post featuring a news clip about the centers received approximately 132,100 views, 2,800 likes, 1,300 reposts, and 540 comments as of February 26. Some comments expressed support for overdose prevention centers and explained that they save lives. Others alleged that they “enable” drug use, with some falsely claiming that overdose prevention centers do not connect people to treatment.

On February 12, a West Virginia state senator introduced Senate Bill 203, which would ban syringe services programs from operating in the state, and Senate Bill 204, which would ban OUD treatment programs that offer opioid agonists like methadone on site. However, programs that treat OUD by prescribing partial opioid agonists like suboxone could continue to operate. Opioid agonists activate opioid receptors in the brain, whereas partial agonists activate those receptors to a lesser degree. Social media users discussed the bills across platforms, with most posts focusing on SB 204. Commenters on a thread about the bill in the subreddit r/Methadone noted that expanding, rather than eliminating, OUD treatment options would save lives. Many shared personal stories about how methadone helped them and their loved ones treat OUD. Comments on a Facebook post sharing an article about SB 204 questioned how methadone helps people with OUD.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about reproductive health. 

In light of questions about tramadol, communicators may explain that tramadol is a prescription opioid approved to treat moderate to moderately severe pain. Anyone who takes prescription opioids can develop OUD, but some people face higher risk, such as people with a history of substance use disorder or mental health conditions. Patients should talk to their health care provider about their medical history and the risks and benefits of opioids before deciding on the best pain management option for them and should never share prescription medication with others. Highlighting the signs of opioid use disorder is recommended.

In response to persistent confusion about overdose prevention centers, messaging may emphasize that overdose prevention centers save lives by providing a space where people can use pre-obtained drugs in a supervised environment. More than 20 years of research show that no one has ever died of an overdose while at an overdose prevention center. Messaging may also note that overdose prevention centers do not increase crime and are associated with increased access to treatment. Additionally, overdose prevention centers are rare in the U.S., and they are different from SSPs, which have been shown to reduce the spread of infectious diseases by offering harm reduction tools like vaccinations, testing, and sterile syringes.

Trending conversations about methadone provide an opportunity to explain how medication for OUD works. Methadone binds to opioid receptors in the brain to reduce cravings and block the effects of opioids. Patients taking methadone to treat OUD typically receive the medication under the supervision of a health care provider. However, some may be allowed to take methadone at home after a period of stability. People receiving medication for OUD should share their medical history with their health care provider. Communicators may share local recovery groups, drug treatment centers, and SAMHSA’s National Helpline (1-800-662-HELP).