Tramadol for maintenance treatment for an elderly "doda" (poppy husk) user

Natural opioids have been in use in the North Western part of India for a long time. We present the case of an octogenarian doda (poppy husk) user, who sought treatment with us due to unavailability of natural opiates. The patient was treated successfully with tramadol maintenance for over 8 months. This case suggests that tramadol can be used as a harm reduction approach, for maintenance of patients with opioid dependence.