Occupational Drivers of Non-Medical Tramadol Use among Artisans, Miners, and Farmers in the Western Region of Ghana: A Secondary Data–Led Analytical Expansion

Background: Non-medical tramadol use is a growing public health concern in Ghana. Research has mainly focused on youth prevalence, with limited attention to occupational drivers in informal work settings. Physically demanding jobs may encourage tramadol use to manage pain and fatigue.Objective: To examine occupational patterns and drivers of non-medical tramadol use among artisans, small-scale miners, and farmers in the Western Region of Ghana.Design: Analytical cross-sectional study using secondary data from a previously published community-based survey.Setting: Wassa Amenfi West Municipality, Western Region of Ghana.Participants: 300 respondents engaged in informal occupations, including artisans, small-scale miners, and farmers.Measurements: Self-reported lifetime tramadol use, frequency, daily dosage, duration of use, and co-consumption with alcohol and energy drinks. Occupation type was the main independent variable. Covariates included age, sex, education, marital status, alcohol use, and energy drink consumption. Descriptive statistics and chi-square tests were used to examine associations between occupation and tramadol use patterns.Findings: Non-medical tramadol use was highest among small-scale miners (87%) and artisans (78%), compared to farmers (63%) [2,12]. Daily use, higher dosages, and longer duration were more common among miners and artisans (p<0.01). Co-use with alcohol and energy drinks was also more frequent in these occupational groups. Occupation type was significantly associated with patterns of tramadol use.Conclusions: Non-medical tramadol use in the Western Region of Ghana is strongly influenced by occupational demands. Workers use tramadol to cope with pain, fatigue, and productivity pressure rather than solely for recreational purposes. Interventions should address workplace conditions, improve access to pain management, and strengthen regulation of informal drug markets. Policies focusing only on individual behavior are unlikely to be effective.Keywords: Tramadol; Occupational health; Informal labor; Small-scale mining; Artisans; Substance use; Ghana