Tramadol, often sold under the brand name Ultram, is an opioid pain medication usually used to treat moderate pain. It is often prescribed for patients with fibromyalgia, arthritis and other chronic pain conditions. Because Tramadol has a different pharmacological makeup than most commonly prescribed narcotic pain medications there is some misunderstanding about it’s potential for abuse and the associated dangers. In fact, when it was first approved by the Food and Drug Administration (FDA) in 1994 it was not considered an opioid. It was not until further study that the FDA designated it as an opioid and a controlled substance in 2014. (1) While it is classified a synthetic opioid, Tramadol also acts as a serotonin-norepinephrine reuptake inhibitor (SNRI). This second quality resembles the action of many popular antidepressants. It is also why Tramadol is contraindicated in patients who already take an SNRI or a Serotonin Reuptake Inhibitor (SSRI) as it can lead to dangerous interactions.
Tramadol is classified as a Schedule IV drug by the DEA, which means it is considered to have a lower potential for abuse than some of the more conventional semi-synthetic opioid pain medications containing hydrocodone or oxycodone. However, this should not be taken to mean that Tramadol use is without risk for dependence or that people do not abuse it. (2) The fact is, taken as prescribed it may be safer than some other narcotic pain medications. But it can create some physical dependence as do all opioid compounds. Whether you are prescribed Tramadol or you have taken it recreationally, you should understand that abruptly quitting may lead to withdrawal symptoms and psychological cravings, much like any other opioid. (2) Furthermore, if you are taking it without a prescription you may be putting yourself at risk of a seizure or other serious reaction with other medications.
Instances of Tramadol abuse are well-documented. However, your physician may not be aware of this or what your history is. It is important to be honest with your doctor if you have any history of alcohol or drug dependence as well as letting them know about any other medications or supplements you are taking if Tramadol may be prescribed to you. Reduced risk of dependency does not mean there is no risk. Abruptly quitting Tramadol after a period of consistent use can lead to withdrawal symptoms that include anxiety, panic attacks, profuse sweating, insomnia, chills, nausea and diarrhea. The fact that Tramadol acts similar to an antidepressant can further complicate these effects.
The purpose of all this information is not to alarm you, but simply to encourage you to remain informed. When taken as prescribed by a doctor with a full knowledge of your medical history, Tramadol can be safe and effective. However, any person with a history of substance use disorder should be especially wary of any controlled substance, including Tramadol. If believe you or someone you care about is abusing Tramadol and/or dependent on it, give us a call. We will be happy to discuss the options for treatment and care.