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Newsflash: Tramadol Really is an Opiate

For years, tramadol was thought of as a safe alternative to opiates. It was viewed as less habit-forming and easier to tolerate than its “stronger” counterparts like oxycodone. Doctors handed out free samples of Ultram (tramadol’s brand name), with little restriction on usage due to its drug classification.

Then things sort of fell apart.

Did the drug change? No; tramadol was and has always been an opiate – so why the sudden turn-about?

Digging for the Truth

The DEA defines tramadol as a “centrally acting opioid analgesic.” Centrally acting refers to its interaction with the central nervous system, while analgesic simply means “painkiller.” In short, tramadol binds with opioid receptors in the central nervous system and blocks pain signals.

So, what did change? Awareness. Members of the healthcare industry began to see that patients experienced severe reactions to tramadol. It seemed the drug’s potency had been underestimated. Like other opiates, they realized this drug is addictive and has a high risk of abuse.

Potential Dangers

Structurally similar to other opiates like codeine and morphine, tramadol is dangerous. People have experienced severe side effects while taking tramadol. These side effects include:

  • Vomiting
  • Constipation
  • Headache
  • Nausea
  • Drowsiness
  • Dizziness
  • Difficulty Breathing
  • Depression
  • Seizures

People who stop taking it abruptly can experience withdrawal symptoms including diarrhea, pain, tremors, nausea, anxiety, sweating and insomnia.
Due to its interactions with brain receptors, tramadol can be habit-forming. Its euphoric effects are often sought by those abusing the drug. Increased tolerance combined with physical and psychological dependence create a cycle of addiction that can prove lethal.

What’s in a Name?

The rising use and abuse of tramadol prompted the FDA to issue an advisory in 2010. Doctors were directed not to prescribe tramadol to anyone suffering from depression or at risk for addiction. But this wasn’t enough. In fact, 2011 saw over 20,000 ER visits that were linked to tramadol.

In 2012, 3.2 million people were using tramadol for non-medical purposes. And by 2014, the DEA had seen enough evidence to classify tramadol as a controlled substance.

With this re-classification came stricter regulations. Now, tramadol prescriptions must be written on tamper-resistant prescription pads, the prescribing doctor must personally sign and date all prescriptions the day they are given and physicians cannot delegate signature authority.

In addition, tramadol prescriptions can only be given by a practitioner who has evaluated the patient in person. This means no more phone-in prescriptions without seeing the doctor. Limits on the length of prescriptions and number of refills are also in place. Tramadol can only be refilled up to five times within a six-month period after the prescription is written. At this point, a new prescription is needed.

Moving Forward

The truth about tramadol is slowly sinking in, but many are still unaware of the dangers involved with the use and abuse of this drug. Public awareness of this opiate must increase if we are to decrease the numbers at risk.

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