The Trouble With Tramadol

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Physicians frequently prescribe tramadol to people suffering with chronic pain. Unfortunately, if other methods of pain management or elimination aren’t used in conjunction with it, there’s a chance some individuals develop a dependency on tramadol.

What Is Tramadol?

Tramadol is a synthetic opioid analgesic. It alters how the brain and nervous system perceive and respond to pain. However, unlike other opiates, it has more of a stimulant effect. Considered less habit-forming, it’s often prescribed as another option to help people manage pain after injury or surgery or provide some relief from chronic discomfort due to other conditions.

Brand names for tramadol include ConZip, FusePaq Synapryn, Rybix ODT, Ryzolt, Ultracet (contains acetaminophen), Ultram, and Ultram ER. A physician may prescribe tramadol in various ways, including as a capsule, tablet, liquid solution, or as an extended release, depending on the nature of the treatment and a person’s age and weight.

The United States Drug Enforcement Administration categorizes tramadol as a Schedule IV drug, indicating that it has a lower risk of abuse and dependency than other opiates, such as hydrocodone, which is a Schedule II drug. However, it’s still listed as part of the federal Risk Evaluation and Mitigation Strategy for controlled substances such as opioid analgesics, which means healthcare providers are required to follow a series of protocols when prescribing tramadol to reduce the possibility of misuse and addiction.

Yet Tramadol Is Still a Problem

In a 10-year study of nearly 450,000 patients, the Mayo Clinic of Emergency Medicine concluded that there was an increase in prolonged use of tramadol by patients, making them just as likely “as people who got hydrocodone or oxycodone to continue using opioids past the point where their surgery pain would have been expected to be resolved.”

Study participants refilled tramadol far beyond normal usage, including:

  • One refill 90–180 days after surgery, considered “additional use.”
  • Another refill 180–270 days after surgery, defined as “persistent use.”
  • Ten or more prescription fills or 120 or more days’ supply, considered “long-term use.”

The 2019 study authors also indicated that “while tramadol may still be an acceptable option for some patients, our data suggests we should be as cautious with tramadol as we are with other short-acting opioids.”

Additionally, individuals taking tramadol have the potential to develop a tolerance to the medication. This means as their body adapts to it, they need more of the drug to achieve the same pain-relieving effect. This is one reason why opioid addiction develops for some people who never had a problem with substances before.

Illicit tramadol is also a problem. Shortly before press time, a woman was arrested in Jackson, GA on charges of possession with the intent to distribute numerous controlled substances, including nearly 20,000 tramadol tablets.

According to a September 2022 TIME article, the “prices and potency” of illegal opiates have never been higher, and with stricter prescribing controls, “there are a lot of abandoned people who were on pain medications who cannot get access to adequate pain management anymore, and are therefore, increasingly, turning to the street. We hear those stories every day,” an article source states. Street names for tramadol include chill pills, trammies, and ultra.

Tramadol Side Effects

Even with monitored use, tramadol has some particular side effects, including, but not limited to:

  • Breathing problems
  • Changes in mood
  • Chills
  • Constipation
  • Diarrhea
  • Dizziness
  • Dry mouth
  • Headache
  • Hives
  • Indigestion
  • Muscle tightness
  • Nausea and vomiting
  • Nervousness
  • Risk of serotonin syndrome
  • Seizures
  • Swelling throughout various parts of the body
  • Sleepiness or, for some people, insomnia
  • Uncontrollable shaking

It’s imperative not to stop taking tramadol abruptly; otherwise, some of these side effects could be life-threatening.

Finding Better Solutions

Even if a physician prescribes a medication such as tramadol, that doesn’t mean it’s without risk. A thorough continuum of care pain management plan, especially for someone in recovery or who is prescribed opiates for short-term relief, should also include holistic options to help reduce or eliminate chronic pain. Some of the more effective methods include:

  • Acupuncture
  • Biofeedback
  • Cognitive behavioral therapy
  • Nerve blocks
  • Myofascial release therapy
  • Passive muscle relaxation
  • Reiki
  • Turmeric
  • Synthetic capsaicin
  • Yoga

Also talk with your doctor about alternatives to opioids both post-surgery and during recovery.

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