Tramadol is not "opioid-lite"

Abstract

Prescribe with care and review treatment regularly

Low-dose naltrexone for treatment of pain in patients with fibromyalgia: a randomized, double-blind, placebo-controlled, crossover study

“…25 Paradoxically, in clinical FM studies, opioids generally demonstrate limited analgesic efficacy, 15 but because tramadol also has serotonin-norepinephrine reuptake Inhibitor (SNRI) properties, this may explain the observed weak analgesic effect. All opioids, including tramadol, 40 carry a risk for the development of tolerance, dependence, and substance abuse, highlighted by the "opioid epidemic" in the United States. 30,47 Small-scale studies 10,55,56 indicate analgesic efficacy of LDN with few adverse effects, and thus, our rationale for this study was to corroborate the findings in a higher volume.…”

Opioid analgesics, stigma, shame and identity

“…Changes in prescribing category have been addressed elsewhere. For example, in the UK, the synthetic opioid tramadol was re-classified as a Schedule 3 controlled drug some twenty years after its introduction, following concerns about increased overdose deaths (Stannard, 2019).…”

The use of tramadol in combination with pseudoephedrine and caffeine in sports

“…Although the US Drug Enforcement Administration considers tramadol as a substance with a low potential for abuse and with a low probability of dependence, 6 very recent evidence suggests that the risk of abuse and dependence induced by the chronic intake of tramadol might have been underestimated. 7 It has recently been found that tramadol produces similar risks of dependency to other short-acting opioids. 8 In addition, the United Nations has recently reported that Africa is experiencing a crisis of tramadol abuse and there is a high prevalence of misuse of this substance in Europe and America.…”