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Tramadol is an opioid painkiller. Brand names formulations include Ultram, Ultracet, and Conzip.1 Tramadol is used in the management of moderate to moderately severe pain and, in extended-release form, for the management of chronic pain.2
The Drug Enforcement Administration (DEA) lists tramadol as a Schedule IV medication, unlike other opioid drugs, like oxycodone and hydrocodone, which are considered to have a higher potential for abuse and are classified as Schedule II substances.3
The World Health Organization (WHO) notes, however, that while tramadol’s abuse potential is lower than morphine, it is still abused and dependence may develop in a matter of weeks, especially among people taking more than the prescribed dose. People who develop tramadol dependence often have a history of drug abuse.4
Tramadol dependence may develop in a matter of weeks to months. When someone is physically dependent on this medication, they need it to feel normal. When the dose is lowered or they discontinue their use, they may experience typical opioid withdrawal symptoms such as:5,6
Tramadol is a unique opioid medication in that, in addition to its effects as an opioid agonist, it also has some activity as a serotonin and norepinephrine reuptake inhibitor. As such, upon abrupt discontinuation, it has some withdrawal symptoms atypical of other opioid drugs. The DEA notes that about 10% of people who quit will experience a withdrawal syndrome unlike that of other opioids that may include symptoms such as:5