It is a prescription painkiller intended to treat mild to moderate pain that the National Library of Medicine (NLM) publishes is marketed under the following brand names:
Opioid drugs act on opioid receptors in the brain, not only blocking pain, but also increasing pleasure and producing a mellow and euphoric “high” when abused. Heart rate, blood pressure, body temperature, and respiration rates all slow down, easing stress and producing relaxation. Opioid drugs are some of the most abused drugs in the country, potentially due to these desirable effects when taken recreationally.
The National Institute on Drug Abuse (NIDA) estimates that more than 50 million Americans have abused a prescription drug, and the most commonly abused prescription medications are opioid pain relievers.
Tramadol acts on opioid receptors and increases the levels of dopamine present in the brain like other opioids, but it also inhibits norepinephrine and serotonin from being reabsorbed. This action is similar to the way many selective serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant medications work on the brain, the journal Experimental and Clinical Psychopharmacology reports. This method of action may differ from traditional opioids, having both analgesic and antidepressant effects simultaneously.
The effects of tramadol may be intensified when its extended-release formations are altered (e.g., crushed to be snorted, injected, or smoked; or chewed and swallowed), and the entire dosage is sent into the bloodstream at once instead of slowly over a period of time. This can increase the risk for an overdose and may cause nausea, stomach cramps, dizziness, and drowsiness. In general, tramadol can cause a high that makes people feel relaxed, elevates moods, dulls pain, and reduces anxiety when it is used for nonmedical purposes.
Tramadol’s “high” may be more mellow than other opioids, making it seem like a valid alternative to other opioid pain relievers with a potentially lower incidence of abuse. In 2014, however, the Drug Enforcement Administration (DEA) elevated tramadol above a “drug of concern” to a controlled substance, moving it into Schedule IV, citing similarities in its abuse potential to those of other scheduled opioid drugs. The Drug Abuse Warning Network (DAWN) reported that nonmedical use of tramadol was the cause of more than 20,000 emergency department visits in 2011, an increase of 250 percent from 2005. Tighter regulations on other opioid drugs may make tramadol a candidate for abuse, as it may be easier to obtain than drugs like OxyContin (oxycodone) or Vicodin (hydrocodone/acetaminophen).Individuals who struggle with opioid addiction are more likely to abuse tramadol, as are those who suffer from chronic pain. Health professionals who are regularly exposed to it and have easy access to tramadol are also at higher risk, the DEA publishes.
Additionally, individuals who are being treated for opioid dependence, and taking opioid antagonist medications like naltrexone, may take tramadol as it seems to circumvent the opioid blockade and still produce a high, Psych Central reports. In this case, tramadol may serve as a substitute for other opioids that are blocked by the antagonist medication. Individuals may also take tramadol as an opioid substitute when trying to avoid withdrawal symptoms after “coming down” from opioids like heroin or more potent prescription opioids. Tramadol may temporarily ease drug cravings and withdrawal symptoms, making it an attractive drug of abuse to those who struggle with opioid dependence. Tramadol is also habit-forming and can lead to drug dependence and addiction with continued abuse, however.