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  • Tramadol is an opioid pain reliever and central nervous system depressant often used to treat moderate to severe pain. Its brand names include Ultram, Ultram ER, Ultracet, and ConZip. It works by altering the way the brain and nervous system respond to pain. 

    Because it can be abused and tolerance can build up in the body, the Drug Enforcement Agency (DEA) classifies it as a Schedule IV drug and the Food and Drug Administration (FDA) labels it a controlled substance.

    Controlled Substance Classification

    The FDA does consider tramadol a controlled substance and the DEA classifies it as a schedule IV drug. While schedule IV drugs don’t have a high rate of abuse, tolerance, or addiction, it’s still possible for them to be abused and can be fatal when taken in high doses.

    Since its potency isn’t as high as other opioid medications, tramadol is not higher on the schedule list. Similar opioids like oxycodone and fentanyl are more potent so are higher on the controlled substance schedule.

    How Does Tramadol Work?

    Tramadol works by binding to the brain’s opioid receptors associated with the transmission of the pain sensation from the body to the brain. The transmission is blocked and the pain is relieved.

    It also works as an antidepressant by keeping neurotransmitters like norepinephrine and serotonin in the brain. This produces the euphoric feeling many people experience while on tramadol.

    Despite its efficacy, tramadol is one of the least potent opioid painkillers on the market. It’s often prescribed because it has a lower risk for abuse and addiction than other opioid painkillers. Unfortunately, that doesn’t mean it can’t be abused and addictive.

    Is Tramadol An Opioid?

    Tramadol is considered a prescription opioid analgesic (painkiller). It’s often prescribed for pain management after surgery, for severe back pain, or for those experiencing chronic pain from conditions like fibromyalgia. 

    For severe pain, it’s often prescribed in its extended-release formulation (Ultram ER). 

    Is Tramadol A Narcotic?

    Tramadol is considered a narcotic since opioids are a type of narcotic medicine. It’s also an addictive one. It can be abused, misused, and may lead to addiction, overdose, and even death.

    Is Tramadol An NSAID?

    Tramadol is not a nonsteroidal anti-inflammatory drug or NSAID. While NSAIDs do help relieve pain, they also reduce inflammation and bring down a high fever. Tramadol isn’t able to do those things. 

    Because it’s not an NSAID, tramadol also doesn’t have an increased risk of stomach ulcers or internal bleeding that often comes with this type of drug.

    Is Tramadol A Benzodiazepine?

    Tramadol is not a benzodiazepine or benzo. It’s an opioid painkiller. While it is also a CNS depressant like some benzos, it doesn’t work on the same receptors in the brain as benzodiazepines do. 

    Since it’s an opioid, it works on the opioid receptors, not the GABA receptors like benzo would.

    Tramadol Abuse

    Tramadol is often abused due to its pain-relieving capabilities and its calming and euphoric effect. People can chase that relaxed and happy feeling, go against the medical advice of their doctor, and take more than the prescribed amount. 

    This puts them at a higher risk of developing a physical dependence on the drug and makes it difficult to stop taking it.

    When they do try to stop, withdrawal symptoms may set in, and they may begin taking the drug to relieve those withdrawal symptoms.

    Side Effects Of Tramadol Abuse

    When tramadol is abused, it brings on many serious side effects that may include:

    • pinpoint pupils
    • changes in appetite
    • nausea or vomiting
    • drowsiness
    • slurred speech
    • constipation
    • fever
    • depression
    • headaches
    • impaired coordination
    • serotonin syndrome

    Opioid Overdose

    When someone takes too high a dose of tramadol, an overdose can occur. This brings on many dangerous side effects that can be fatal. Some of the signs of an overdose may include:

    • sleepiness
    • unconsciousness
    • coma
    • seizures
    • respiratory depression
    • very low blood pressure
    • slow heart rate
    • sweating or clammy skin
    • weak muscles
    • pinpoint pupils

    If you suspect you or a loved one is overdosing, call 911 immediately and make sure they get help as soon as possible.

    If you or your loved one is struggling with opioid addiction, it’s never too late to get help. Call our helpline today to find out what treatment options are available.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Food & Drug Administration (FDA) - Tramadol
    Food & Drug Administration (FDA) - Tramadol Full Prescribing Information
    National Center of Biotechnology Information - Tramadol
    National Library of Medicine: MedlinePlus - Tramadol

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 18, 2022
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