Tramadol Dependence
Some controversy exists regarding the dependence liability of
Tramadol. Grnenthal has promoted it as an opioid with a low risk of
dependence compared to traditional opioids, claiming little evidence of such
dependence in clinical trials. They offer the theory that since the M1
metabolite is the principal agonist at μ-opioid receptors, the delayed
agonist activity reduces dependence liability. The noradrenaline reuptake
effects may also play a role in reducing dependence.
Despite these claims it is apparent, in community practice, that
dependence to this agent does occur. This would be expected since analgesic
and dependence effects mediated by the same μ-opioid receptor. However, this
dependence liability is considered relatively low by health authorities,
such that tramadol ultram is classified as a Schedule 4 Prescription Only
medicament in Australia, rather
than as a Schedule 8 Controlled Drug like other opioids (Rossi, 2004).
Similarly, Tramadol is not currently scheduled by the U.S. DEA, unlike other
opioid analgesics. Nevertheless, the Prescribing Information for Ultram
warns that Tramadol "may induce psychological and physical dependence of the
morphine-type."
Tramadol APAP used to treat
- Severe pain
- Most types of Neuralgia, including Trigeminal Neuralgia
- Multiple other conditions that result in severe pain to
the victim.
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