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Tramadol is a synthetic (man-made) pain reliever (analgesic). Researchers and doctors do not know the exact mechanism of action of tramadol, but it is similar to morphine. Like morphine, tramadol binds to receptors in the brain (narcotic or opioid receptors) that are important for transmitting the sensation of pain from throughout the body to the brain.
Like other narcotics used to treat pain, patients taking tramadol may abuse the drug and become addicted to it.
Tramadol is not a nonsteroidal anti-inflammatory drug (NSAID), therefore, it does not have the increased risk of stomach ulcers and internal bleeding that can occur with NSAIDs.
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Doctors prescribe tramadol to manage moderate to moderately severe pain. Extended-release tablets are used for moderate to moderately severe chronic pain in adults who require continuous treatment for an extended period.
Tramadol should not be used to treat pain in children younger than 12 years of age, and it should not be used to treat pain after surgery to remove the tonsils and/or adenoids in children younger than 18 years of age. Children between 12 and 18 years of age who are overweight or have breathing problems such as obstructive sleep apnea or severe lung disease should not receive tramadol.
Is tramadol a narcotic? Is it addictive?
Tramadol is a narcotic and is addictive. Tramadol is a Schedule IV controlled substance that has been associated with addiction, abuse, and misuse. Tramadol may be addictive, even at the dosage, your doctor has prescribed. Abuse or misuse of tramadol can lead to overdose and death.
Like other opioids, people who take tramadol for a long time will develop withdrawal symptoms if your doctor reduces the dosage, or if you suddenly stop taking tramadol.
Tramadol and its Mechanism of Action
Antiepileptic and tricyclic antidepressant drugs find common use in the management of neuropathic pain. Their precise mechanism of action, nevertheless, remains unknown. Use of both drug groups is limited by their side effects as it might be difficult to reach the optimal plasma concentrations needed for pain control without affecting the patient’s well-being.
Initially, neuropathic pain was considered refractory to opioids. It was only recently that opioids were rediscovered as a possible treatment for neuropathies. The mechanism by which classic opioids suppress pain is mediated by mu-receptors. Receptors of this kind are present on the pre- and post-synaptic membranes of primary afferent nerve fibers. Their activation on the presynaptic membrane reduces glutamate release. On the postsynaptic membrane, however, this process causes hypopolarisation due to an increase in potassium influx. Even with the biochemical details still unexplained, it is quite certain that the mitigating effect of Tramadol has mu-receptors as its main leverage.
Tramadol and doping
Aside from its analgesic effect, Tramadol is known as a euphoric, mood-enhancing and performance-enhancing medicine. It is exactly this combination of analgesic and euphoric properties that has put this substance on the doping list. The World Anti-Doping Agency (WADA) has informed that Tramadol was found in more than 4 percent of urine samples collected from cyclists and athletes in 2017. While being effective for sport-related traumas, this drug is argued to have a considerable performance-enhancing effect, which alone is a strong cause for banning it from competitions. For reasons unclear, the new doping list of WADA for 2019 still does not include Tramadol.
When it comes to recreational use, healthcare experts strongly advise against taking the drug due to its performance-enhancing properties. Aside from unpleasant side effects, such as nausea and vomiting, there also is the dependency problem. Sportsmen who choose to dope with Tramadol take a habit of overexercising on a daily basis, and then they quite naturally become addicted — this scenario is typical for all opioids. While there are sports organizations like the world cycling federation (UCI) which have recognized the problem and listed Tramadol as doping, most sports governing bodies continue to allow it. For instance, Tramadol has never been banned from football, and FIFA believes that it finds only very limited use among footballers and, therefore, takes no official action against it.
Withdrawal symptoms that may occur include:
- Excessive tear production
- Muscle pain
- Joint pain
- Abdominal cramps
- Weight loss
- Increased blood pressure
- Respiratory rate
- Heart rate