How addictive is tramadol?
Josue
I heard it's non narcodic so how can it be addictive.
Dorsey
it certainly is. medications do not need to be a narcotic to be addictive. there are online support groups and things like that. Physical dependence and withdrawal:Tramadol is associated with the development of a physical dependence and a withdrawal syndrome.[19] Tramadol causes typical opiate withdrawal symptoms as well as atypical withdrawal symptoms including seizures. The atypical withdrawal effects are probably related to tramadol's effect on serotonin and norepinephrin reuptake. Symptoms may include anxiety, anguish, pins and needles, sweating, and palpitations. It is recommended that patients physically dependent on pain killers take their medication regularly to prevent onset of withdrawal symptoms and when the time comes to discontinue their tramadol, to do so gradually over a period of time which will vary according to the individual patient and dose and length of time on the drug.[20][21][22][23][edit] Psychological dependence and drug misuseSome controversy exists regarding the dependence/addiction liability of tramadol. Grünenthal has promoted it as an opioid with a lower risk of opioid dependence than that of 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.Studies into the dependence liability of tramadol show that patients are no more likely to abuse the drug than normal NSAIDs. Despite these claims, it is apparent in community practice that dependence to this agent may occur, but in higher doses and long-term usage.[24] However, this dependence liability is considered relatively low by health authorities, such that tramadol is classified as a Schedule 4 Prescription Only Medicine 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. A controlled study that compared different medications found the percent of subjects who scored positive for abuse at least once during the 12-month follow-up were 2.5% for NSAIDs, 2.7% for tramadol, and 4.9% for hydrocodone. When more than one hit on the dependency algorithm was used as a measure of persistence, abuse rates were 0.5% for NSAIDs, 0.7% for tramadol, and 1.2% for hydrocodone. Thus, the results of this study suggest that the prevalence of abuse/dependence over a 12-month period in a CNP population that was primarily female was equivalent for tramadol and NSAIDs, with both significantly less than the rate for hydrocodone. This means that the abuse liability of tramadol was almost the same as that of normal NSAIDs, such as ibuprofen.[25]However, due to the possibility of convulsions at high doses, recreational use is very dangerous.[26] Tramadol can however, via agonism of μ opioid receptors, produce effects similar to those of other opioids (e.g., morphine or hydrocodone), although not nearly as intense due to tramadol's much lower affinity for the receptor. However, the metabolite M1 is produced after demethylation of the drug in the liver. The M1 metabolite has an estimated 200x greater affinity for the μ1, and μ2 opioid receptors. In addition to acting as an opioid, tramadol is also a very weak but rapidly acting serotonin-norepinephrine reuptake inhibitor.[27] Tramadol can cause a higher incidence of nausea, dizziness, loss of appetite compared with other opiates which could deter abuse to some extent.[28] Tramadol can help alleviate withdrawal symptoms from more addictive opiates, and it is much easier to lower the quantity of its usage, compared with opiates such as hydrocodone and oxycodone.[25] It may also have large effect on sleeping patterns. High doses may prevent sleeping.[29]
Ava
It is non-addictive.
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