Tramadol: Pain Relief vs. Abuse

A Modern Affliction

Opioid addiction isn’t new in the year 2013. Oxycodone and its derivatives have become some of the most destructive substances in the United States, especially in rural areas where harder drugs are harder to come by. In the slums of India, poor children sniff empty bottles of correction liquid to get high, and the opium explosion moving north from Afghanistan only worsens as economic and political conditions in Russia deteriorate and demand grows there as well as all over the world.

Tramadol’s Functions and Mechanisms

A scourge, or perhaps godsend, of the UK drug market has been tramadol. Like most strong painkillers, it must be dispensed by a registered pharmacist at a licensed UK pharmacy.  However you can also buy tramadol online.  Doctors prescribe it for moderate to severe pain, which in diseases like osteoarthritis or fibromyalgia can last for years or even decades. Like other opiates, it stimulates opioid receptors, but it is important to note that tramadol also increases serotonin levels in the brain. It is widely used to treat moderate to severe pain, but only with a prescription filled at a licensed UK pharmacy.

Tramadol—also known as Zydol or Zamadol—is a synthetic opioid, but quite similar to natural ones derived from the poppy plant.  Examples of other opiates are codeine, methadone and heroin. Of course, none of these are routinely used as oral outpatient painkillers in the 21st century, partly due to their notorious likelihood to create a dependency. Tramadol is less addictive than the true opiates which is why it tends to be prescribed so often. In addition to lessening pain, possibly because of its serotonin stimulating effects, tramadol can also create a temporary feeling of warmth and well-being, relaxation and sleepiness. If taken with other medications that affect serotonin levels, dysregulation of sleep, breathing and mood may occur.

An Epidemic of Pain

Official medical use of tramadol has almost doubled since 2005; every day in England, doctors write, and registered pharmacists fill, prescriptions for many thousands of doses of the drug. These medical professionals, the licensed UK pharmacies and their patients, are of course concerned that tramadol will become inaccessible to those who really need it; however, the UK government wants to list it in schedule III to show that the drug will still be legally available for medical use.

Most weaker painkillers, known widely as NSAIDs (non-steroidal anti-inflammatory drugs) carry a variety of side-effects such as indigestion and stomach ulcers. One alternative drug, Vioxx, was taken off the market in 2005 due to mistakes in testing (and subsequently underestimating) the drug’s chances of exacerbating heart attack and stroke symptoms.

Too Much of a Good Thing

Quite far down on the list of potential problems on a fact sheet for tramadol, withdrawal reactions are mentioned–with symptoms such as restlessness, watering eyes, runny nose, nausea, sweating, and muscle aches. The fact sheet also mentions that, if taken continuously over the long term, tramadol may not work as well. This is the exact kind of diminishing-returns situation (caused by users’ increasing tolerances) that creates addiction. Sure enough, the manufacturer’s info sheet is required to mention that tramadol may cause drug-seeking behavior, also known as addiction.

Part of the controversy has been over the revelation that tramadol had been mentioned in 154 death certificates in the UK in 2011. It was described as the “sole agent” in 23 deaths in 2010, and played a less clear role in a further 109 deaths that year. Its popularity has blossomed partly because of its newly available price tag as a non-branded generic drug, it costs the NHS £1.99 for 100 tablets. While other street drugs, like oxycontin and methamphetamine, get more screen time as potentially life-threatening, it’s the tablets most available that will become the new standard. Today, in the UK, those tablets appear to be crossing the counters of registered pharmacists most often in the form of tramadol.