I was on a pain contract before and my doctor said that I broke my contract by going to the E.R. so I'm no longer on the pain contract and she has tried to precribe Tramadol(ULTRAM) for me before but the pharmacy said I could't take it at the time because of two other meds that I was on and I asked my doctor again if she could prescribe it for my pain but since its an opiod and I don't have a pain contract anymore she can't prescribe it for me! ok, I understand that since I no longer have a contract with her she is unable to prescribe me any narcotic drugs but I don't understand why she can't prescribe it to me if its only a narcotic-LIKE drug please help!!!
How is Ultram (tramadol) only a narcotic-like drug if its an opioid?
Question posted by nevaehandtashia on 18 Aug 2011
Last updated on 10 December 2017 by Karen 1966
The information on this page reflects personal experiences shared by our community members. It is not reviewed for medical accuracy and should not replace professional medical advice.
8 Answers
Karen 1966
10 Dec 2017
When you are on a pain contact you can not accept any medication from the ER. The doctor will no longer prescribed any medication for you anymore.
gianopoulos33
13 Nov 2012
If you are looking for and answer to, if it is a drug or narcotic? Yes,, it is,, the diference between other narcotics is that it does' not come out on the drug test, but, it is really adictive if you use it more than a 15 days to a month, also if you are taking more than prescrived.
It haves the worst side efects than a many natcotics like vicodin norco or other prescrived drug pain kilers, i dont advise anyone to go over the limit your doctor prescrives,,some people taking this as a way to get bust,, omg i wish you all the luck in the world when you try to get out of it, my doctor prescrived this to me once for chronic back pain and it work fine but after 3 weeks he put me back on non-narcotic pain kilers and it was hell what i whent to get it out of my system,, then after it was sso hard to sleep sweets all the time nervousnes upset all the time,,
and i did not knew that was because i stoped the pills untill my doctor told me that was a side effect when you take it more than 3 weeks,, it comes adictive and he forgot to tell me that,,, duhh!!! so any ways they say it is not narcotic other Dr's say it is,, it does the same efect but it hooks you up in days even with 50mg dosage every 8 hours,, so is u to you!!! good luck!!!
Saraberry
9 Nov 2012
I understand what you are going threw. For chronic pain, tramadol and Flexeril, are just a little help, but they really go along way to help. It is probly okay to take these on a regular basis. The one and only reason the doctor dropped you and I have been threw this, is because you went to the E.R. and it does somehow break your contract, I know that little thing you forgot they told you when you were in sever pain. It sucks, but it is important and I found that out. I had a F.R.A. done, and then I was on Neurontin and so all was like pain became too sever for me to even walk I wanted to drive myself to the E.R. and could not. It was horrible. So , I told the E.R. guy about it and who my doctor was, and that guy was soooo mean to me. Come down to it, he gave me a shot of Toradol, and because of the medicines I was on I had a drug reaction to it.
I was screaming and they called the cops on me for loosing it, then when I got home I found out, that it was part of the side effect that was bad and I was supposed to be hospitalized for it instead of cops coming. LOL okay so next morning I was still screaming and could not help myself but that the beginning, I was dehydrated, over urinating and went you know in my pants and stuff, then diarrhoea and vomiting then hypersensitivity. So, I called my pain doctor and told him. He did not drop me because it was a holiday weekend and I could not get a hold of him on emergency. that is only reason why but his nurse was telling him to drop me. So when we sign that contract they don't' tell you why exactly you just imagine like I thought they wanted me to not get pills like from two doctors (because drug addicts do that) so, you think well not to worry because you don't abuse your meds. But then I learned alot more, I went searching and found out alot of side effects of some pain meds and they are not pretty, So, what the side effects of tramadol are I'm not sure , they could be anything, I found out the lidoderm and cortisone pain shots cause hypoglycemia, diabetes and osteoporosis, what a thing. These pain meds are not fun. I wish you the best and just Ib profen is about the safest thing (If you are not prescribed anything that goes against it) research N.S.D.S you will learn so much I never knew how much crap goes with this. I am wishing you a pain free day someday.
subsailorslady1980
24 Aug 2011
I can answer this question for you and I will try and do it in the simplest possible way. Most PM doctors that have you sign a pain contract require that they be informed of any ER visits even if they were for something completely unrelated to why you are seeing them. The reason that she can not prescribe Ultram (Tramadol) is because according to the FDA it is classified as a "Narcotic". Therefore, because of that classification and the fact that you broke your pain contract with her she can no longer prescribe anything that is considered a "Narcotic" to you. Now, having said that I am wondering what it was that you went to the ER for... without to much information if it was for pain that was regarding the reason that you see her and you received either a narcotic injection or they wrote you a prescription for a narcotic then depending on your contract legally she is not allowed to give you any more prescriptions for pain medication.
Now, I would suggest that you find your copy of the contract that you signed, or ask them for a copy of the one you signed and read it to make sure that you did in fact break the contract. I say that only because I see my PM doctor for several reasons and they prescibe my pain medications but do not prescribe all of my "Controlled" substances, ie... Valium, Ambien, but I am tested by them for those drugs since I am on them. I do get terrible migraine headaches and according to my contract, and every doctor has their own version, I am allowed to go to the ER for anything including a migraine headache and I am allowed to receive an pain injection (Dilaudid and Phenergan) to help take the pain away and relieve the migraine. However, I am not allowed to go to the ER for pain related to the reasons that they are treating me for, but I do have to call them and inform them after any visit for any reason. A visit to the ER should not have been enough of a reason to break that contract unless you were there for something that she is treating you for. A PM doc can not prevent you from going to the ER if something is wrong but again depending on what your contract states if you received any kind of pain medication from the ER than you may have violated that contract. I strongly advise you again to get a copy of the contract that you signed and find out if what you went to the ER for broke that contract. Also, it may be time to seek out a different PM doctor, if that is who you are seeing. To do that you will have to tell that PM doctor that you want to be discharged from their care and give you paperwork and your records, which may take a few days, and ask to be reffered to a different PM doctor. If the doctor you are seeing is just a PCM(Primary Care Manager), then ask for a refferal to a PM doctor who can keep track of things. I am sorry that you are having such a difficult time with all of this and I hope that this and all the other answers have helped you out in some way. I wish you the best of luck and as many pain free days as possible.
DzooBaby
19 Aug 2011
I hate the word "narcotic" when speaking of pain meds. It is actually an antiquated word and it speaks of illegal substances since "narcotic" is often used by law enforcement for illegal drugs. Narcotics generally refers to a drug or substance that produces stupor, complete insensibility, or sleep. It can be drugs derived from opium, cannabis, belladonna derived drugs and also even alcohol, although alcohol is not usually classed with narcotics, it could be technically. In law enforcement, it also refers to cocaine, ecstasy, heroin, and a host of other drugs that alter a persons state of mind. Opioid or opiate is a better way to describe pain medications. Opium has been used for social and medicinal purposes for thousands of years to produce euphoria, analgesia and sleep and to prevent diarrhea.
Several pharmacologically active compounds are derived from the opium poppy, Papaver somniferum, including morphine, codeine, papaverine, thebaine and noscapine. Opioids is the term given to natural or synthetic drugs that have certain pharmacological actions similar to those of morphine by the interaction with some or all opioid receptors.Tramadol is not derived from opium and is very chemically different than opioids. It is more closely related to antidepressants in that it affects serotonin. It is "opioid like" though because it acts on the same pain receptors as opioids do. These are the mu, delta and kappa receptors. Not all opioid analgesics act on all receptors. Most of them effect the mu receptor though. Since Tramadol acts on these receptors it is considered "opioid like" and therefore still has all the addictive properties of opioids. In the beginning they did think since it was not derived from opium it was going to be less addictive than most opioids. It didnt take long to find that this was not true. As others have said a contract is used to protect both patient and Dr and it shows as a document to state the Dr has counseled you in the dangers of opioid drugs and you are promising to abide by certain agreements to obtain these meds like using one pharmacy, not obtaining these meds from any source other than your PM Dr. Emergency situations are handled differently by different Drs though and I usually encourage people to discuss this with their Dr prior to signing a contract so they know how a Dr will handle emergency situations. Some dont mind if drugs are given in an some emergency situations. Some want to be contacted prior to their patients being given any opioids and some dont want their patients to receive any pain meds that they did not prescribe, period! So always be sure you bring this up to any Dr handling your pain management. Your Dr was one who decided you violated your contract by receiving meds without notifying her. Perhaps it was the circumstances. If you had been in a severe car accident and needed immediate pain relief that may have been excusable but if it were just a flare of your back pain, say, that is something that you could have called her for advice first and if she said "Go to ER" then she would have gave permission and even on weekends Drs are usually available by answering services so it being weekends is usually not a good enough excuse to go to ER without contacting your PM Dr. Once a contract is violated then the Dr genrally wont give anymore opioids and in this case she feels like opioid-like drugs count too. You can either abide by this or you might try things over with a new Dr. As far as the pharmacy saying you could not take Tramadol because of other meds you were on. that was probably due to a drug you were on that affected the serotonin. Too many drugs affecting serotonin can cause what is known as serotonin syndrome and drugs that do this are contraindicated to be taken together. I hope this explains some of the differences between narcotic, opioid and opioid like!
Thor283
19 Aug 2011
Hey Dzoobaby, ... I am going to have to disagree with you. I usually wouldn't bother, but I guess I'm bored. There doesn't seem to be any serious issues right now. Originally the word narcotic meant opium derived drugs, not all the ones you mentioned. And I double checked this with a doc who was even older than me. Narcotics were Morphine, Heroin, Codeine and those drugs. What we now call opiates or opioids. I'm actually one of the people who started this differentiation here on the Internet about 7 years ago. Everyone was using the word narcotics, and I stopped using narcotic and started using the word opiates for everything that's opium based. And to the best of my memory this whole problem with the words came about after NA was formed. Back in the early days of NA, people who weren't hooked on Heroin used to apologize for being there when the introductions were done. But no one with any drug problem at all was ever turned away, as far as I know.
So over the years, everyone started to believe that any drug that people got hooked on and had a problem with was a narcotic. With the single exception of alcohol and that's probably because there is an AA besides NA. Additionally, even in today's enlightened and educated world, most people refuse to believe alcohol is a drug. Of course these same people don't believe a medicine is a drug neither. I used to get angry at all this. Then I used to laugh at it. Now I generally ignore it. But like I said, I was bored at the moment.
So since your answer is more contemporary than mine is, we'll go with what you said. But just FYI, I thought I'd tell you how things were back in the dawn of people knowing what drugs were. I can actually go back even further but it's gets ridiculous back then. At one time the average person didn't even know the word narcotic at all. They simply called it dope. That's another interesting word to look into. Dope was anything that today is a narcotic, although it was supposed to mean opium based drugs.
It's really amazing how things change with the passage of time. It will be interesting to see if the introduction of the PC and the Internet will really improve the over all intelligence of society. Theoretically it should. But putting theory into practice is a whole other issue. Maybe this is something sweet lemon can squeeze into her book. A chapter on society trying to upgrade the general intelligence level of the people. I doubt I will be around to see what happens. I wish you all the best with this.
Thor
Inactive
24 Aug 2011
... and to think, I thought it was dope = dopamine.
Thor are we telling secrets now? Things we ought not share in PUBLIC???
Lara
Inactive
19 Aug 2011
I will try to explain 2 answers here. First to nevaehandtashia, Ultram to my understanding as described to me by a Pain mgmnt doctor is synthietic, & does not actually become opiate like until it mixes with your body chemicals. That is why is became so popluar for doctors to write for it. They were pretty fooled by the drug company reps into prescribing it not realizing all the problems it can cause the patient. The contract you are speaking of is required now by the FDA for all doctors prescribing any & all pain meds. Too many of prescription drugs are ending up on the street, & this is their way of cracking down. If they are going to write scripts for pain meds, they must have specail schooling to be able to do this. A lot of the Internists don't have the time or aren't willing to go back to school to take the required training..
My own physician had to have me sign a contract & do a urine test just for a prescription for Xanax so we ended up just letting my pain mngmt doctor take over that script along with the pain script. I hoope I have explained this to your satisfaction, & answered Thor's query also.
Inactive
19 Aug 2011
great job Mary + Mel !! I didn't understand the Q, duh!!
Inactive
19 Aug 2011
Thanks SL.
Inactive
19 Aug 2011
Well, you were up all nite gurl!!! That explains a lot. Love ya sis, Mary
Inactive
19 Aug 2011
insomnia sux ~ from Lara's dictionary, as you well know sis. ugh
shellyjo
11 Dec 2012
Mary, You are misinforming people. The FDA does NOT require contracts. I get narcotics for my animals-no contract. I got Vicodin for an injury-no contract. I didn't like the Vicodin, threw it out and got Tramodol (Ultram)-no contract. Check your facts before you post as facts. Also, there is no "special schooling" for writing prescriptions other than many years to get your MD, DMV, DO or what ever initial you earn.
Inactive
11 Dec 2012
So sorry, but you are misinformed. Just ask any medical doctor that treats chronic pain patients. The FDA & DEA are cracking down on doctors that write pain scripts. Vicodin is a class 3 narcotic & therefore does not fit into the class 2 drugs they are trying to get off the streets that they believe are coming from the pain patients selling their scripts. Where have you been for the past 2-3 years? Ask your doctor for oxycodone or oxycontin, & you'll find the truth. My own PCP told me this, & my own pain doctor just closed her practice because of the 'war of prescription drugs'. There are so many of our members that are having their pain scripts reduced or taken away because so many of these doctors are so afraid of losing their license or ending up in jail. I don't know where you live, or what you condition is that you take vicodin, but I hope it continues to help you as you may never get anything stronger when needed.
They want patients to do PT or some other stupid thing that doesn't work for their chronic pain. I do know of what I speak. If you would do more reading I think you will find I speak the truth. My PCP stopped prescribing pain meds, because of the required urine tests, & contract that has to be signed stating you will not share, sell or use your prescription drugs in any other manner than prescribed. Even our President is involved with this. He started a program in North Carolina to better educate physicians to weed out the drug seeking patients that come into the ER for drugs. Yes, doctors including the pain specialists have had to take classes to prescribe class 2 narcotic or opiate drugs for their patients, but because of the pressure on them from the FDA/DEA many are closing their practices. Ask a few more members of this site. I think you wil be surprised. As far as vet medicine, they usually don't used these type of opiate pain drugs or benzos. The reason that tramadol is not included is because it's a synthetic opiate, & also is not a class 2. Please do your research before saying someone is wrong. I have a petition to Congress right now for getting the DEA out of medicine. They have no business telling doctors or patients what they can prescribe or take for pain control. They are suppose to keep drugs off the street not take away meds from patients that need them to be able to function on a daily basis. Now, if you don't believe me, ask this as a question on this site. I would love to see the responses... Mary
Inactive
11 Dec 2012
Here is just one article put out by the FDA concerning this matter:
https://www.drugs.com/fda-consumer/fda-works-to-reduce-risk-of-opioid-pain-relievers-221.html
Just click on & read. This is posted in the Consumer updates right on this page to the right... Mary
braveboyjames
1 July 2013
I know this is a couple of years old but I feel I need to comment on this because it is only partially true and for future readers so they wont have the wrong concept. The FDA does NOT require doctors prescribing opioid pain medicine to put their patients on "pain contracts". It is up to the doctor and, yes, pain management doctors do this with all of their patients. But I see my family physician and I have never been put on a contract. And I take a CII, CIII, and a CIV. So the contract is not required but doctors want to use one to cover themselves. As for me I would never agree to sign one of those contracts because it shows that the doctor doesn't trust the patient before even meeting them, and if I am going to trust a doctor with my life, then I feel it should be mutual. But this last part is my feeling. Don't let it be a deterrent to getting the treatment one needs.
Inactive
19 Aug 2011
Tramadol is considered to be opiate like because it plays on the same opiate receptors on the brain as a true opioid does.. I would imagine that under the pain contract you were not allowed to take narcotics either. All opioid are narcotic but not all narcotics are opioid. Most PM doctors make you sign a contract that while under there care you are not to get narcotic prescriptions from any other doctor and that if you do have to go to the ER you are to notify the PM doctor first. Also you have to get all prescriptions filled at the same pharmacy. The contract is to be signed by every patient under the PM doctors care. Not just people who are weaning off meds or are addicts. It is a precaution that doctors have to take in order to protect themselves , but also to protect the patient.
To wrap it all up... Tramadol plays on the same opioid receptors in the brain that true opiods do. It is less addictive than other opiods but it is addictive none the less. In fact if you look in the Tramadol support group on this site you will find many people that are or have been addicted to Tramadol. That is why the doctor won't prescribe it to you after you broke the contract. Maybe a fresh start with a new doctor could help you. Just be sure you fully understand the contract so you don't run into the same problem.
Good Luck-Mel
Inactive
19 Aug 2011
Sorry Mel, it's very early & I didn't scroll down far enough to see your answer. Duh! You have answered this way better than I did...
Inactive
19 Aug 2011
Oh Mary, I thought your answer was good too, but yes you were up early. I just rolled out of bed about 15 min. ago! Ahhh, the joys of summmer! ;-)
Thor283
18 Aug 2011
I'm confused by your whole question. Usually docs only make you sign contracts when they're trying to detox you off opiates. And if you have legitimate pain issues, and I mean they can be proven with real tests like X-rays, CT Scans, MRIs, and you went to an ER for a good reason and the doc threw you out, then I call that a bad doc.
I also don't know if you mean the pharmacy is refusing to fill a script because of another opiate they think you're taking, or is it your insurance is refusing to pay for it?
So I'm all confused on that.
But I want to tell you what I know about Tramadol/Ultram. First of all, those are the same thing. Ultram is it's Brand name and Tramadol is the generic name. Regardless of how you classify it, Trammies are VERY addictive. I used to help people do a detox and I almost had more people coming to me who were hooked on Trammies than I did Vicodin and Percocet put together. This is because too many docs think Ultram/Tramadol isn't addictive. But it is, and from what my people told me the withdrawal from it is worse than Vics and Percs. So be careful with it.
Also, these words: opiates, opioids and opiate like drug are used wrong most of the time. Maybe I don't know the correct usage neither. The latest thing I read is an opiate is only a drug that is completely organic. So that means very few pain pills being sold are true opiates. And then I read that technically, as soon as the lab produces the drug as partially synthetic or entirely synthetic it's called an opioid. That would mean almost all the popular pain killers sold are opioids. And then to understand an opiate like drug requires the knowledge of more chemistry than I have. So in my chemistry stupid opinion I believe an opiate like drug is a drug that chemically is very different from a real opiate, but it shares the characteristics of opiates, meaning it kills pain and it's addictive. But I may be wrong. So don't quote me.
Inactive
19 Aug 2011
Thor,
You are not the only one confuzzled by this Q!!!
Opiates/Opioids/Schopioids...
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ultram, pain, tramadol, doctor, opioid, narcotic
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