for nearly 3 years . As my condition has deteriorated, the pain has become more frequent as has my use of tramadol which I can buy over the counter where Ilive.. recently I have been taking an average of 6x50mg per day and am worried about getting addicted , if not already , The doctor tells me my condition will not improve and controlling pain will be a part of my life from now on .What is there to substitute the Tramadol as a painkiller which is safe and works as effectively ?