Is tramadol a controlled substance / narcotic opioid?
Tramadol is a narcotic (opioid) and is designated a controlled substance (Schedule IV) by the U.S. federal government. Controlled substances are regulated by the government to prevent abuse and misuse and lower the risk of overdose.
Tramadol is a Schedule IV drug according to the Controlled Substances Act. There are five schedules in this Act, with Schedule 1 being the most tightly regulated. Schedule IV drugs like tramadol have a medical purpose, a low to moderate potential for abuse and a low risk of dependence compared to other controlled substances.
In terms of regulations, tramadol prescriptions in all 50 states may only be refilled up to five times within a six-month period after the date that the prescription was issued. A new tramadol prescription is required after five refills or after six months.
Based on 13 human laboratory studies, tramadol has lower abuse potential than most opioids it was compared to. Key distinguishing factors include: producing more negative effects as doses increase, having fewer positive effects when injected, showing delayed onset of effects, and creating non-linear dose responses. These characteristics likely discourage dose escalation and abuse, though tramadol still carries some abuse risk.
When compared with other opioids, tramadol is less likely to be obtained under false pretenses or sold and bought by non-medical users on the street. In addition, the rate of snorting tramadol is 4 to 7 times lower than it is with other opioids. The rate of injecting tramadol is 14 to 34 times lower than other opioids like morphine and oxycodone. Snorting or injecting opioids allows users to get high quicker.
Tramadol is also most likely obtained by a patient’s own prescription, while other opioids are more likely to be obtained via diversion through dealers or family and friends.
In case of overdose, individuals who are prescribed tramadol should always have a rescue medication called naloxone on hand. This medication can block the effects of opiates to reverse an overdose.
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References
- Drug Enforcement Agency. Tramadol. https://www.deadiversion.usdoj.gov/drug_chem_info/tramadol.pdf.
- Drug Enforcement Agency. Drugs of Abuse. 2024. https://www.dea.gov/documents/2024/2024-12/2024-12-12/drugs-abuse-2024
- Green JL, Dailey-Govoni T, Butler SF. Real-World Data on Nonmedical Use of Tramadol from Patients Evaluated for Substance Abuse Treatment in the NAVIPPRO Addiction Severity Index—Multimedia Version (ASI-MV®) Network. Drug Saf 44, 235–244 (2021). https://dx.doi.org/10.1007/s40264-020-01012-4
- U.S. National Library of Medicine. Tramadol. https://medlineplus.gov/druginfo/meds/a695011.html#how.
- Dunn KE, Bergeria CL, Huhn AS, Strain EC. A Systematic Review of Laboratory Evidence for the Abuse Potential of Tramadol in Humans. Front Psychiatry. 2019 Sep 26;10:704. doi: 10.3389/fpsyt.2019.00704. https://pmc.ncbi.nlm.nih.gov/articles/PMC6775208/
Read next
How long does tramadol withdrawal last?
Symptoms of tramadol withdrawal can start 8-24 hours after the last dose. Untreated, withdrawal symptoms usually last for 4-10 days. Withdrawal is caused by stopping the drug suddenly. Continue reading
Is tramadol stronger than codeine?
Both tramadol and codeine are prescription opioid painkillers, and they seem to be equally effective in terms of pain relief. There is no evidence that tramadol is any stronger than codeine at relieving pain. Continue reading
How long does tramadol stay in your system?
Tramadol is eliminated from your system within roughly 2 days of taking the drug, but this does not mean that it can no longer be detected by certain drug tests. Continue reading
See also:
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Drug information
- Tramadol Information for Consumers
- Tramadol prescribing info & package insert (for Health Professionals)
- Side Effects of Tramadol (detailed)
- Tramadol user reviews (1,887)
Related support groups
- Tramadol (502 questions, 2,704 members)