Tramadol has mu-opioid agonist activity. ULTRAM can be abused and may be subject to criminal diversion.

Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. Drug addiction is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, use for non-medical purposes, and continued use despite harm or risk of harm, and craving. Drug addiction is a treatable disease, utilizing a multidisciplinary approach, but relapse is common.

“Drug-seeking” behavior is very common in addicts and drug abusers. Drug-seeking tactics include emergency calls or visits near the end of office hours, refusal to undergo appropriate examination, testing or referral, repeated “loss” of prescriptions, tampering with prescriptions and reluctance to provide prior medical records or contact information for other treating physician(s). “Doctor shopping” to obtain additional prescriptions is common among drug abusers and people suffering from untreated addiction.

Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may not be accompanied by concurrent tolerance and symptoms of physical dependence in all addicts. In addition, abuse of ULTRAM® can occur in the absence of true addiction and is characterized by misuse for non-medical purposes, often in combination with other psychoactive substances.

Concerns about abuse and addiction should not prevent the proper management of pain. However all patients treated with opioids require careful monitoring for signs of abuse and addiction, because use of opioid analgesic products carries the risk of addiction even under appropriate medical use.

Proper assessment of the patient and periodic re-evaluation of therapy are appropriate measures that help to limit the potential abuse of this product.

ULTRAM® is intended for oral use only.

Dependence

Tolerance is the need for increasing doses of drugs to maintain a defined effect such as analgesia (in the absence of disease progression or other external factors). Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist (see also WARNINGS, Withdrawal).

The opioid abstinence or withdrawal syndrome is characterized by some or all of the following: restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

Generally, tolerance and/or withdrawal are more likely to occur the longer a patient is on continuous therapy with ULTRAM.

Actually, tramadol is a synthetic version of a narcotic. You can become physically addicted to it. I had an addiction specialist talk to me about my extended use of this drug a while back, so I’d know the risks. Alot of doctors will tell you it is not addictive, because they themselves aren’t clear on that fact. It is definitely addictive, it will definitely cause withdrawal if you stop taking it suddenly without gradually stepping down from it. If you want to stop taking it, consult your doctor, but whatever you do, do not stop cold turkey. Slowly reduce your dosage, until its small enough that you can quit altogether. I currently take 300 mg. a day, everyday. And if I were to quit right now, without tapering, even at 300 mg I would have terrible withdrawal from it. I did that before, and can tell you, it was awful. I will never stop cold turkey again.

Holy Cow! Yes, yes, yes Tramadol is addictive. I was on much higher doses than you for 6 years. I resulted to methods I never dreamed I would ever resort to to get it. I tried so many times to work down and failed. The doctor found out about my abuse and cut me off. I had enough to cut my dosage in half (16 to in one day and half of that in one more day. Way, way too fast. I’ve now had 10 days of 0. It’s been hell on earth. My sister saved me by bringing over some lortab and some xanax, (not a lot). I cut them each in 4ths and used about 1 1/2 pills of each a day. I don’t know how wise that is, but I couldn’t have survived without them. My husband has been a saint, and we are people of great faith and I know the Lord is the only way my pain could have been faced. But the central nervous, jerks and shaking is horrible. Xanax helped with that. Had no appetite for days and could only get 2 hours sleep a night. After 10 days that has improved, but I have trazadone for sleep and I have no idea how good that is, but have used it. I still need the 1 1/2 pill per day of the lortab and xanax, but the extreme weakness is horrible too. I feel like I can’t even lift my head from my pillow. When pain, nerves and weakness hit all at once I want to die. That breaks my husband’s heart so I have to keep quiet about it. Any advice would be appreciated. Lizzy’smom