Phil.McKeer
Bluelighter
I've worked with pain patients with no prior history of drug abuse, who were prescribed tramadol and more often than not, it worked well for them. So no, it's not what doctors prescribe to people they'd consider prone to abusing "real" opioids.
I put tramadol beyond oxycodone and codeine recreationally. Funny how opinions vary, ain't it? Tramadol isn't your usual opiate/opioid high, but that doesn't make it useless.
Riddle me this, then - why not give them codeine, the low-dose variations of bupe for pain, or even hydrocodone instead? You don't have to answer. I'll answer. It's because Tram is MUCH WEAKER, thus lower risks of everything, from abuse to being eyed out by the DEA and having your license revoked.
Tramadol may have an "effect" on opioid-naive individuals, but I'd bet you pennies to the dime that if you gave them the same amount (converted, of course) of codeine, it would result in greater analgesia.
Now, wheover has that magical gene, good on them. But nobody I know has it. And that's why there is almost no demand for Tramadol (and thus no supply) on the black market. I can get almost anything, but not a single soul I know can get tramadol unless its from their own medicine cabinet, from their own prescription.
Edit: And I'm not blind, I see the posts from people worried about withdrawing from tramadol, and I see that it actually happens. I'm not denying that it binds to the mu-opioid receptor, I'm just saying it doesn't do so with much efficacy. And to those people - try kicking a gram of heroin/day for two years. Then come back and tell us about your tramadol withdrawal.
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