Tramadol, Usage, Misuse, and Addiction Processes

Tramadol is a centrally acting synthetic opioid, which is currently one of the top most–prescribed medications in the United States. Tramadol and its active metabolite can relieve acute and chronic pain including musculoskeletal and neuropathic pain as well as postoperative, gynecological, obstetric, and cancerous pain. It has been supposed that tramadol has a low abuse potential. Therefore, it was approved as an unscheduled analgesic in the United States in 1994. Over time, evidence of increasing tramadol-related diversion and overdose caused it to be scheduled in some countries. The aim of this chapter is to review the pharmacokinetics, drug indications, probable adverse effects and drug interactions, and possible mechanisms relating to tramadol’s rewarding effects and abuse.