The medicine tramadol is atypical for an opioid-like substance in that medical studies have shown mixed results on whether or not the drug is addictive. Typically, the results are framed around a potential for abuse, dependence, tolerance, and addiction being less of a risk than with morphine, but still present. The World Health Organization (WHO) published a report on tramadol in 2014, stating these findings, but emphasizing that tramadol is a risky substance for many people across the globe. In the US, tramadol is the generic name for a Schedule IV prescription opioid painkiller, which can be found under various brand names, such as:
- Ultram ER
- Rybix ODT
The Food and Drug Administration (FDA) first approved tramadol when Ortho-McNeil-Janssen Pharmaceuticals submitted the medicine. It became available for prescription in 1995 under the brand name Ultram. Currently, Janssen is a subsidiary of Johnson & Johnson.
Since tramadol is no longer patent-protected, Janssen is not the exclusive manufacturer of medicines using this opioid any longer. For example, ConZip is manufactured by Vertical Pharma.
Although tramadol medicines were approved in 1995, the opioid has been more widely prescribed and available since opioid prescribing guidelines were loosened around 1999. The Centers for Disease Control and Prevention (CDC) found that, since 1999, the demographics of opioid abuse have shifted from urban areas with low-income, predominantly non-white populations to suburban regions with primarily white populations, with middle or upper income levels. The link between more lax prescribing of these addictive narcotic medications and those with better access to health insurance was quickly noted, and the CDC, lawmakers, and medical researchers began to advocate for a return to tighter regulations around prescribing opioid medicines. However, as more opioid drugs – especially oxycodone and hydrocodone medicines – became harder to acquire with the Drug Enforcement Administration’s (DEA’s) scheduling changes, these individuals turned instead to illicit purchase of drugs, especially heroin.