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Comment by telecuda | Hacker News Reader

Tramadol recently became more regulated as a controlled substance and now requires patients to jump through more hoops (pain management visits, drug tests, etc.) to obtain. Source: Family member on Tramadol and http://www.businessinsurance.com/article/20140818/NEWS08/140...

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I think its stupid they did that, but then I do remember widespread use of "Tromol" in Moscow. People would take it in high doses and veg out for days at a time.

Is this is the same Tramadol that is incredibly addictive and kills people if they taper off too quickly? Why wouldn't you want some hoops for this?

I was prescribed it after I broke a leg in judo. I was shocked when I looked it up and found forums rife with addicts in great distress.

Tramadol, like several other opioid drugs, e.g., hydrocodone and oxycodone, has been increasingly associated with dependence in recent years, so have been rescheduled to a more highly controlled classification by the DEA/FDA.

This is not a new phenomenon. Many opioids, including heroin, when introduced where thought to be "less addicting" than older opium-derived drugs. Of course, this turned out to be mistaken and now it's being played out with several "less addictive" opioids in common use.

I certainly wouldn't regard tramadol as innocuous, besides abuse and dependence, it can also have serious interactions with other medications, particularly serotonin overload which can be deadly.

Hoops are good, yes, and I don't disagree with the decision to reclassify it. The extra time and expense of new doctor appointments, urine tests, pill counting, questioning, etc. for someone who has been on the drug responsibly for a long time can just be aggravating.

That does sound a bit much. In the UK we'd expect free healthcare and doctor's appointment for re-ups.

It's not as addictive as other opiates. It is physically addictive though, yes.

Opiate withdrawals don't kill you, although you'll want to die; Tramadol has a weird secondary set of effects that act like an SSRI/anti-depressant, so you get both the opiate withdrawal symptoms as well as SSRI discontinuation syndrome symptoms which is a very unpleasant combination.

It's a decent painkiller, but like any opiate based pain medication has potential for abuse.

I think I read about seizures from cold turkey which required a 35 week long tapering schedule to avoid. Checking for a source I don't find this mentioned in official side-effects, only less formal guidance for addicts. Strange.

Seizures can also be caused in "overdose", which is unfortunately very very close to "recreational" doses. It's a very very weird drug in terms of secondary side-effects, the "SSRI" side can cause dangerous issues as well (serotonin toxicity when coupled with other serotonin affecting drugs).

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