Tramadol is an atypical, centrally acting, synthetic
analgesic, acting through
opioid and non-
opioid systems. We present a series of seven cases, all men, who sought treatment at our centre for
tramadol-dependence. The majority were using other
opioids at some point in their lives. Their
tramadol use had begun with a prescription of
tramadol for
opioid detoxification, for
headache and body pains, and as an alternative to
injectable opioids. The doses of
tramadol used varied from 50 to 1500 mg per day. All subjects reported an experience of euphoria with
tramadol use. Four patients were put on
naltrexone, but had poor compliance. This case series underscores the need for caution, while using
tramadol in substance-dependent patients.