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TRamadol Reserach and Advocacy

Oct 19, 2009 - 21 comments






Welcome to the Tramadol reserach and advocacy site. Maybe someone can come up with an acronym for us. Thanks to Fred and madtram for everything they do on the sister Tramadol site. This site wouldn't be here without them.

We have created this site as many of us have unanswered questions about Tramadol.  We come from different parts of the world on the Tramadol support site....many, of course, in the US and UK. If you'd like to identify your country, it would help when we look at your laws, for example.

We are people who have personal experience with tramadol and we know that for us, it was a negative experience, in part because we believe we were not informed about the addiction and abuse potential of the drug. Some of us are lawyers and aspiring doctors, pharmacists, students, etc. In the end, our professions don't matter much, but I can tell you that, as a lawyer, I plan on using my resources to help this group. My point here is that everyone has something to offer, including some excellent chemical analysis and research skills and we welcome whatever skills you can offer, including moral support.

My personal goal is consumer advocacy. I want to publish as much information and analysis about Tramadol as I can find. If you have something to share, welcome.

My personal agenda: I am for personal empowerment through information. I am a lawyer who has done consumer protection class action work. I am not filing a Tramadol products liability lawsuit and will not consider a consumer class action because everybody knows that success in a class action comes on the day everybody gets paid to shut up. So I'm going to take a different route here.

Let's start with the FDA. Tramadol is an unscheduled drug in the US, except for in the few states that have started to regulate it. This is because the DEA did not recommend that it be scheduled when it came up upon its introduction into the US. If the FDA doesn't recommend scheduling, the DEA cannot regulate it. In the coming days, look here for my information on the dates that Tramadol was approved by the FDA. I will give out addys to petition the DEA for Freedom of Information requests regarding Tramadol's history at the FDA.

Let's study some history about the drug's maker, a German pharma firm called Chemie Grunenthal. They are best known for developing thalidomide. In the coming days, I will post links to their website,  where they provide their own backgound and mission statement.

In an effort to promote clarity, let's me tell you that, like many others who have studied drug policy in depth, I am anti-regulation, at least in the sense that we have regulated drugs up until this point in the US. The FDA/DEA structure is riddled with conflciting policy and sometimes dirty politics. However, I am not indicting the often good people who work for regulatory agencies that truly want to protect us from harm. The problem is that its not working.

I am also not anti-doctor. Though I believe that many doctors neglgently prescribed Tramadol, I cannot lay the blame at their feet, as I believe many of them were misled by the published medical trials. I will publish links to studies done by various doctors at Johns Hopkins and other established, preeminent facilities, so you can see if you agree with their findings about tramadol's addiction and abuse potential.

Also, let's look at the firms that Chemie Grunenthal cross-licensed with in the US, such as Ortho-McNeil and Caraco. In the US there is current pending litigation in  a US District court about when generics will be allowed for some Tramadol compounds. Chemie G still owns the patent here.

Additionally, Chemie Grunenthal has developed a kind of "second generation" tramadol style drug. It is called, I believe tapentadol. I will correct this if wrong, but I can't navigate away right now. It is currently on track to be a schedule ii drug, which is more regulated than CG would have liked.

Finally, we need to discuss strategies for getting our information out there. A google search of Tramadol brings up mass marketing sites, many of unclear origin, which promote Tramadol. Time to fight the rankings war. Computer and math people, where are you?

Listen, we are not going to be a normal group here. I think of it as a guerilla information campaign. Even if Tramadol were to be scheduled, it wouldn't solve all our problems. But let's start did we get here? Let's track down the spread of this drug from inception to this point. What is its European history? Why the misunderstanding with addiction potential? Why the skewed reseach? Why the unscheduled status in the US? How did this happen? This drug had, if you excuse the term, some heavy pushing behind it.

And let's be clear: this drug works for some people. But let's do a cost/benefit analysis as to how well it works as oppossed to regular opiates that are regulated to the...let's say, high the point where doctors are afraid to prescribe them. Yet, tramadol, which quickly spirals into an intense jones and nasty wd, even after short-term usage, is available over the counter in many places, and is available even in the US over the internet counter, with an internet prescription.

I'm not going to remain anonymous forever. But you can. You can fight right here with us as part of your effort to get free from whatever is is your're fighting. It helped some of us to ask these questions when we were struggling to shake the tram out of synapses. For me, the Tram smoothes out everything that made me an effective advocate. I was good and smooth with it. But now I'm off it and I'm great and...let's face it, not so smooth. In fact, you might say I'm ready to fight a little rough. All for a good cause.

Care to join me? Let me know what you can do best.


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Avatar universal
by nancy652, Oct 19, 2009
If you posted on the test site, please copy your post here as that thread is closed and I don't want to lose your comments.

Avatar universal
by FinallyFred, Oct 19, 2009
Nancy,  Thank you for the great idea of beginning this site,  dedicated not to our own personal battles with this drug, but rather, what we can do to see that the DEA/FDA properly recognize the dangers of this drug and make certain that the public has a fighting chance.  

Research does seem to be the first order - into the  history of the company that introduced the drug into the world, the tests they did dor did not do, and how it is that the FDA was convinced to not schedule the drug or otherwise regulate the online commerce related to Tramadol.   I envision this place as a location where we can share research and stategy and information.

I would not expect that this thread would have a wide appeal to the masses, but rather a place we can direct that occassional tramadol warrior, who expresses an interest in working on the general problem of reckless, uncontrolled tramadol distribution and/or on improving public awareness.

I am not personally all that concerned about fighting the "rankings war' on google.  Emily's journal is right up there and it will continue to bring people into health and healing on her site.   Sites move up based on the number of "hits" a particular site gets.   Maybe someone will come along with other knowledge or concerns.

Prospero, I don't believe that anyone has suggested that this drug ought to be outlawed.   Scheduled yes possibly.   Because if it were scheduled, doctors would think twice refilling prescriptions without at least face to face examinations.   And scheduling would also make it more difficult to sell this online.

Getting the public informed should also be another aspect of our attack that we may want to look into.    

I expect that people who post here will have work schedules that will wax and wain.  I expect to be quite busy in the next few weeks.  But I will also have times when my work schedule isn't crushing, when I will be able to devote time to the business of the guerilla information campaign Nancy mentioned.  Fred

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by Prospero73, Oct 19, 2009
Nancy, your post was extremely interesting to me, for several reasons.  It's almost as if this journal came into existence in response to my personal situation.  I have had Tramadol on prescription for about 8 months, for chronic pain from an arthritic right thumb.  I had been taking Tylenol #3 with codeine for a year or so, and didn't like the side effects (constipation) or taking that much Tylenol.  I asked my doctor for a prescription for Celebrex, which had given good results earlier, but it had been discontinued because I wasn't taking enough of it (one a day was a non-standard dose, according to the insurance co.).  

So my doctor suggested that I try Tramadol, which, he said, was non-narcotic and non-addictive.  A familiar story to people here!  Anyway, I took the first one in the late afternoon and it worked pretty well, but I had terrible insomnia that night and concluded that it was useless to me because it made me wired.

A few months later, I gave it another try, earlier in the day, and it worked OK, with no insomnia.  When I took it more than once a day (the prescription was for one 50mg tab every six hours) the constipation problem recurred, so I limited the dose to one/day and filled in with ibuprofen as needed.  

So far, so good.  Last April, we suffered a tragedy.  Our son, age 27, died of an overdose of methadone, after a two-year effort to recover from an addiction dating back to his first year in college, in 2000.  As much as we had been through with methadone, I still knew very little about it, and the effort to understand led me to MedHelp and the Substance Abuse forum, where I also encountered many frightening stories about Tramadol.  The more I read, the more it seemed to me that it was very similar to methadone: a synthetic opioid, with a long half-life, taken orally, prescribed for chronic pain, and extremely difficult to kick.  

My wife and I have begun a campaign to improve understanding of the dangers of methadone.  Because of its usefulness as a legal substitute for heroin addiction, it is widely regarded as a "good" drug.  In recent years, it has been prescribed for pain more frequently, and between that and the maintenance programs, there is a lot of it in circulation, with the result that deaths from overdose are on the rise.  

The same lack of awareness exists with Tramadol.  Doctors, let's face it, do not always know what they're doing when they prescribe the drugs that are saturating the market, plugged by billion-dollar media "ask your doctor about..." ad campaigns.  My doctor is as good as they come: he's been my family physician for 32 years, he saved my wife's life 16 year ago by diagnosing her Type 1 diabetes, and he's a 10-year member of the state legislature and one of the founders of our state health care plan.  If he can prescribe Tramadol the way he did, anyone could.  And if I had taken it as prescribed, 200mg daily, I would probably be addicted to it by now.

I am basically libertarian about drug usage, and I don't think increased regulation and/or legislation is the answer.  But a libertarian attitude depends on a high level of awareness and information.  The information is there (I found it), but there's so much information going around that people don't know what to trust.  You have pointed out the physician's dilemma of prescribing Tramadol because all the bad publicity has made them afraid to prescribe drugs like Oxycontin.  It seems to me that one of the basic purposes of education (originating in prehistoric times) is to warn us about things that will get us in
bad trouble.  In this respect, it would seem to be a total failure: people continue to start smoking, have unprotected sex, die in drunken car crashes, and succumb to drug overdoses, as if no one had ever told them that these things would cause them problems.  Perhaps educating the doctors is a good place to start.  People do listen to their doctors, far more than to their parents, their educators, or their political leaders.

Thanks for setting up this journal.  I look forward to reading other comments.      

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by madtram, Oct 19, 2009
Repost from this afternoon:

Finally found some sense in the European Journal of Psychiatry from March this year & couldn't wait to post this summary, (the article is included in the bundle I have emailed to you both):-

"Pain, depression and pain, somatic diseases, previous addiction diseases, psychiatric family history, being a member of medical staff increase the risk to develop dependence to prescribed tramadol. Tramadol dependent patients show a high rate of suicidal trials and of seizures."

So pain increases the risk of dependence,  hmmm, maybe it's a drug more suited to recreational drug users with no pain.

Our challenge remains all the other studies that conclude that tramadol is no more addictive than Advil.

Avatar universal
by nancy652, Oct 19, 2009
I certainly agree with you that these issues have no easy answers. I saw the photo of ( I assume) your very beautiful son on your page and my heart failed a little contemplating your loss. I am very sorry for it.
Methadone does indeed share some properties with tramadol. From a chemical standpoint, as you point out, they are both synthetics. There are many great books on methadone and its development, origins, etc which I have skimmed as I've always been interested in drugs that have been introduced into the population for reasons which may be entangled with social engineering goals. The goal with methadone, arguably, was that exactly, albeit, in my limited understanding, to be used on a limited population: existent opiate addicts. Much has been written as to whether this mission has been successful here in the U.S. I can recommend some books to you, if you like or google books will pull up alot of material, some of which you have probably found by now.
I spent the afternoon looking at the Erowid vaults, a collection of personal drug experiences, that chronicle methadone experiences, some of which have, incidentally, cross-overs with Tram usage.
Methadone too has what is termed an agonizing wd, the chemical aspects of which I am not clear on yet. But a cursory examination of its chemical structure seems to show that when synthetic opiates are entagled with other agents, it makes for a altered chemical experience characterized by both a difficult initiation and wd both. Many people have reported that their initial Tram experiences were not pleasant. My own was not. I actually had to teach myself to like it. When I did, watch out. Many methadone users say the same thing.
My personal md gave me Tram as well. He is a good person and been with the family a long time. He is a somewhat (though not radically) conservative prescription writer, reluctant to prescribe more than a 30 day dose of an opiate in a year. He handed out gobs of Tram to me as samples. I already had an appetite for it, so I didn't reject it.
I agree that the doctors are the frontline sources of information. I am somewhat worried that if they can't prescibe the Tram, some people won't be getting any opiates at all when they need them. That is how ###### up the pain management situation is. But nothing is as awful as what you have had to endure.
Thank you so much for being here and I hope you join us permanently, or at least, when your life allows. I'd love to have more of your input.

Avatar universal
by nancy652, Oct 23, 2009
Morning all. My goal for today is to draft the Freedom of Information Act request to the DEA as to Chemie Grunenthal, the owner of the tramadol patent. I will ask for all communications between the FDA the CG leading up to the initial FDA approval process. I will ask which medical studies were relied upon, specifically if they came out of American facilities like Johns Hopkins. I will post a redacted copy here when I'm done over the weekend. I will only redact my name and addy for now till I get on my feet with this. If you have any suggestions, feel free to post them.

890982 tn?1259091185
by Prospero73, Nov 08, 2009
Nancy, thanks for your reply to my post of 10/19.  My wife and I left that day for our first vacation of over a week in 15 years, and I only just now read it.  

Did you communicate your experience with Tram to the doctor that prescribed it?  I haven't talked to mine yet, perhaps because I'm afraid he'll revoke my prescription.  I think the standard prescribed dose (4 X 50mg/day) is way too high.  I take one in the morning and it seems to linger around until evening.  Like methadone, it stays in the system a long time, and I have started cutting the pills in half, i.e. 25 mg/day.  

I consider myself an experiment of one, to see if that dose is low enough to provide effective pain relief and avoid addiction.  

1090333 tn?1264508493
by GreatWhite, Nov 13, 2009
Ok so i just googled tramadol and this is what i found from a website called: cant believe there is a website called that:

"It is wise to keep a few facts in mind in order to be safe with your drug. Tramadol is not harmful to your health but this doesn’t mean you don’t have to think before you use it with other medication. Please let your doctor know about any prescribed and non-prescribed drugs you take, including vitamins and herbs.

Most of the time it is recommended to consume Tramadol during the pregnancy.

A drug doesn’t have to be bad to be good. Some people think that when we treat our heart, our liver may suffer. It is not the case with Tramadol. This doesn’t mean Tramadol doesn’t have side-effects, though. It does. But there is hardly a case a doctor could recollect when Tramadol did more bad than good to the patient. The side-effects that could happen are: vomiting, nausea, dizziness, drowsiness. Less commonly reported side effects include itching, sweating, visual disturbances, and vertigo. So at least you have to know them all."

that last paragraph is most disturbing to me along with it is recommended during pregnancy!>?!>!>!>!>! I cant believe this info is out there!!!

890982 tn?1259091185
by Prospero73, Nov 13, 2009
More wisdom from the same source:

"What is Tramadol?
It is a synthetic pain reliever, very effective in treating severe pain.
How does Tramadol come?
Tramadol is released in tablets, extended-release tablets, oral drops, suppositories and injections. Tramadol is marketed in different pharmaceutical forms all over the globe.
How should I use Tramadol?
The maximum permitted dose is 400 mg/ daily but your doctor should advise you the best possible treatment and dosage schedule for your personal medical case.
Can side effects occur?
Yes, they can occur but if you inform your doctor all the details of your medical history, he will have the possibility to avoid these side effects with you.
What are the most common side effects or adverse reactions?
Tramadol is usually well handled. But the most frequently known side effects are: nausea, constipation, dizziness, headache, drowsiness and vomiting. Remember that sudden withdrawal can cause anxiety, sweating, insomnia, pain, nausea, diarrhea, tremors and hallucinations.
What should I do if side effects occur?
In such cases you should contact your doctor immediately.

May Tramadol induce addiction? 
Abuse is totally different from physical dependence. Prescription is meant to control these situations and stop the patient from getting addicted. [Note the vagueness of the language here.  Whoever wrote this has very poor command of English, and obviously no first-hand experience with Tramadol.  Remember that this is a site that offers the sale of large quantities with no prescription or medical consultation!]

Can I crash [sic] the tablets?
Tramadol pills should be swallowed only.
Is it possible to take Tramadol once daily?
Yes. Extended-released tablets are to be taken once a day but do not decide upon your treatment yourself. Make up a schedule together with the doctor. He will know what suits you best.
Who can’t take Tramadol?
It is not a secret that Tramadol is very effective. But unfortunately it is not to be taken by anybody at all. Pregnant and nursing women are not recommended to take this drug. Patients, who are under 18 years old, should be prevented as well. Tramadol should be used with special caution in patients older than 75 years old.
Can I take Tramadol if I am taking other medicines?
It will depend on the medication you use. Your doctor will decide if it is possible or not. Prepare a list with the drugs you are using that come with or without a prescription and seek for doctor’s advice.
Can I take Tramadol with food?
Tramadol can be taken with food as well as without it.
What should I do if I forget a dose?
If you have prescribed Tramadol regularly and you miss a dose, take it as soon as you remember it. If it is already too late, please skip it and go on with the medication as it was prescribed by your healthcare assistant.
Where can I buy Tramadol?
You can buy Tramadol from your local pharmacy or from online pharmacies. If you purchase it online, you should choose a licensed drugstore. Prescription is necessary.
What should I do in case of emergency or overdose?
You should call your nearest poison center or emergency room. Try to let your doctor be aware of everything that goes on in your life that is related to Tramadol. He will be of a great help."

Avatar universal
by nancy652, Nov 15, 2009
Greetings all. Thanks for joinging me here. I've moved into a new office (the better to attack you with tramadol, my dear!) and I haven't had time to respond to the messages, which I've appreciated. But we will pick up the pace with the help of everyone here.

I am setting up a blog as it is easiest to administer and I can dump the med studies there. At that point, we can all post and whomever is interested can take assignments such as Freedom of Information requests and google-based research. We can also make phone calls and draft letters to doctors who might have performed studies. We need to be polite, organized and determined. We will get noticed, I guarantee it.

Let me know what you might be able to do and in turn I will create the blog, hopefully by the end of the week. Stay tuned here and direct others over, if you think they might benefit or be of us to us.


1090333 tn?1264508493
by GreatWhite, Nov 16, 2009

i can do any kind of research and definitely make some calls. I have my aunt who is a pediatric oncologist, a addiction specialist therapist in the family, and connections to many doctors that I can talk to about this drug. Let me know when the  blog is set up, I appreciate all you are doing, you are doing an amazing thing! Let me know if i can be of assistance at all!

Avatar universal
by nancy652, Nov 18, 2009
Thank you Chris. I have my regular office almost set up and am finding a simple blogging platform we can use. I'm setting up a couple sites at once for work, so I'm doing this one this week as well. Your help would be much appreciated and we can use all the connections we can get. I'll be back with an update in the next couple days.


Avatar universal
by janesweet, Nov 20, 2009
Hi nancy,
I have struggled with this nasty drug on and off for awhile.  I know many people who are or were addicted to tramadol.  I am a healt care provider (psychotherapist) and would be very happy to help in any way I can to get this drug regulated.  

I was working in a recovery house for women and they were giving them tramadol for pain relief!  These are narcotic addicts, alcoholis and etc...

It is so available on line and now that I am not ordering it anymore I am receiveing phone calls constantly reminding me to reorder.  The people are pushy and very obnoxious.  When I tell them never to call again, they wait a few days and start calling again.


890982 tn?1259091185
by Prospero73, Nov 29, 2009
Has this site moved again?  It's been pretty quiet this last week.

Avatar universal
by nancy652, Nov 30, 2009
No, I'm still here. Holidays and new office have me on the run. I'm going to wordpress today. I was going to set up something with a server, but let me get us started today with a blog. I need a place to "post and host" in a simple way so I can place med studies in an archive and put up stuff the FOI requests. I'll be back later today with a link. Thanks for your patience.

Avatar universal
by nancy652, Nov 30, 2009

here is our site and first post. Please come on over and comment if you like.

Avatar universal
by Sorry_I_took_that_crap, Sep 26, 2013
I almost died after a couple of weeks of a sharply increased dose of Tramadol. I attempted suicide & was on a ventilator for three days. The doctor had little to no hope for me and asked my family if he should call the Chaplan & to start thinking about what they wanted to do with my body. Years before I had a horrible reaction to Cymbalta but I had noticed the change in my mental stability and promptly weaned myself off. I've always had bad reactions to antidepressants so I avoid them like the plague. I wasn't aware that Tramadol has similar SNRI activity as Cymbalta. It appears that I get violently suicidal when my nueropinepherine levels are messed with. If just one doctor had mentioned that it was "so safe" because it has antidepressant properties, I would have not have taken it. Instead it was given to me as a non addictive pain pill & I almost lost my life.

Avatar universal
by TBIunderdog, Jun 23, 2015
Tramadol destroyed mine, and my families lives.
Read more: http://m.************/HumanRightsComplaintsNewZealand,

Avatar universal
by TBIunderdog, Jun 23, 2015
Facebook, Human Rights Complaints New Zealand, Tramadol, here in New Zealand Medsafe "Failed to include the FDA Tramadol suicide risk warning for people with addiction issues, mental health issues, and suicidal ideation
Tramadol is a dangerius drug.
I was 16 months sober from drugs and alcohol, i was administered morphine in large quantities, then Tramadol, i tried to take my own life, i relapsed into my life threatening addictions.
Warning: Tramadol is a "dangerous drug for people recovering from addictions, and, or people who have a history of mental health issues.
Facebook, Human Rights Complaints New Zealand, Tramadol.

Avatar universal
by TBIunderdog, Jun 30, 2015
New Zealand "cyber bullying law" could re-victimise victims of negligent crimes perpetrated by New Zealand government employees, and then face two years in jail for expose of facts.
Link to part of my story: http://www.***********/TBIunderdog/journal/new-zealand-harmfull-digital-communications-bill-re-victimising-victims/

Further information: http://m.************/HumanRightsComplaintsNewZealand,

Paul Riddler, TBI underdog.

Avatar universal
by Tramadolpsychosis, Jan 16, 2016
Hi nancy
I am curious to know if you have had anyone who became psychotic on this drug? I unfortunately had a terrible experience with this drug that almost ruined my life. Not because of the addiction properties but because of the psychosis.

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