Is Tramadol a Controlled Substance?

Edmund Murphy
Dr. Paul Hetrick
Written by Edmund Murphy on 10 January 2022
Medically reviewed by Dr. Paul Hetrick on 25 November 2024

The Controlled Substance Act (CSA) controls the distribution, use, possession, importation, and manufacture of certain substances based on medical use, potential for abuse, and safety. This guide outlines where tramadol, an opioid pain medication, falls under the Controlled Substances Act.

Key takeaways:
  • Tramadol’s classification as a schedule IV drug has been contested owing to concerns that the medication’s opioid content increases the risk of abuse, addiction, and overdose.
  • Rates of snorting tramadol are 4 to 7 times lower than with other opioids such as oxycodone.
  • Despite its perceived low risk and low schedule classification, tramadol can still be addiction-forming.
Hand holding two green and yellow capsules, many capsules in background.

Tramadol controlled substance status

The United States Drug Enforcement Administration classified tramadol, an opioid pain relief medication available under prescription, as a schedule IV drug under the Controlled Substances Act (CSA) as of August 2014.

Prior to the Schedule C-IV designation federally in 2014, tramadol was a controlled substance in ten states in the US. Tramadol’s classification as a Schedule IV drug has been contested owing to concerns that the medication’s opioid content increases the risk of abuse, addiction, and overdose. 

Schedule IV substances have less strict regulations as they are seen to have a lower potential for abuse and serve a medical purpose. Substances like tramadol that fall under Schedule III or IV are only available with a prescription that can be refilled five times in a six-month period before another prescription is required.

Implications

  • Studies have shown that tramadol is less likely to be obtained from pharmacies under false pretenses than other opioid medications.
  • It is also less likely to be bought and sold for illicit purposes on the street. 
  • Rates of snorting tramadol are 4 to 7 times lower than with other opioids such as oxycodone.
  • Injecting tramadol is 14 to 34 times lower than with other opioids.
  • Tramadol still holds the potential for abuse, dependence, addiction, and overdose. When prescribed tramadol for pain relief, it is important to only take the recommended dose and to not misuse the drug.

Tramadol addiction

Despite its perceived low risk and low schedule classification, tramadol can still be addiction-forming. Opioid painkillers are one of the most abused substances in America and can lead to substance use disorders that are difficult to stop without treatment.

If you or someone you care about is at risk of becoming addicted to tramadol, or if a drug dependence has already formed, then contact an addiction rehab center today.

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Resources:

  1. Tramadol - Top 8 Things You Need to Know. Retrieved from on Jan 10, 2022.
  2. Is tramadol a narcotic opioid / controlled substance? Retrieved from on Jan 10, 2022.
  3. Federal Register: (n.d.). federalregister.gov.

Activity History - Last updated: 25 November 2024, Published date:


Reviewer

Dr. Paul Hetrick is a licensed pharmacist with over two decades of professional experience. He currently works as a medical writer for a large pharmaceutical company and as a freelance medical content reviewer and consultant pharmacist.

Activity History - Medically Reviewed on 25 November 2024 and last checked on 25 November 2024

Medically reviewed by
Dr. Paul Hetrick

Dr. Paul Hetrick

PharmD

Reviewer

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