Ultram® (
tramadol hydrochloride) is a prescription medication used to treat moderate to moderately severe pain.
Originally, Ultram was marketed as a medication with weak narcotic effects and little potential for abuse. As a result, many healthcare providers came to view Ultram as a relatively safe medication for use in people at risk for drug abuse, such as people with previous problems with drug or alcohol abuse. However, research has since demonstrated that Ultram works primarily through
morphine-like activity, and numerous cases of abuse and dependence have been reported
(see Tramadol Abuse).
Because Ultram is not classified as a controlled substance in most states, many healthcare providers use it for their patients when they want to avoid the inconveniences of prescribing a controlled substance (such as many other pain medications) or if they are not authorized to prescribe controlled substances.
Ultram is classified as a "centrally acting opioid analgesic." This means that it works in the central nervous system (the brain and spinal cord), acts much like morphine in the body, and relieves pain. Much like morphine, Ultram binds to certain opioid receptors in the body known as μ ("mu") receptors.
Ultram also works in a similar manner as some
antidepressant medications, by inhibiting the reuptake of certain brain chemicals (serotonin and norepinephrine). Serotonin and norepinephrine are two of several chemicals used to send messages from one nerve cell to another. As a message travels down a nerve, it causes the end of the cell to release serotonin or norepinephrine. The chemical enters the gap between the first nerve cell and the one next to it. When enough serotonin or norepinephrine reaches the second nerve cell, it activates receptors on the cell and the message continues on its way. The first cell then quickly absorbs any serotonin or norepinephrine that remains in the gap between cells. This is called "reuptake."
