In your opinion, which is more addictive tylenol 3 or tramadol?

[Blackheartednurse]

I have noticed that a lot of my patients are on either on Tramadol or tylenol 3, not so many on Narco.

[Murse901, MSN, RN]

Tylenol #3 by far. Most of our drug seekers get really PO'd if they leave with a prescription for Ultram. I've never had a patient whose drug of choice was Ultram. Plenty whose drug of choice was Codeine.

[ChuckeRN, BSN, RN]

I remember reading or hearing somewhere (maybe a Podcast ) that vicodin (or Norco) is the #1 most abused narc.

[carolmaccas66, BSN, RN]

Tramadol is great & is a very underused pain killer. But our govt down under is getting rid of it off the market next year, as it's causing cardiac problems - in cardiac patients!! And I like to use it for bad headaches etc so I will have to look for another pain killer now. Sometimes Panadol & Ibuprofen just don't cut it.

[xtxrn, ASN, RN]

T#3....hands down. NEVER had a patent enter drug rehab for tramadol.

I hear about the tramadol being taken off the market- first it was propoxyphene.. they're leaving few options besides the hard stuff- and then docs hate to prescribe that.... don't know what to do. I guess it's back to the pain management doc....I hate adding another doc in the mix.

[ayla2004, ASN, RN]

Don't like tramodol as a pain killer, however it works for the 10% codiene doesn't work for. However i did know a patient say they took 2-3 tmes the daily dose of codiene 480=720mg per day probaly since 30mg codiene tabs exist in the uk.

[K+MgSO4, BSN]

don't like tramadol as a pain killer seen too many people have hallucinations on it both young and old. Panadine forte (the Aussie equvilant of T3) way more addictive. As a colo-rectal nurse not fond of either as they cause constipation and perforation!! but more perfs on Panadine forte.

[ayla2004, ASN, RN]

opiates of any class need a bowel regiem be it prune juice etc or tablet laxatives considered prescribed.

[xtxrn, ASN, RN]

Tramadol CAN be very helpful for different kinds of pain. I'm in constant pain- no pain free days since 1996.... docs won't prescribe the Norco to take it enough to be pain 'tolerable' (I don't expect anything near pain free- that's just not realistic). SO, the tramadol and cyclobenzeprine help take up the slack...at least so I can tolerate contact with the mattress at night.

To look at me, you wouldn't think "pain"...it's my new 'normal'....

But a "real" opiate is definitely going to be more addictive- but that doesn't mean everyone who has it prescribed will become an addict.....studies show about 2-4% of those prescribed routine opiates have addiction issues....and keep in mind that tolerance and dependence are not the same as addiction....very important distinction. :)

[diva rn, BSN, RN]

Tylenol #3 is much more addictive due to the codiene of course. Although it would take a lot to become physically dependent on it.

Ultram or tramadol is a synthetic opiod agonist that is actually similar to the SNRIs such as Effexor and Celexa and it's being used to treat other disorders now in clinical trials...not just pain.

But because it is similar to the SNRI, it is being used to treat fibromyalgia with some success.

Neither one is suited for treatment of severe pain, nor are they "highly" addictive.

[mmc51264, BSN, MSN, RN]

I am on tramadol for arthritis and it really helps with its serotogenic effects too.

I have done some research and there are plenty of websites that discuss the difficulty of getting off tramadol. I had a classmate that just broke her foot and is allergic to opiods so they had her on tramadol and a new, similar drug that I can't remember the name of. I don't see much T3. I have also noticed that doctors are prescribing more percocet that vicodin.

[diva rn, BSN, RN]

mmc51264 said:

I am on tramadol for arthritis and it really helps with its serotogenic effects too.

I have done some research and there are plenty of websites that discuss the difficulty of getting off tramadol. I had a classmate that just broke her foot and is allergic to opiods so they had her on tramadol and a new, similar drug that I can't remember the name of. I don't see much T3. I have also noticed that doctors are prescribing more percocet that vicodin.

Right, that's because T3 is so mild, it really doesn't do much. I've noticed the percoset vs vicodin too, the only thing I can think is that the oxycodone in percoset is stronger than the hydrocodone in the vico...so maybe more bang for the buck?

Maybe the docs think the patient will not have to take as much?

It is a more elegant drug.