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

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

Specializes in Trauma SICU.

My mom has taken tramadol 2-3x daily for the past 10-15 years for severe rheumatoid arthritis. I really hope they don't take it off the market because she needs it badly.

I've taken it and it doesn't produce euphoria or any sort of rec. drug effect. Do people really become addicted to it?

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Specializes in orthopedic/trauma, Informatics, diabetes.

Google it and see some of the posts. It is supposedly really rough for a few days. No sleep and terrible restless leg, racing HR.

the new drug is tapentadol (Nucynta) which is similar. IF they take tramadol off.

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Specializes in allergy and asthma, urgent care.

I have seen several patients abuse tramadol. I have a high incidence of substance abusers in my patient population, so I try to steer clear of narcotics and tramadol as much as possible. I've only prescribed Nucynta once, and that patient had hallucinations. I'm not too eager to try it again with someone.

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Specializes in Psych ICU, addictions.
xtxrn said:
T#3....hands down. NEVER had a patent enter drug rehab for tramadol.

I've had plenty of patients come in for tramadol addiction. Compared to the other detoxes, they were pretty pleasant patients: the withdrawal symptoms mirrored opiate withdrawal but were not as severe. The main issue with them was to be on guard for seizues since tramadol lowers the seizure threshhold, so they were put on a phenobarbital taper just to be safe.

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Specializes in ICU, step down, dialysis.

I've had 3 physicians refuse to prescribe me more tramadol for fibromyalgia pain because they feel I will become addicted to it. I have no history of substance abuse, do not get high off of it and it worked well with the pain. Now I cannot work and am headed for SSDI.

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Specializes in Government.

I agree with the poster who said Tramadol is underutilized. I've taken it every day for 10 years for RA. It keeps me moving and working. I now am able to do yoga, work, sleep at night. While it did snow me for the first few weeks, I am now acclimated to it.

An MD who was trying to talk me into bilateral knee replacements told me it was a "horrible drug". 10 years later with original equipment? I disagree.

I see addicts only using Tramadol when they can't get anything else. Never met an addict for whom it was a drug of choice.

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I have seen Tramadol used for a narc. addict who was fighting not to take narcs. for pain because he knew it would activate the disease. He found no relief from the Tramadol. He did end up on very controlled amounts of narcs for pain prior to knee surg.

He found the Tramadol activated the disease. My guess is that it is close enough to a narc that the receptor sites are easily activated by either drug.

Are you asking about addiction or tolerance or physical dependence? Review the WHO ladder for pain control. We see Vicodin as being only slightly more effective than tylenol. Percocets are higher on the ladder. No matter what narc you use there will probably be tolerance developing.

Side effects must always be considered. That is one difference between an adequate nurse and a good one. The anticipated effects get treated before they appear.

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xtxrn said:

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. ?

but if we do that we won't get to be indignant and judgmental. ;)

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Horseshoe said:
But if we do that we won't get to be indignant and judgmental. ;)

Isn't that the truth.

This same man I described previously had a knee replacement. The day after surg. he was out of the room for PT. Of course his PCA was stopped during this time. When he returned to his bed he waited a good 1/2 hr for the nurse to come and restart his med. When she finally came by the first words out of her mouth were "You know you can't take this machine home with you."

She seemed to find the time to be judge and jury about his need for narcotics but did not have smarts to keep her mouth shut. Just for the record... I was in the room and heard this first hand. No hearsay.

He was walking with crutches the length of the hall less than 24 hr. after surg. I had no problem with his need for narcotics at this point. His physicians knew his needs.

I then became judgmental and indignant with the nurses.

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Back pain and physician gave me 2 sample packs. Took one dose at night and slept like a baby. The 2nd dose was the problem. In the morning before I left for clinical to give my first meds ever, I took another. Withinn 20 minutes I started feeling warm and my eyesight started to get better--I knew I was in trouble. Was feeling worse by the time I got to the hospital. Gave my med quickly and went to ED - s/s low b/p, continuous n/v, vertigo, weakness. Now, I make sure I am not given tramadol or Ultrace--too bad as that first dose worked wonderful.

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