The following are some key things to know about the prescription drug Ultram and the facts surrounding the Ultram schedule according to the DEA:
- Ultram is also known by the generic name tramadol, and it’s a prescription painkiller that is opioid-like
- Ultram was once touted as a safer and less addictive alternative to other opioids, but in recent years there has been increasing evidence that it is also addictive and carries the potential for abuse and other dangerous effects
- Ultram is now a Schedule IV controlled substance according to the U.S. DEA, and it was previously not a controlled substance
- A controlled substance is one that’s regulated, and in this case is available only by a prescription
Before looking at the specifics of the Ultram schedule classification, it can be helpful to have an overview of what controlled substances are.
A controlled substance may be a drug that’s completely illegal, like heroin, and it’s seen as having an adverse effect on the health and well-being of a person. A controlled substance can also include drugs like Ultram that are available only in regulated situations and by prescription for medical treatment.
The government started schedules with the Controlled Substances Act of 1970, and the schedules include the following five groups:
- Schedule I drugs have no medical use accepted in the U.S., they are considered generally unsafe, and they have a high potential for abuse. Some of the examples of Schedule I drugs include heroin, peyote, ecstasy, LSD, and marijuana.
- Schedule II drugs include both narcotics and stimulants, and they have a very high potential for abuse and the potential for both physical and psychological dependence. Schedule II drugs include methadone, Demerol, Percocet, morphine, codeine, amphetamine, and methamphetamine.
- Schedule III drugs have less of a potential for abuse but can still lead to physical and psychological dependence. They include Vicodin, Suboxone, and anabolic steroids.
- Schedule IV drugs have a lower potential for abuse than Schedule II substances, and they include Ultram as well as Xanax, Klonopin, Valium, and Ativan.
- Finally, Schedule V substances may have limited amounts of narcotics, such as a cough syrup with codeine.
If you are prescribed one of the substances that are Schedule II and above, it’s not against the law. If you have Schedule I drugs, or you have the other drugs without a prescription, it can be against the law.
As was touched on above, the Ultram schedule classification is Schedule IV. This means there is a potential for abuse, although it is lower than with Schedule II and III drugs. This also means Ultram is available only by prescription and to possess or use it otherwise is unlawful.
It wasn’t until 2014 that the Drug Enforcement Administration officially added tramadol (Ultram) to the list of Schedule IV controlled substances. The legislation to make this change took about a year, and it went into effect relatively quickly after the change was made. While Ultram is now seen as being potentially addictive, it still tends to have a safer profile than a lot of other opioids, and because it acts on the central nervous system in a slightly different way than other opioids, it’s in some cases considered an alternative to opioids.
Despite the fact that Ultram is somewhat safer than other opioids, it still causes physical dependence that can lead to serious withdrawal symptoms. There is also the possibility of tramadol overdoses, and serotonin syndrome with the use of this drug, and Ultram does result in a number of emergency room visits each year.
When Ultram was first approved, the FDA didn’t recommend it be scheduled because it was believed to have a low potential for abuse, but then after a committee was formed to monitor patterns of abuse and dependence, it started to be seen to have abuse potential.
In some cases, physicians may still consider tramadol as a non-narcotic pain reliever, but current evidence is pointing the fact that it is, in reality, a narcotic, including the Ultram schedule IV classification.
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