Tramadol

TRA

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Primary Products

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DrugSURE® Integrated Test Cups

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DrugSURE® Dip Tests

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OralTox® Oral Fluid Tests

ng/ml

Cut-Off Levels

Rapid Urine Test: 200 ng/mL

Rapid Oral Fluid Test: 5 ng/mL

WOD

Window of Detection Times

Urine Specimen: 1 – 3 Days

Oral Fluid Specimen: 48 Hours

What is Tramadol?

Tramadol is a synthetic opioid analgesic used medically to treat moderate to moderately severe pain. It acts on the central nervous system by binding to opioid receptors while also inhibiting the reuptake of serotonin and norepinephrine—giving it both opioid and atypical antidepressant-like properties. Because of its dual mechanism, tramadol carries risks of dependence, withdrawal, seizures, and serotonin syndrome.

Prescription tramadol is supplied as tablets, capsules, or extended-release formulations. Colors, shapes, and markings vary by manufacturer, but most tablets appear white or off-white. Illicit or misused tramadol may appear as loose tablets, counterfeit pills, or crushed powder.

Medical use:

Prescribed for pain management
Often used after surgery, injury, or for chronic conditions
Available in immediate-release and extended-release forms

Recreational misuse:

Some individuals misuse tramadol for its sedative, mood-altering, and opioid-like effects. High doses increase the risk of overdose, seizures, respiratory depression, and dangerous interactions with other CNS depressants or SSRIs/SNRIs.

Effects:

Pain relief and reduced discomfort
Mild euphoria or mood elevation
Drowsiness or sedation
Dizziness or impaired coordination
Constipation or gastrointestinal slowing
Nausea or vomiting
Headache
Risk of seizures at high doses
Respiratory depression (especially with other depressants)
Dependence, tolerance, and withdrawal over time

Commons Slang Terms:

Trams
Trammies
Chill pills
Ultras (from brand-name Ultram)
O-Ds (street shorthand for opioid-like depressants)

(Tramadol has fewer slang names compared to classic opioids but these are most recognized in misuse contexts.)

Legal Status:

Tramadol is classified as a Schedule IV controlled substance in the United States, recognizing its accepted medical use but also its potential for misuse, dependence, and diversion. Because of its opioid-like properties and increasing rates of abuse, many workplaces, treatment programs, and monitoring agencies include tramadol in their toxicology panels—especially in sectors where opioid impairment creates safety risks.

For POC rapid toxicology testing programs, tramadol’s legal status means that facilities must be equipped to differentiate between legitimate prescription use and misuse or diversion. Rapid screening devices can identify tramadol or its metabolites on-site, allowing prompt action when necessary. Programs typically rely on confirmatory laboratory testing to verify positive screens and to assess prescription validity, ensuring fairness, compliance, and accuracy in monitoring environments such as pain clinics, probation settings, healthcare employment, and rehabilitation programs.