Tramadol: Subject to the NJ Opioid Law and Regulation
Did you know that Tramadol (brand name: Ultram and/or Ultracet) was reclassified as a Schedule IV opioid? For years, Tramadol was thought of as safe for pain relief, less habit-forming, and easier to tolerate than its “stronger” counterparts, such as oxycodone. However, the Drug Enforcement Administration (DEA) revised its rules in 2014 to make Tramadol a Schedule IV Controlled Dangerous Substance (CDS). This means it is subject to the NJ Opioid Law and Regulation requirements.
Although prescribed less often than other opiate painkillers, there has been a steady increase of both the use and abuse of Tramadol. Its desired effect is to produce consistent pain relief. But, like other opioid drugs, there are multiple side effects including nausea, vomiting, lightheadedness, drowsiness, headache, loss of appetite and dry mouth. Individuals who use Tramadol long enough and/or at higher doses can eventually develop tolerance, physical dependence and/or addiction to the drug. Habitual users who develop tolerance need to increase the dosage amount or frequency to achieve the desired effects of either pain relief or the euphoric effects of a “high.” Therefore, considering this drug’s addictive nature, it is recommended that providers query the NJ Prescription Monitoring Program (NJPMP) before prescribing Tramadol, although it is not mandatory for a Schedule IV CDS. As a reminder, it is mandatory to query the NJPMP prior to prescribing Schedule II opioids for new or current patients and on at least a quarterly basis during the time that a current patient continues to receive the prescription.
A current list of Schedule I – V CDS can be found at 21 CFR part 1308.
To learn more about the opioid crisis and your obligations as a prescriber, Conventus members can log into the "member only" section of the Conventus website and listen to podcast recordings regarding various aspects of pain management including laws/regulations, informed consent, pain management agreements, the New Jersey Prescription Monitoring Program, and more. As always, Conventus members can also contact the 24/7 Practice Advice Hotline for additional assistance.
DISCLAIMER: The information contained herein is intended for educational purposes only. NIP Management Co., LLC/Conventus takes reasonable efforts to provide accurate information but cannot guarantee its accuracy or that it meets local, state, or federal statutes, laws, or regulations. NIP/Conventus disclaims any and all liability for reliance upon the information contained therein. It is suggested that you consult your legal counsel or other professional consultants about how it pertains to your specific situation.