On July 2, 2014, the Drug Enforcement Administration (DEA) published its Final Rule placing tramadol into Schedule IV of the Controlled Substances Act (CSA).
Tramadol is a synthetic opioid analgesic used in the treatment of pain, and brand names for the substance include Ultram®, Ultram ER®, Ultracet®, and ConZip®.
Tramadol initially was approved for marketing in 1995, but the drug was not scheduled under the CSA at that time. DEA’s rescheduling of tramadol comes at a time of growing concerns relating to abuse and misuse of opioid analgesics. Tramadol increasingly is abused in combination with other controlled substances. One commenter described tramadol as a “loop hole drug” that is “addictive, abused, and diverted” but that may have not been considered dangerous because it was not controlled. Notably, a number of states already had scheduled tramadol as a controlled substance, including Arkansas, Illinois, Kentucky, Mississippi, New Mexico, North Dakota, Oklahoma, Tennessee and Wyoming.
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