Is tramadol a controlled substance?

Yes. Tramadol is a Schedule IV controlled substance under US federal law, and the DEA list marks it as a narcotic. It is also an opioid analgesic. In the United Kingdom it is a Class C drug under the Misuse of Drugs Act 1971 and a Schedule 3 drug under the Misuse of Drugs Regulations 2001. Both countries scheduled it in 2014.

What is tramadol?

MedlinePlus says tramadol is in a class of medications called opiate (narcotic) analgesics. The label for generic tramadol hydrochloride tablets (Amneal Pharmaceuticals, DailyMed, published September 18, 2026) describes the approved use in Section 1:

Tramadol hydrochloride tablets are an opioid agonist indicated in adults for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

The Federal Register notice that scheduled tramadol says the FDA first approved it in 1995 under the trade name Ultram.

Is tramadol a narcotic?

In the way the DEA records it, yes. The NARC column of the DEA list shows "Y" for tramadol. In 21 CFR 1308.14, the Schedule IV regulation, tramadol sits in paragraph (b), which is headed "Narcotic drugs". Alprazolam and zolpidem sit in paragraph (c), "Depressants".

The statute is more specific. 21 U.S.C. 802(17) defines "narcotic drug" by listing opium, opiates and their derivatives, poppy straw, coca leaves, cocaine and ecgonine. The DEA's 2014 rule scheduling tramadol quotes the statute's opiate and narcotic definitions and says HHS and the DEA deem tramadol to be an opioid. The answer to "is tramadol a narcotic" therefore depends on who is asking. In federal scheduling practice it is flagged as one, and MedlinePlus uses the words opiate (narcotic) for its class. The general difference between the words is covered in what is a narcotic.

Is tramadol an opioid?

Yes. The label calls it an opioid agonist, as quoted above. The Federal Register notice that placed tramadol in Schedule IV, published July 2, 2014 (79 FR 37623, effective August 18, 2014), says that both the Department of Health and Human Services and the DEA deem tramadol to be an opioid because it shares pharmacological activity with opioids controlled under the Controlled Substances Act. In 21 U.S.C. 802(18), "opiate" or "opioid" means any drug with an addiction-forming or addiction-sustaining liability similar to morphine, or one that can be converted into such a drug. More on the family is on what is an opioid.

What does Schedule IV mean for prescriptions?

The federal rules for Schedule IV appear in 21 CFR 1306.21 and 1306.22. Section 1306.22 says:

No prescription for a controlled substance listed in Schedule III or IV shall be filled or refilled more than six months after the date on which such prescription was issued. No prescription for a controlled substance listed in Schedule III or IV authorized to be refilled may be refilled more than five times.

The 2014 final rule applied this to tramadol from August 18, 2014. Before that date tramadol was outside the federal schedules, so these federal limits did not apply to it. States may add rules of their own, and the state board of pharmacy is the source for them. A fuller outline of the five schedules is on the drug schedules page.

Why was tramadol scheduled?

The 2014 rule describes a review by HHS and the DEA. In its response to comments, the DEA compared tramadol mainly with propoxyphene, a Schedule IV narcotic, and said that strong scientific evidence showed similar behavioral pharmacology and abuse potential patterns between the two. The effect was to bring tramadol under the registration, record keeping, prescription and penalty rules for Schedule IV.

The current label supports the same picture. Section 9.1 says tramadol is a Schedule IV controlled substance, and Section 9.2 describes it as a substance with potential for misuse and abuse that can lead to substance use disorder, including addiction. The boxed warning lists these headings:

• addiction, abuse and misuse
• life-threatening respiratory depression
• accidental ingestion
• the Opioid Analgesic Risk Evaluation and Mitigation Strategy (REMS)
• risks from concomitant use with benzodiazepines or other CNS depressants
• neonatal opioid withdrawal syndrome
• ultra-rapid metabolism of tramadol and other risk factors in children
• interactions with drugs affecting cytochrome P450 isoenzymes

What class is tramadol in the UK?

Class C, Schedule 3. The Misuse of Drugs Act 1971 (Ketamine etc.) (Amendment) Order 2014 (S.I. 2014/1106) added tramadol to the Class C list, and the Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) (England, Wales and Scotland) Regulations 2014 (S.I. 2014/1275) added it to Schedule 3 to the 2001 Regulations and to the exempted drugs under the Safe Custody Regulations 1973. The Home Office circular 008/2014 gives June 10, 2014 as the date these changes came into force.

For Class C, the government's penalties page lists up to 2 years in prison, an unlimited fine or both for possession and up to 14 years, an unlimited fine or both for supply and production. See UK drug classes and schedules for what the classes and schedules mean. The Home Office list of commonly encountered controlled drugs shows tramadol as Class C, Schedule 3, which matches the legislation.

Where to ask questions

This page is legal information. It does not say who should or should not take tramadol, or how. A prescriber or pharmacist can answer questions about a prescription. In the US, the Poison Help line (1-800-222-1222) answers questions about accidental or excess intake, and in an emergency anyone should call their local emergency number (999 in the UK). Someone in distress in the US can call or text 988.

Related pages

• Suboxone and buprenorphine, a Schedule III narcotic on the DEA list
• Fentanyl, Schedule II
• What is a controlled substance?
• All drugs with their US schedule and UK class

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