Fentanyl vs Tramadol: A Complete Understanding Of Opioid Painkiller Addiction

Post-operative pain and similar forms of severe pain pose a serious issue which can only be managed by powerful painkillers. These chronic pains are dealt with opioid painkillers. Two common opioids that can deal with both moderate pain and discomfort that need medical supervision are Fentanyl and Tramadol. Tramadol is one of the most effective pain relievers used for the last three decades. Fentanyl is one of the strongest pain relievers available today in hospital settings. One of the major disadvantages of using the two opioids is their high potential for addiction. Let us compare Fentanyl vs Tramadol to understand which drug can cause more harm to our health if misused.

A Detailed Comparison Of Fentanyl vs Tramadol

Fentanyl: Definition And Mechanism

Fentanyl is a very powerful opioid analgesic used for severe forms of pain. People have no real idea of its potency because it is almost 50 times stronger than Morphine. It is strictly a prescription drug that should be used only under medical supervision. The mechanism of Fentanyl involves binding to μ-opioid receptors and other receptors like G-protein from where it inhibits intracellular cAMP that carries pain signals to the brain. This dual functioning helps Fentanyl provide a strong pain relief in the body. It is used under strict medical supervision because its mechanism can also lead to respiratory depression in some cases.

Tramadol: Definition And Mechanism

Tramadol has been an FDA-approved opioid pain reliever since 1995 and is branded in various other names like Ultram, Ultram ER and Qdolo. It is way less powerful than Fentanyl making it perfect for moderate pain in not just humans but animals like dogs and cats too. Just like Fentanyl Tramadol works by binding to μ-opioid receptors and releasing chemicals like serotonin and norepinephrine. This is an advantage for people suffering with moderate pain as Tramadol will provide a gradual, long-lasting pain relief over a stronger and quicker one. But in some cases it can release dopamine that leads to its addiction.

Tramadol vs Fentanyl Potency

Comparing the potency of Fentanyl vs Tramadol is important because the intensity of the pain may differ person-to-person. Fentanyl, if not the strongest, is one of the strongest opiates in availability. People must take small, prescribed amount of this drug. But anything more than the limit is a gateway to addiction. DEA suggests that as much as two milligrams of Fentanyl can be a dangerous dose. Fentanyl addiction is a strong and one of the most dangerous addictions. Tramadol does not even come close, but is also a highly potent drug. Even if Tramadol is less potent it will remain safe to use as long as one uses the drug as per doctor’s direction.

Is Fentanyl And Tramadol The Same?

There are few similarities as both of them are opiate drugs. Fentanyl and Tramadol are of course in the same drug class of opioid analgesic painkillers. They serve the same purpose by treating moderate-to-severe pain with the same mechanism of binding to opioid receptors. As opioids they produce similar analgesic effects on our central nervous system. Tramadol and Fentanyl can show similar side effects on misuse too, Fentanyl being much more powerful. The most common ones are respiratory depressions and sedation caused in the nervous system which effectively changes the pain perception. Some differences between the opioids also exist with these similarities.

Fentanyl And Tramadol Difference

The difference between Fentanyl and Tramadolare very evident because the two opioids affect the overall health much differently. We already know thoroughly how the two drugs have different potency levels, but the drug status, application, and duration of Fentanyl and Tramadol differ too

Categories	Fentanyl	Tramadol
Potency	Has a high potential for addiction.	Comparatively has lower potency still carries risk of addiction.
Application	Available as transdermal patches and mostly used in clinical settings as intravenous injections.	Mostly used as oral tablets but also used as capsules, solutions and intravenous injections.
Duration	Onsets in as rapidly as 2 minutes and effects will last for 30-60 minutes only while patches can last for 1-2 hours.	Duration depends on the dose one is administered to take. Immediate-release tablets take 4-6 hours to act and extended-release can take upto 12 hours.
Mechanism	It has dual mechanisms, primary being binding to opioid receptors and secondary is binding to G-protein receptors.	It has only one function of binding to opioid receptors and stopping pain signals from reaching the brain.
Controlled Status	Fentanyl is a Schedule II substance.	Tramadol is a Schedule IV substance.

Can Fentanyl And Tramadol Be Taken Together?

Taking Fentanyl and Tramadol together can be the most fatal mistake of your life. Misusing them individually already has intense side effects. Tramadol overdose can give seizures, and with Fentanyl this gets worse. The same goes for serotonin syndrome, which might happen in the case of Tramadol alone but becomes a guaranteed side effect when combined with Fentanyl. Overdosing on Fentanyl can compromise our heart health. But a combination with Tramadol can cause Arrhythmia, a condition where our heartbeat rhythm starts fluctuating abnormally. So we need to be at a distance from Fentanyl and Tramadol combination.

Fentanyl vs Tramadol Side Effects

One thing that people always face while using opioids regularly as per the dose is the side effects. Sometimes these effects are very harmful as they occur when individuals grow tolerance towards the drug or abuse it. Common side effects between Fentanyl and Tramadol can be nausea, vomiting, drowsiness, sedation and constipation to name a few. But they have other side effects which differ and are much more harmful.

Fentanyl side effects	Tramadol side effects
Muscle Stiffness	Seizures
Irregular Heartbeats	Low Blood Sugar
Excessive Itching on skin	Serotonin Syndrome
Retention of Urination	Respiratory Issues

Are Fentanyl And Tramadol Addictive?

Both opioids are addictive and there is a good reason for that. Tramadol and Fentanyl do raise some dopamine levels in our brains. This happens when the drugs bind with opioid receptors in the ventral tegmental area. These opioids inhibit certain interneurons that release dopamine in the brain. This dopamine release does not affect pain management but it triggers the reward system. This not only makes one feel relaxed from the pain but it also makes them feel rewarded for taking the two drugs for pain relief. What begins after this is the vicious and painful cycle of Opioid addiction.

Fentanyl Addiction

This is one of the deadliest opioid addictions as Fentanyl is one of the strongest opiates. The signs of Fentanyl addiction are too quick and last for a short while. This is the reason many people grow tolerance to Fentanyl and start abusing it leading to its addiction.

Behavioral Symptoms

• Intense cravings
• Mood swings
• Anger issues
• Irritation

Physical Symptoms

• Extreme drowsiness
• Constricted pupils
• Diarrhea
• Shallow breathing
• Weight loss

Tramadol Addiction

The signs of Tramadol addiction include behavioral changes and withdrawal symptoms when one is not under the influence of the drug. Comparatively it may not be as fatal as Fentanyl addiction but is not at all safe. Tramadol addiction treatment will help an addict fight these symptoms.

Behavioral Signs

• Tolerance
• Excessive use
• Anxiety
• Social Isolation
• Irritability

Withdrawal Signs

• Slower heart rate
• Dizziness
• Seizures

Measures To Treat Opioid Addiction

The treatment of Fentanyl and Tramadol addiction comes under the medical treatment of Opioid Use Disorder (OUD). This will involve a lot of steps that will help addicts recover from dependence. The very immediate step in this recovery is the medical detoxification of the opioids from your body. Doctors will use medications like Methadone and Buprenorphine to remove the drug as they are opioid agonists. Then comes the recovery journey where doctors will advise the addicts to take up one of the three major therapies provided in this Tramadol and Fentanyl addiction rehab:

• Cognitive Behavioural Therapy brings behavioural changes that will help reduce addiction.
• Group and Individual Therapy teaches coping strategies to a group of addicts or just an individual.
• Family Counselling helps addicts with their families to recover from physical and social consequences of the addiction.

FAQs

How strong is Fentanyl compared to Tramadol?

This question can be answered best by comparing both drugs with Morphine. Tramadol is just 10% to 20% of Morphine’s total strength. According to a study in the National Library of Medicine, Fentanyl is 50-100 times stronger than Morphine.

Can I take Tramadol after Fentanyl?

Taking them together is dangerous but taking Tramadol after Fentanyl is not safe either. This combination is rarely taken under medical supervision.

Is Fentanyl used for sleep?

Absolutely not. The sedative effects may make people believe Fentanyl can make one sleep but it does not. It is highly potent, taken only for severe pain.

Conclusion

We must use opioid painkillers safely. Doctors prescribe the two drugs as they are excellent pain relief medications. Tramadol has been a popular painkiller for years and Fentanyl is a leading drug for post-operative pain in the medical world. But their addiction can lead to harmful consequences for which people should seek treatment as soon as possible.