CanadiEM - By Shahbaz Syed - December 13, 2017
"Conclusions
We’re in the midst of an opioid crisis, with increased emphasis on opioid prescribing and the utilization of alternative or adjunctive medications. The emerging evidence against Tramadol should deter us from reaching for this medication as an alternative. While we should be mindful of prescribing opioids in general, Tramadol likely should not be a first line agent for patients, and we need to be very careful prescribing this medication for those who are already on serotonergic agents. Health Canada is apparently looking into the scheduling of this medication, and that would go a long way to increasing awareness about the harms of Tramadol."