Patients previously consuming artisanal opiates taking tramodol for:
1) ease of cancellation after eating handmade acetylated opiates,
2) vicarious tramadol drug addiction (sometimes combine techniques from a number of benzodiazepine tranquilizers),
3) a deliberate technique to samokupirovaniya state cancel Tramadol [4]. It is interesting to note that some patients claimed that the “jump off” with Tramodol it harder than with “junk”. Some patients reported a combined dependence on tramodol and other opiates. Thus, there are reports of patients who once tried to stop yourself Anesthesia heroin with tramodol, started to use tramadol combined with heroin. At the same time to achieve a comfortable state needed a reception after the two drugs. This may indicate that tramodol, along with the ability to communicate with the mu-opioid receptor has other mechanisms of dependence other than heroin.

The relative availability of Tramadol and its ability to induce euphoria, even at doses exceeding the therapeutic and led to rapid and widespread abuse of tramadol among adolescents.

Many adolescents reported that the first drug taken to achieve the euphoria was tramadol. Never trying other opiates, they became dependent on opioid substances. Some of them later moved to receive handmade acetylated opiates.