Tramadol is the best painkiller? Tramadol is an opioid painkiller. While some legitimate pharmacies may sell tramadol online, they always require a valid prescription from a doctor. Many other fake pharmacies sell the drug illegally. If you suffer from severe pain, you should see a doctor and never attempt to self-medicate by purchasing prescription drugs online. If you purchase tramadol from a fake pharmacy online, you could receive drugs that aren’t actually tramadol at all. If the pills are cut with powerful substances like fentanyl, overdose, and even death are possible. Objective This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to purchase prescription drugs rather than using the traditional doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those who obtain the same drug through legitimate health care channels. Methods We selected tramadol as a representative drug to address our objective because it is widely prescribed as an unscheduled opioid analgesic and can easily be purchased from NPOPs. Using search engine marketing (SEM), we placed advertisements on search result pages stemming from the keyword “tramadol” and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to obtain tramadol (traditional users, n=349) or purchased it on the Web without a prescription from their local doctor (ie, nontraditional users, n=96), were then asked to complete an online survey. How to take Tramadol? Your doctor will start your treatment with the minimum possible dose and gradually increase or decrease your dosage if required. To determine the best suitable dosages for you, your doctor should examine you properly. Your doctor will prescribe you Tramadol dosages keeping the following factors in mind: Age and weight of the patient The medical condition of the patient Other health disorders the patient is suffering from How does the patient respond to the first dose of the medicine? Take Tramadol as prescribed by your doctor and take care of all the instructions and directions given on the prescription or medicine label. Please don’t use it more often than recommended and tell your doctor if you do not observe any improvement in your condition. It is best to avoid medical errors and try to be consistent throughout your treatment. The following are the usual Tramadol dosage that your doctor can prescribe you: Dosage for treating pain In the form of immediate-release tablets For older adults (65 years and above) Doctors should be extra careful while prescribing Tramadol dosage for older adults as their internal organs might not work well. For adults (18 years or more but less than 65 years) Your doctor will initiate your treatment with 50 mg of the medicine, which you need to take a day thrice, then after, your doctor will adjust your medication as required. However, the maximum Tramadol immediate-release dosage should not exceed 400 mg per day. For children (below 18 years) Using Tramadol for patients younger than 18 years to treat pain (moderate to severe) is not recommended. Is it Ever Legal to Buy Tramadol Online? There are some pharmacies that sell prescription drugs online. The U.S. Food and Drug Administration (FDA) offers guidelines to be sure you are purchasing prescription drugs from a legitimate pharmacy. They should require a physician’s prescription, and they should be licensed by the state. Ask if they are licensed and require a doctor’s prescription. They should also have a licensed pharmacist available to answer any questions. The pharmacy you choose should be based in the U.S. Overseas pharmacies are likely to be fake. Legal Risks of Purchasing Tramadol Online There are many risks to purchasing a prescription drug online. First, there are legal risks associated with illegal purchases. It is a felony to import drugs over the U.S. border except through very specific channels. Many online dealers are based in foreign countries. This potential criminal charge will be in addition to any other criminal charges that can be brought against you for the illegal purchase of controlled substances. Systems are in place to screen packages for drugs, and they are growing in capability. Even if many illegal goods get through the system, it’s more likely you will get caught if you repeatedly purchase illegal prescription drugs online. If a law enforcement agency hits an online store and manages to seize their servers, they may also acquire enough data on your purchases to charge you with a crime. Online Tramadol Scams There are two primary scams surrounding tramadol. One promises a variety of types of tramadol at various price points and dosages; the other promises a version of tramadol without any withdrawal effects. In both cases, you will likely receive either nothing or similar-looking but useless pills. It may take a while to realize you have been duped. Some of these sites will completely max out your credit card once they get your information. If you receive “tramadol” pills that have been cut with other substances, you could be in unknown danger by taking them. A dealer may cut tramadol with cheaper, more dangerous chemicals. These substances are meant to mimic the real effect of tramadol, so users won’t notice it isn’t a legitimate drug. They may even try to make the “tramadol” more addictive, so you come back to buy more. Conclusions Although online pharmacies can offer distinct advantages in terms of convenience and cost, users of these “rogue” pharmacies that offer drugs with no prescription or doctor supervision do so at great risk to their health, as evidenced by much higher rates of adverse events. The most logical explanation for these findings is that the lack of physician oversight of dosage schedules, contraindicated conditions, and concomitant medications, were responsible for the increased intensity and frequency of adverse events in the nontraditional users. Although we only examined tramadol, it is logical to postulate that similar results would be observed with dozens of equally accessible prescription drugs. As such, the geometric growth in the use of online pharmacies around the world should prompt intense medical and regulatory discussion about their role in the provision of medical care. 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