DEATH FROM DRUGS

I have been taking Tramadol for pain caused by arthritis of my lumbar beginning in 2009.  Once due to a mixup with my physician, I ran out of pills and got very unsteady on my feet, dropped my cane, and fell trying to pick it up (a friend of mine had a similar experience).  I was fine using my walker.

At any rate, I have heard of deaths caused by Tramadol and wondered about it as I feel nothing on taking my pills except I have less pain, not elation or depression, etc.  In fact, I don't crave Tramadol at all and on occasion forget to take a two-pill dosage, usually at lunch.  If I miss once, there is no problem, but, if I skip twice, I begin to feel pain.

I don't know how many pills a day it would take to overdose yourself on Tramadol, but, presumably, it is more than 8/day which is the maximum dosage recommended.  (I take 6/day).  I have found the table* below that is very instructive, I think (Dark blue is for 2016 and light blue is for 2015).  You will note that Tramadol is down the list at #14.

Number 13 is Gabapentin that I also take for nerve pain.  I take a relatively small dose of 300 mg/day and had a friend who would take a gram a day for shingles.  So apparently, you have to take a lot to overdose yourself.  Frankly, I can't tell if Gabapentin does me any good (my friend says it didn't help him much), but it is not a controlled substance.

Please notice the list includes fentanyl that now is the leading cause of death by suicide and over-dose (quotes are in italics).*
As an example, roughly 40 percent of people listed as dying of a cocaine overdose also had fentanyl in their system.

After fentanyl, heroin, cocaine and methamphetamine were the deadliest drugs in 2016. After declines earlier in the decade, the report said, overdose deaths from both cocaine and methamphetamine were starting to rise again.

The study said illegal drugs such as fentanyl and heroin were the primary causes of unintentional overdoses, while prescription drugs such as oxycodone tended to be used in suicide overdoses.*

(click on figure to enlarge)

Incidentally, I have read that about 2/3rds of deaths from Tramadol are suicides and 1/3rd overdoses.   This follows the statement above that prescription drug deaths are more from suicide. You are instructed if you want to discontinue Tramadol not to go off the medication "cold turkey," but to phrase out of it at decreasing one pill per week so It would take me 6 wks, presumably.

Note: I couldn't get #15 on the list, but it is Amphetamines at 1,193 deaths in 2016, that was not ranked in the top 15 in 2015.

* https://www.usatoday.com/story/news/nation/2018/12/12/fentanyl-now-america-deadliest-drug-overtakes-heroin/2287343002/
Also see:
https://drugabuse.com/featured/the-rise-of-tramadol/
https://medicalxpress.com/news/2017-11-tramadol-dangerous-illegal.html
https://www.pdr.net/drug-summary/Ultram-tramadol-hydrochloride-950