Ultram is an opioid analgesic of central action. According to the mechanism of action, it belongs to the group of agonists / antagonists of opioid receptors of the brain (μ- and κ-receptors). The drug significantly reduces the need for other opioids, while withdrawal symptoms are minimal when the drug is discontinued. It activates the antinoceptive system and thus disrupts the interneuronal transmission of pain impulses at different levels of the central nervous system, changes the emotional coloring of pain. The duration of analgesia is longer than that of morphine.
Ultram depresses the respiratory center less than morphine and there is less risk of drug dependence in case of prolonged use. Officially, Ultram is not considered a drug. The World Health Organization (WHO) classifies it as psychotropic substance, but it does not cease to be a dangerous substance. At the same time, Ultram is just a trademark that hides buprenorphine, a semi–synthetic opioid. In Europe, it is already being replaced by Suboxone, and its predecessor was Methadone. The drug also forms the basis of substances such as:
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Ultram is specially designed for substitution therapy programs, but it is also used as an analgesic, since its effect is several times superior to analogues, including morphine traditionally used for this purpose. The main idea of substitution therapy is to reduce the harm from drug use. The concept came to Arab countries from the West, where at the end of the XX century there was a prevailing point of view that it was impossible to cure drug addiction.
It is believed that Ultram is the least toxic drug among the "substitutes" and has no long-term negative health effects. Since Ultram is one of the latest developments used in substitution therapy, the substance gives less feeling of euphoria and more analgesic effect. It should be taken intravenously (the action comes after 1-2 minutes), intramuscularly (10-15 minutes) and sublingually (under the tongue – 10-15 minutes). The reception of Ultram once a day allows the patient to satisfy the need for opiates, since methadone acts within 24-36 hours after a single dose. Heroin acts with intravenous administration for 6-8 hours. The regular intake of heroin or homemade opium leads to the fact that the patient experiences a state of intoxication and withdrawal 2-3 times during the day. When treating with the drug, there is neither one nor the other. The duration of exposure is from 6 to 8 hours, depending on the dose. Despite the low toxicity, exceeding the dosage immediately leads to poisoning. It manifests itself in side effects:
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• difficulty breathing, • interruptions in the work of the heart, • dizziness, • nausea turning into vomiting, • hallucinations.
A person who has taken Ultram has confused consciousness, constriction of the pupils, sweating. The overdose may also lead to a comatose state and death.
Proponents of substitution therapy insist that the tolerance of the body to Ultram either does not manifest itself, or grows very slowly. This supposedly allows you to avoid a large number of overdoses and addiction. However, instant dependence on Ultram is an irrefutable fact. Few of the participants in substitution therapy can refuse to use it. Those who try, expect two months of abstinence ("physical withdrawal"), which will be accompanied by pain, chills, cramps, vomiting and insomnia.
Like any other substitution therapy, the therapy with the use of Ultram has one flaw – a dependent person needs a feeling of euphoria when taking the drug. When one drug – "dirty" and "dangerous" – is replaced with another – "clean" and "safe", then, as a rule, the euphoric effect is reduced. Thus, the "pure" drug excludes withdrawal syndrome, but does not bring pleasure. That’s why, consumers turn to the black market and try to get large doses of Ultram. This increases the risk of overdose in pursuit of ecstatic sensations.
Although deaths from drug use decrease due to substitution therapy, such a method does not allow to completely decriminalize drug trafficking. However, the main thing is that a dependent person remains dependent, a drug addict remains a drug addict. Moreover, they do not get rid of the stigma – they remain ill under the control of the state. This is always doubly dangerous – you can get caught buying/selling drugs.