Tramadol Utilization Patterns: A One-Year Retrospective Review

Background: Tramadol is a widely used analgesic with a unique dual mechanism of action, combining weak μ-opioid receptor agonism with inhibition of norepinephrine and serotonin reuptake. It is frequently prescribed for various acute and chronic pain conditions. Evaluating prescribing trends can provide valuable insight into clinical practice patterns and inform institutional pain management strategies and policy development.

Objective: To assess tramadol prescribing patterns over a one-year period in a university-based health system and compare them to overall opioid prescribing. Methods: A retrospective review was conducted using electronic medical record (EMR) data from January 1, 2024, to December 31, 2024. The number of tramadol prescriptions was quantified quarterly and compared to the total number of opioid prescriptions (including tramadol) during the same period. No identifiable patient information was collected.

Results: A total of 17,660 tramadol prescriptions were written in 2024. Quarterly breakdowns were: Q1 – 4,347; Q2 – 4,382; Q3 – 4,369; Q4 – 4,562. Overall, tramadol prescriptions accounted for 25.9% of the 68,212 total opioid prescriptions written during the year.

Conclusion: Tramadol constituted over one-quarter of all opioid prescriptions in this academic medical center. Prescribing remained stable across all quarters, with a slight increase observed in Q4. These findings highlight tramadol’s significant role in opioid prescribing practices for acute and chronic pain management. Psychopharmacology Bulletin. 2026;56(1):64–70.