Chronic pain, severe arthritis, fibromyalgia, cervical fusion-currently partial herniation of cervical spine above fusion, loose SI lumbar spine. So I have been on tramadol 2-3 x per day for about 20 years! I am not addicted, I don’t crave it! I always take 1 tab 2x/day to manage daily continuous pain. That said I do have a tolerance level, if I miss a minimum dose I do become nauseous, increased pain, worsened fatigue. Then I realize I need to take my dose. Those symptoms resolve. THERE IS A DIFFERENCE BETWEEN TOLERANCE & ADDICTION! Retired nurse and this so irritates me that legitimate patients are being treated like drug addicts! (Limited number of pills, urine drug screens etc. Rant over! thanks!