Hi Renee, my understanding about Tramadol was that it is an opiate product with an epinephrine product added to it thinking that would prevent the opiate euphoria. I remember always clenching my teeth and having insomnia when I took it and it really wasn't strong enough for my type of pain. I don't know if my understanding is correct but I never liked the drug anyway. Take care and again thanks for your good information! Many blessings, and warmest wishes, Sunny flower