Tramadol is a synthetic opiate, which carries with it all the problems of addiction, respiratory depression, hallucinations, dizziness and feeling a bit spaced out.
It works quite well (IME) but is on a par with Codeine, which for me had less weird side effects.
We used to give it IV before we had access to Morphine and for a short while it was a back up analgesia if you’d had no vehicle check, it tended to treat patients acute pain well but also caused a high degree of sickness (sometimes alleiviated if given slowly) Though bare in mind this is in relation to 100mg being given IV, as such it was usually given with an anti sickness injection at the same time.
Heroin addicts as a rule aren’t keen on using it IV due to the sickness, but as a tablet it si fairly sow release and keeps the monkey off your back so to speak and is fairly easy to find.
A lot of GP’s are tending towards Co-codamol it seems, and 30/500 is a popular choice for acute pain, weaned down to 10/500 for chronic pain.