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Some debate with respect to the abuse capability of tramadol exists. Grünenthal has advanced it as an opioid with a lower danger of opioid reliance than that of conventional opioids, asserting little proof of such reliance in clinical trials (which is valid; Grünenthal never guaranteed it to be non-addictive). They offer the hypothesis that, since the M1 metabolite is the primary agonist at µ-opioid receptors, the postponed agonist action lessens manhandle obligation. The norepinephrine reuptake inhibitor impacts may likewise assume a part in diminishing reliance.
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