Tramadol is a centrally acting opioid analgesic that is classified as a Schedule IV controlled substance under the Controlled Substances Act. This means that it has a low potential for abuse and a low risk of dependence compared to other opioid analgesics, but it still has a potential for abuse and dependence. Tramadol is typically administered orally in 50 to 100 mg tablets as needed for pain relief every 4 to 6 hours, not to exceed 400 mg/day. Since its approval in 1995, there have been reports of diversion and abuse of tramadol, which led to revisions to the product labeling and the addition of warnings about its abuse by the Food and Drug Administration. The DEAs decision to classify tramadol as a Schedule IV controlled substance in 2014 was based on evidence of its potential for abuse and dependence.