Abstract: Tramadol is a centrally acting analgesic with a dual mode of action.Its analgesic efficacy is attributed to its partial affinity for the μ-opiate receptor and its inhibition of norepinephrine and serotonin reuptake.Acting in a synergistic manner and being more efficacious,tramadol is used worldwide for the treatment of moderate to severe acute or chronic pain.Abuse and dependence of tramadol as well as tramadol-related deaths have been increasingly reported,either ingested alone or taken in combination with other potentially interacting drugs.The possible toxic effect of tramadol was reviewed from aspects of its analgesic mechanisms,adverse effect,dependence,and abuse.

Key words: forensic toxicology, intoxication, review publication type, drug dependence, tramadol