I don’t think there’s even opioids in tramadol. It’s how it works in the brain. Seems Anti-depressants taken with tramadol may lead to serotonin syndrome ?
But, I agree with you, it’s a med one shouldn’t take unless it’s for a short time.
tramadol is a semi-synthetic opioid with powerful SNRI anti-depressant effects as well ... it’s addictive like all opioids ...