Tramadol is an opioid and coverage is subject to our opioid rules and guidelines. See WAC 296-20-03030 through WAC 296-20-03085 for rules on opioid prescribing.
Tramadol is a centrally acting analgesic drug. Its pharmacologic effect is due to the binding of both parent and metabolite, M1, to mu opioid receptors as well as inhibiting the reuptake of norepinephrine and serotonin.
The American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification recognizes tramadol as an opiate agonist. This determination is made regardless of the risk level for potential abuse or whether it has "pure" opiate agonist properties.