Tramadol is a baby compared to oxy as you say TT, morphine doesn't come close either imo.
Paddy, opiates cost next to nothing to produce. I briefly worked in a practice, the costs are negligible.
I suffer lower back pain, some days I'm fine but if iv sat improper for a few hours im crippled.
As you know the only reason opiates are combined with paracetamol is to avoid people taking a recreational dose as they would have 'overdosed' on paracetamol before they feel high.
Studies prove paracetamol (acetaminophen) is a placebo anyway. I'd rather not take it.