ok, it's been a while since I have visited this highly recommended Naturopath (people from all over our region recommended her highly because of her background) But this is basically how she explained to me LDN and compounds it at her office, personally. The way she explained it was how LDN was manufactured and used in the UK (England) for Heroin overdoses, it was coincidence that it helped other illnesses including HIV, and Cancer, research was done in UK regarding, but not here in States. (so there may be further documents in UK regarding studies on LDN) Ultram and Tramadol are the same drug, they are not actual opiates, such as morphine, demerol, etc. The contradiction is regarding LDN and narcotics is that the LDN would stop the opiod from working. (and briefly, short acting) She mentioned a few times how short acting the LDN is, and for prescribed chronic illness it is very very low dose. The above link I had posted, regarding LDN, the website is maintained by a friend of family, she is also a medical advocate. (we've had some interesting discussions regarding auto immune, cancer, diet, food allergies, medications, etc similar to things I've seen few others post in here regarding alternative therapies) I did do the LDN and Tramadol, and had no trouble, but can say at that time the major thinking of my illness was Lymphoma or type of blood cancer, as it has turned out, it is Dysautonomia, which was not looked at. (OH, PAF, with possible Parkinsonian cause) (the Hemotologist/Oncologist wrote me up for seeing a Naturopath in his chart notes, and for taking LDN which he admitted he knew nothing of, but wanted to learn more regarding, his eyes perked up when I told him that this Naturopath had spent twenty years in Cancer research at Fred Hutch) Since Dysautonomia has so many different possible causes, (and no cures) it may be helpful for the ones with auto-immune based, given the LDN research supports some benefit in regards, as well CFS. Here's another link I grabbed from the Naturopath's website: http://www.ldners.org/resources.htm#Forums Another one explaining the Narcotic/Opiod and other: http://www.digitalnaturopath.com/treat/T74481.html