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tramadol belongs to a class of drugs called opioid agonists. a class of drugs is a group of medications that work in a similar way. these drugs are often used to treat similar conditions. tramadol works by changing how your brain senses pain. tramadol is similar to substances in your brain called endorphins. endorphins bind to receptors (parts of cells that receive a certain substance). the receptors then decrease the pain messages that your body sends to your brain. tramadol works in a similar way to decrease the amount of pain your brain thinks you’re having.