While both Tramadol and Codeine are opioids, they differ in strength, metabolism, and long-term safety. Tramadol is often prescribed as a “safer” opioid with a lower risk of respiratory depression. It also has a dual-action mechanism, acting on both opioid receptors and serotonin pathways. Codeine is typically combined with acetaminophen and used for milder pain. However, Tramadol may be preferred for moderate to moderately severe pain and is often considered more suitable for longer-term use under strict medical supervision. Both carry addiction risks, so close monitoring is essential.