none that i know of other than the dependance. i thought when the other poster said hydro was worse for the long term he was speaking of the dependance. but i guess iwas wrong because he replyed and agreed that tramadol has a worser withdrawal. the only other thing i could think that he was speaking of is the APAP contant and your liver. so i was refering to dependance as i thought he was when he said 'long term'