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I think they would be a great substitute for pain. They work differently. They don't make you as tired and sluggish and actually give you a bit of energy. But do not have the same fuzzy, warm effect as the other stuff. When tramadol is taken for a while it lets you go to sleep real well. Only in the beginning it can cause sleepiness. But later they work just the same as the hydros. If I take a hydro now I am actually disappointed at how little it lasts, how fast the pain relief is over with. And how bad the WD really is. Tramadol has WD too but isn't half as bad. The thing is that everyone reacts differently to it. But is working for me for instance, someone who was convinced not making it without hydros or codeine. The thing is that one gets different types or strengths of tramadol. Don't know which it is. But I have had some that made me extremely nauseas and gave me terrible ringing in the ears (horrible, unbearable - like the head was exploding or something). Then I've gotten some that worked the same but without these awful side effects. And then I got some that worked almost exactly like codeine, with a bit more sleepiness to it than the other tramadols. It all depends on what pharmacy you get them from. But yes, they work nicely for pain. However, it is not the same strong (and short) pain relief as hydro or codeine gives you. Not even close. But one can survive with these.