This is a bit of a strange and difficult one

No, it doesn't come as you're describing.

Can you switch to someone like Pharmacy2U where it's delivered and carefully counted?

I have tramadol as part of my prescription and haven't had an issue with P2U.

I take a variety of prescribed meds, and they definitely don't all come in multiples of 7. Some do, but not all. They certainly don't all run out at the same time, that would be too simple.

I hope the med review goes okay and it all gets sorted.

It could well be someone’s taking them for themselves or to sell. Someone at the pharmacy or someone in your home. Don’t assume people in your home (husband, son, cleaner, visitor) wouldn’t be the culprit, because they’re ’not the sort’ or ‘wouldn’t have it in them’. Anyone can get addicted to prescription drugs and, if they are, can be v devious. They could reseal a packet. You sound like you know something’s not right.

I’d mention to your GP you seem to be short, and you’re going to keep a record, but you’d also like to discuss alternatives, especially until your next prescription. Then, start checking your prescription thoroughly at the pharmacy. Take a photo if you have to, to be certain. That should establish if an error or theft is happening at their end.

Then, take precautions at home. Keep them somewhere secure no one in your home can access. Maybe ask if you can have smaller but more frequent prescriptions, so you have fewer in your possession. Every time you take them, check how many are left in the packet and record that. If you keep them in your handbag, make sure they’re in an inside pocket and the handbag is never out out of your sight and they’re under your pillow or somewhere secure at night when you’re sleeping.

My Tramadol varies, most makes are in strips of 10 and the sealed box will usually have 10 strips in ie 100 tabs. But sometimes I get a make with strips of 20. My prescription is not for multiples of 10, it’s for between 6 and 8 tablets for 28 days so I always get a box with less than 100 in that has been opened and repealed by the pharmacist but each box always says how many tables are in it and has the date on when I can next renew the prescription.

I take between 6 to 8 Tramadol together with paracetamol every day, have done for several years. I get prescribed 28 days at a time. My GP will not make up my repeat prescription request until the exact date on the box ie 28 days after the previous prescription. I have a prescription review every year to discuss all my prescriptions ( lots of them due to high blood pressure and a TIA three years ago) and we go through in detail what I am taking, how often and how they help me.

I need two replacement knees but am too anxious at the moment to have the operations, I’m working towards it though. I will need strong painkillers until I undergo the procedures but I don’t want to take anything stronger despite being offered them. My father in law died during an operation to replace his knee so I am terrified of the same thing happening to me - not logical I know.

I am not addicted to the Tramadol, I might have taken them long enough to have issues with effective pain relief, but if I forget to take a dose or two, I don’t get withdrawal symptoms - just increased pain in my knees when I walk about. I sometimes forget if I’m feeling ill and am not going out for a few days. When I had Covid earlier this year, I hardly took them at all for over a week as I pretty much only left my bed to go to the toilet!

My pharmacist is brilliant and agrees with me that I am not addicted as in her experience, people with a long term use of tramadol who do become reliant on them, are unable to make a prescription last so try to get more. She has had people in her shop crying that they have lost some, had them stolen or have forgotten to renew their prescription but she is not allowed to give emergency supplies - yet she could if I ran out of my blood pressure meds!

It’s not nice to have so many people commenting that the OP is addicted due to taking them for so long, I feel like they are implying that she is lying just to get more tablets. Unless you have been in long term pain and taking opioid pain relief then your comments about addiction are only anecdotal, based on media reports and other comments.

I was given the wrong medication (controlled drug) for my son. Fortunately his medication comes in two little bottles and this was a box so I knew immediately, without opening it, that it was wrong and could hand it back. Interesting I was also given another cats medication at the vet recently. The receptionist noticed when handing it over. I’d have been annoyed if I’d got home to find it.

I had this happen before, I take high strength codeine for a chronic health condition and a few years ago the box was missing a strip out of the usual amount I usually get. I rang up the pharmacy immediately and they told me I was lying and basically was treating me as if I was an addict who just wanted more. They ended up having to go to the gp for them to assess it before they could prescribe me ‘more’ over their mistake. But it was so degrading, they could see on my record I had never had that happen before it was a genuine mistake on their end but they really made me feel awful and embarrassed when I done nothing wrong

I smell bullshit

I’ve had this a few times recently with the contraceptive pill, strips missing from the box.

Doesn't Tramadol come in standard sealed boxes of blister packs in multiples of 7 like most other prescription tablets? (Maybe it doesn't but it seems odd to me).

A box of 100 and a box of 68 sound like really strange quantities. Does the pharmacist have to manually dispense a set number of tablets per box?

My wife and I have both been on regular medication for 20 years and I collect both sets of prescriptions. There is a notice at the pharmacy counter reminding everyone to check before leaving that they've been given the correct prescription as mistakes can't be corrected after you've left.

I always check what I've been given but that's easy with manufacturer sealed standard boxes of blister packs. I don't know how I'd go about confirming in the pharmacy that I'd received 168 tablets of a particular drug...

Not necessarily. Not everyone becomes addicted or dependent on them. I've taken morphine on and off for a decade. Don't have any issues stopping it. no withdrawal and can stop just like that. Only start taking it again when the pain becomes unbearable without. I've gone anything from a few weeks to 18 months without it before needing them again.

Chocolate on the other hand ......

Because people notice things If they live with / often see other people!
If you're taking 6 tramadol a day, it will show sometimes. You'll sometimes be in pain and then you won't. Maybe you'll be spacy. He'll see that. He'll see your husband bringing meds home. He'll see that you go to X place 3x per day, at roughly similar times.

Also you asked him if he saw them and he denied more than you asked.
Honestly I'd consider he could be involved.

I think you've given us the answer. Tramadol is a classic black market drug. If the pharmacy are supplying the appropriate number and you're running out quickly either you're taking too many or someone in your household knows where you keep them and is selling them. It's naive to imagine there's anyone in your household who isn't aware of exactly where you keep them. I knew where my parents kept their emergency stash of cash. Occasionally, as a teen, I'd help myself to a fiver. They never said anything, presumably because they believed no one but them knew where it was hidden.

You won't get anywhere with the pharmacy. They are a controlled drug so they won't be able to hand over what you're missing, even if it is likely an error on their end. Unfortunately tramadol isn't a class of controlled drug that needs to have stock levels recorded either so they won't have anything to check against. GP will be your only option. As for an alternative, look into pregablin or gabapentin

About 2 year ago, the pharmacy gave me somebody else's bag of medications.
Same first and surname as me but different middle name and obviously different address.

I was under the impression Tramadol is for short term relief only due to its addictive nature? It's not safe for long term use I was led to believe. It's also bloody awful, leaves most people spaced out and not feeling well at all.

If you're still in pain from a broken back, surely that's a chiropracter/osteopath issue, not taking tramadol for ever?

I'm sure your go will give you something else for the pain , withdrawal from tramadol is difficult and can take months, my husband was on it for years after switching to it from tylex and it took around 6 months for the constant, itching, twitching, jerking and excessive sweating in his sleep to stop. I kid you not it was a nightmare as neither of us got any sleep. After he got free of the tramadol grip he went back to the Dr and she tried him on combination of gabapentin and paracetamol which has been absolutely brilliant for him. Talk to your gp they won't leave you in severe pain

I have had something a little similar happen when leaving hospital with a prescription. I noticed one of the medications was missing but it was a controlled drug so nobody would believe me, it was truly awful as I wasn't in a place to advocate properly for myself. Eventually I managed yo get more from the gp but I truly believe someone dispensing them must have stolen them (I can't figure out how though as I'm pretty sure 2 separate people check? Maybe in it together).

The pharmacy should be able to stock check as they are a controlled drug. They ahve to keep records for 5 years. They should have record of tramadol dispensed and stock levels in the pharmacy

Ask the GP to send your prescription to a different pharmacy going forwards

Count the next lot while you are still there…