What is the ruling on using the drug Tramadol before intercourse and during strenuous work in doses not exceeding four pills per month, knowing that there are differing fatwas regarding its permissibility and prohibition?

"It is impermissible to take Tramadol except upon a physician's directive, and in doses that do not lead to addiction, as necessitated by severe pain when there is no non-narcotic alternative available. However, its use for sexual intercourse leads to addiction. The General Food and Drug Authority has warned against dispensing it to psychiatric patients who are prone to suicide and addiction, or to those who abuse sedatives. It has classified it among narcotic drugs for treating chronic pain after monitoring deaths related to its use."