Can I mention a little about Tramadol?
It was, initially, marketed as a non narcotic pain reliever. It has, since, become a drug of abuse, and I know in the hospital it is counted just like it is a narcotic.
It is not a true narcotic, but it works on the mu receptors, the same receptors that opiates (morphine, heroin) works on. So people who have a history of, or the potential to abuse substances do abuse it. Like someone else said earlier, too, it also works as an SSRI/SNRI, so if he is taking an SSRI (which I think you said he is) he needs to be careful with the Tramadol as he could develop seritonin syndrome.
Tramadol also lowers the seizure threshold.
Has he been tested for or diagnosed with ADHD? I ask this because of the reaction to benzos. People with ADHD often have a paradoxical reaction to benzodiazepines, in that they make them hyper, instead of relaxing them. I have ADHD, which I take no medication for, but the 2 times I have had benzos (pre op) I was insane.
Unfortunately, doctors are at the mercy of the honesty of their patients. The onus is on your son to provide the doctor with an accurate medical history. If he chooses to exclude parts of his history there is no way that a doctor could know any of it, and tramadol is not considered a really potent drug, tough multiple prescriptions for it from multiple providers will trigger a red flag. Fortunately, Florida had a huge overhaul a few years ago in regulating prescription narcotics. So he, now, is in the prescription database system as having received a prescription for a controlled substance. If they start seeing multiple scripts for multiple providers he will get flagged.
I know you know that in the long run they aren't going to do anything that they don't want to do. That rock bottom is different for everyone. The only thing is that you can take solace in the fact that YOU have done everything in your power to help him. You can't give someone a gift if they refuse to take it.