A bilayer composition for the delivery of tramadol and acetaminophen, the bilayer composition comprising: a. a first layer defining a rapid release portion of the composition and comprising acetaminophen; and b. a second layer defining a sustained release portion of the composition and comprising acetaminophen, 100% of the tramadol of the bilayer composition, and cross-linked high amylose starch, wherein, when tested in a U.S.P. Type III Apparatus at 20 dips per minute at 37°C in 250 mL of a solution of potassium phosphate monobasic pH 6.8 for one hour, after which the solution is removed and replaced with a fresh 250 mL of potassium phosphate monobasic pH 6.8 for eleven hours, the acetaminophen and tramadol are released with the following kinetics Time (hours) Acetaminophen % release (by weight) Tramadol % release (by weight) 1 30-60 ≤35 4 60-90 45-65 8 80-90 ≤90 12 ≤90 ≥90; or the bilayer composition comprises: a. a first layer defining a rapid release portion of the composition and comprising from about 70% to about 90% w/w of acetaminophen, from about 5% to about 15 % w/w starch, from about 1% to about 4% w/w microcrystalline cellulose, from about 1% to about 3% w/w croscarmelose sodium, from about 0.5% to about 2% w/w sodium stearyl fumarate, and from about 0.1% to about 1% w/w colloidal silicon dioxide; and b. a second layer adjacent the first layer and defining a sustained release portion of the composition and comprising from about 40% to about 60% w/w acetaminophen, from about 5% to about 15% w/w of tramadol, from about 5% to about 25% w/w cross-linked high amylose starch, from about 5% to about 10% w/w starch, from about 1 % to about 6% w/w microcrystalline cellulose, from about 5% to about 15% w/w hydroxypropylmethyl cellulose, from about 0% to about 5% w/w copovidone, from about 0.5% to about 2% w/w sodium stearyl fumarate, and from about 0.1% to about 1% w/w colloidal silicone dioxide, wherein the second layer comprises 100 % of the tramadol of the bilayer composition. a. a first layer defining a rapid release portion of the composition and comprising acetaminophen; and b. a second layer defining a sustained release portion of the composition and comprising acetaminophen, 100% of the tramadol of the bilayer composition, and cross-linked high amylose starch, a. a first layer defining a rapid release portion of the composition and comprising from about 70% to about 90% w/w of acetaminophen, from about 5% to about 15 % w/w starch, from about 1% to about 4% w/w microcrystalline cellulose, from about 1% to about 3% w/w croscarmelose sodium, from about 0.5% to about 2% w/w sodium stearyl fumarate, and from about 0.1% to about 1% w/w colloidal silicon dioxide; and b. a second layer adjacent the first layer and defining a sustained release portion of the composition and comprising from about 40% to about 60% w/w acetaminophen, from about 5% to about 15% w/w of tramadol, from about 5% to about 25% w/w cross-linked high amylose starch, from about 5% to about 10% w/w starch, from about 1 % to about 6% w/w microcrystalline cellulose, from about 5% to about 15% w/w hydroxypropylmethyl cellulose, from about 0% to about 5% w/w copovidone, from about 0.5% to about 2% w/w sodium stearyl fumarate, and from about 0.1% to about 1% w/w colloidal silicone dioxide,