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Updated on September 26, 2022

Tramadol and Alcohol

What is Tramadol?

Tramadol is a strong pain medication used to relieve moderate to severe pain. It is also used to treat chronic pain when weaker prescription drugs are not sufficient. Tramadol is available under the brand names Ultram, Rybix, and ConZip. Ultracet is a combination of acetaminophen and tramadol.

The drug is in a class of medications called opiate (narcotic) analgesics. It works by adjusting the way the brain's pain receptors and central nervous system (CNS) respond to pain. Tramadol use blocks pain signals that transfer along the nerves to the brain to relieve pain.

Tramadol is available in injectable and oral forms. It is primarily used for relief of acute and chronic pain but is also used off-label for restless leg syndrome and fibromyalgia. The oral forms are prepared as extended-release capsules, or, the long-acting form and as tablets for short-acting effect.

When taken as prescribed by a medical professional, common side effects of tramadol include:

  • Nausea
  • Dizziness
  • Vomiting
  • Constipation

When used correctly, tramadol has a low potential for dependence, especially when compared to morphine. However, addiction to the drug can occur if tramadol is consumed for extended periods.

In 2014, tramadol switched from being a drug of concern to a controlled substance by the FDA and DEA. It is now a schedule IV controlled substance.

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How Do Tramadol And Alcohol Affect The Body?

Tramadol and alcohol both slow the central nervous system’s activity. This can lead to drowsiness, dizziness, and reduced coordination. More serious physiological effects including shallow breathing, lowered blood pressure, and decreased heart rate can occur as well.

The slowing of the CNS can also impair bodily movements and affect the user’s ability to think or judge situations clearly.

When combined, central nervous system depressants like tramadol and alcohol can lead to more intense effects. For people who abuse these drugs, combining them is usually an intentional attempt to experience more powerful effects. Alone, both tramadol and alcohol can lead to addictive effects, including euphoria and relaxation.

Both alcohol and tramadol interact with chemicals in the brain that monitor mood and affect our ability to deal with pain and stress. While they do not affect all of the same brain locations, tramadol and alcohol produce many of the same effects.

Drinking large quantities of alcohol or taking high doses of tramadol can be dangerous alone. Mixing the two drugs can quicken the onset of each substance’s most damaging effects. It can also lead to severe mental and physical impairment and increases the risk of alcohol and tramadol overdose.

What Are the Effects of Mixing Tramadol and Alcohol?

Tramadol and alcohol each have side effects that occur when misused alone. Some of these more severe side effects (drug interactions) are more likely to happen when both drugs are used at once. 

Severe side effects of tramadol and alcohol include:

  • Extreme sleepiness
  • Dizziness
  • Vertigo
  • Reduced coordination
  • Slow or difficulty breathing
  • Lightheadedness 
  • Memory issues
  • Unusual behavior 
  • Loss of consciousness
  • Blackouts
  • A slow breathing rate

The severity of these side effects typically depends on how much alcohol has been consumed, and the tramadol dosage. Having excessive quantities of one or both substances in your body system can result in an alcohol and tramadol overdose, stopped breathing, and death.

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Risks of Mixing Tramadol and Alcohol

There are various risks and dangers of mixing tramadol and alcohol. Combining alcohol and tramadol can intensify the sedative and depressing respiratory effects of both drugs.

This combination can lead to dangerous risks, including:

  • Unconsciousness
  • Coma
  • Respiratory arrest
  • Overdose
  • Death

When opioids are taken with alcohol and other central nervous system depressants, it can result in life-threatening respiratory depression. This can cause severe oxygen deprivation and long-term brain damage, quickly leading to coma or death.

Signs Of Tramadol And Alcohol Addiction

Tramadol and alcohol dependence occurs when a person loses control over many, if not all, aspects of their lives. This is often despite the user being aware of the adverse consequences of their drug abuse. 

Signs of tramadol and alcohol use disorder (AUD) include:

  • Cravings or intense urges to use
  • Developing a tolerance where larger quantities, or more frequent doses, are required to achieve prior effects
  • Experiencing withdrawal symptoms when attempting to quit
  • An inability to stop or cut back on substance use
  • Drinking alcohol or taking larger amounts of opioids more frequently than initially intended
  • Spending a lot of time obtaining, using, and recovering from the effects of tramadol or alcohol
  • Having a psychological or physical issue that is likely the result of use
  • Continuing use despite persistent interpersonal or social problems
  • Overusing alcohol or tramadol in situations where it is physically dangerous to do so, such as driving
  • No longer fulfilling responsibilities at work, home, or school due to use
  • Ceasing recreational, social, or work activities because of use

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Treatment for Tramadol and Alcohol

When a person has an alcohol use disorder and an opioid use disorder, they have comorbid substance use disorders or polysubstance addiction. To address a person’s recovery needs, various addiction treatment options are available.

The first step in substance abuse treatment is usually a medical detox. Detox reduces withdrawal symptoms and avoids potential health complications.

When detox is complete, attending inpatient or outpatient treatment programs can address thoughts and behaviors linked with addiction or substance use. Addiction treatment can also provide new coping skills and strategies for patients to help them remain sober.

Treatment options for tramadol and alcohol abuse also include behavioral therapies. These therapies may be offered in individual, family, and group settings.

Medical professionals may also provide medicine to reduce cravings for opioids and alcohol. This helps lower the likelihood of a relapse.

Treatment facilities may also offer medical advice and services for other issues that frequently occur with opioid and alcohol addiction. These issues include health problems, mental health disorders, and legal problems.

How Long After Taking Tramadol Can I Take Drink Alcohol?

It is safest to avoid drinking alcohol while you are taking tramadol. Ask your doctor when it is safe to consume alcohol after taking tramadol. Their answer may differ based on if your dose was long-acting tramadol or not. The amount of time that tramadol is cleared from the system varies. However, for short-acting tramadol, it is suggested that 32 hours would be a safe time.

Consuming alcohol shortly after or while taking tramadol poses a risk of respiratory depression.

How do you get tramadol out of your system?

The only way to remove tramadol from your system is to stop taking the drug. This gives your body time to process and eliminate it. You should never quit “cold turkey.” It is essential to go through professional medical detox to slowly taper off the drug.

How long do the effects of tramadol last?

Tramadol injections, drops, and some types of tablets and capsules are fast-acting. Tramadol typically starts affecting the body in 30 to 60 minutes. The effects of the drug wear off within four to six hours.

Can I have a glass of wine with tramadol?

No, you shouldn’t have a glass of wine with tramadol. Patients are recommended not to drink alcohol while taking the drug. Combining the two substances is very dangerous, no matter the situation or how little alcohol is consumed.

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Resources

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  1. Tramadol, MedlinePlus, 2019, https://medlineplus.gov/druginfo/meds/a695011.html 
  2. Tramadol, United Kingdom National Health Service, 2018, https://www.nhs.uk/medicines/tramadol/ 
  3. Serotonin syndrome, MedlinePlus, 2020, https://medlineplus.gov/ency/article/007272.htm 
  4. Understanding the Epidemic, Centers for Disease Control and Prevention (CDC), 2020, https://www.cdc.gov/drugoverdose/epidemic/index.html 
  5. Mixing Alcohol With Medicines, National Institute on Alcohol Abuse and Alcoholism, 2014, https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines 
  6. Schiller EY, Goyal A, Cao F, et al. Opioid Overdose. [Updated 2020 Aug 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan, https://www.ncbi.nlm.nih.gov/books/NBK470415/ 
  7. NIDA, The Science of Drug Use and Addiction: The Basics., National Institute on Drug Abuse, 25 Jun. 2020, https://nida.nih.gov/publications/media-guide/science-drug-use-addiction-basics 
  8. Alcohol withdrawal, MedlinePlus, 2020, https://medlineplus.gov/ency/article/000764.htm 
  9. Detoxification and Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA), 2015, https://www.ncbi.nlm.nih.gov/books/NBK64115/
  10. Shah M, Huecker MR. Opioid Withdrawal. [Updated 2020 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan, https://www.ncbi.nlm.nih.gov/books/NBK526012/

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