What is Tramadol?

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Tramadol, which is the generic name for Ultram or Conzip, is a chronic pain relief medication. Tramadol, like all narcotics, works by binding to opioid receptors in the brain. It has been used for moderate to severe pain relief since the 1960s for its analgesic properties.

Since 2016, there have been over 120 million tramadol prescriptions in the United States. Tramadol is considered safe to use because it has a low potential for addiction and abuse, even at prescribed doses, though addiction is still possible. The pain-relieving effects are far less than more intense opioids like codeine.

tramadol pills

However, Tramadol poses several potential health complications for both casual and excessive users. 

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How Long Does It Take to Feel the Effects of Tramadol?

Tramadol works on the opioid pain receptors located in your brain and throughout your central nervous system. It also weakly reduces the reuptake of two neurotransmitters: serotonin and norepinephrine. The pain relief effects start approximately an hour following a dose and peak in two to four hours.

There are also extended relief forms of Tramadol that distribute dosages in phases over a longer period. This means that a single extended relief pill is present longer in your system. While it is active, tramadol depresses breathing and causes the pupils to constrict.

Tramadol reduces movement in your digestive system, so food takes longer to digest. You may experience constipation. Tramadol also dilates your blood vessels, so you may experience flushing, itching, sweating, and dizziness or faintness when you get up after lying down.

Factors That Affect Detection Time

For some individuals, it takes significantly longer to break down tramadol.

Factors that can affect Tramadol’s detection time include:


Older people metabolize more slowly. They are also more likely to take additional medications that affect metabolism and are at higher risk for impaired kidney or liver function. These factors may all affect Tramadol’s detection time.


Higher doses of Tramadol take longer to metabolize.

Frequency of Use

Tramadol collects in the body as more doses are taken. If some of the previous does have not entirely broken down, your body will likely take longer to metabolize the extra quantities.


A slower metabolic rate heightens the amount of time it takes tramadol to break down. Activity level, body composition, and diet can all affect metabolism.

Reduced Kidney or Liver Function

Impairment of the body's organs to remove waste will increase the amount of time Tramadol remains in the body.

What Are The Side Effects of Tramadol?

Tramadol can produce a high when taken in excess. However, as an opioid, Tramadol disrupts certain brain functions and can severely strain bodily organs. Here are the most common side effects of Tramadol use.

  • Vomiting
  • Nausea
  • Headache
  • Dizziness
  • Irritability
  • Dry mouth
  • Constipation
  • Lethargy 
  • Heart issues

And in rare cases, hallucinations, anxiety, and shakiness. Tramadol side effects can vary based on individual health factors and body composition.

Can Tramadol Cause Long-Term Damage?

Tramadol drug use can cause long-term damage, especially in cases of substance abuse. Here are the most common long-term effects.

Liver damage — Tramadol use can cause acute liver failure. This condition can be fatal. However, even in cases where an individual survives, liver failure tends to scar liver tissue, and the risk for liver failure and liver cancer increases significantly. 

Kidney damage — In cases of chronic drug use, Tramadol harms the kidney. Once filtered through the kidney, Tramadol can leave behind trace elements, known as metabolites, that in excess begin destroying healthy kidney cells. This form of kidney damage takes place over a longer period of tramadol addiction.

Substance dependency — In moderate use, Tramadol has little to no addictive properties. However, Tramadol abuse can lead to addiction. Additionally, in rare cases, Tramadol causes substance dependency in individuals that had no prior substance dependencies. 

Behavioral changes — Substance misuse/abuse changes the way the brain works. It can rewire the reward center and cause extreme prioritization of the drug. Tramadol withdrawal can cause psychosis. 

Seizures — Although rare, Tramadol can cause seizures after taking high or low doses. 

Heart damage — Tramadol has been linked to serotonin syndrome. A condition characterized by an overabundance of serotonin in the brain resulting in anxiety, jitters, heart rate issues, and in extreme cases, hospitalization. 

How Long Does Tramadol Stay in Your System?

The amount of time any drug remains in the body can vary based on individualized factors. I.E., body composition, lifestyle, etc. The half-life of Tramadol in moderate drug use is 5 and 9 hours.

The half-life of Tramadol is dependent on the amount taken. Because of this, a higher dose of Tramadol can lead to a severe overdose that is difficult to reverse even with multiple doses of narcan.

Urine Drug Test

Tramadol stays in the urine for 1 to 4 days.

Hair Drug Test

Tramadol remains detectable in hair follicles for up to 90 days after the last use. Hair tests are generally used to support urine test findings. Hair tests also increase the detection window as most drugs are flushed out of the system within a few days to a week.

Saliva Drug Test

A saliva test for Tramadol can detect the drug anywhere from 24-48 hours after the last dose. Saliva drug screens are rare due to the short window of detection. 

Blood Drug Test

Blood tests, except to test for alcohol, are expensive and only detect recent use. It’s unlikely that a person will receive a blood test for Tramadol. Tramadol stays in the blood for up to 48 hours.

How Is Tramadol Eliminated From The Body?

Tramadol elimination is a two-part process. It begins in the liver, where the body processes the drug. Tramadol, in particular, is heavily processed by the body. When taken orally, Tramadol is over 60% bioavailable. 

After multiple doses, the bioavailability can exceed 90%. This means that the liver processes Tramadol so thoroughly that it is easily and widely absorbed into a person’s system.

The second part of the elimination happens in the kidney. The result is metabolites, essentially what’s leftover from the processing. In cases of excess or tramadol abuse, these metabolites are what build up and wreak havoc on the body.

Treatment for Tramadol Addiction

Treatment options are available if you or a loved one suffer from tramadol addiction or opioid drug addiction. There are also steps to take if you or a loved one are at risk for dependence. The time frame for treatment will vary based on the intensity of the addiction and treatment receptiveness. 

Inpatient — Inpatient treatment is best for those at the height of their addiction or those at risk of dependence. Inpatient treatment implies a 24/7 care schedule for addiction treatment.

An individual is administered and monitored for bodily or mental changes. Inpatient treatment may occur after or to prevent an overdose. Inpatient treatment is in place to ease withdrawal symptoms as well. 

Outpatient — Outpatient treatment is best for those who have a stable home environment or for those who are unable or unwilling to leave their day-to-day life for treatment. Outpatient treatment allows routine check-ups and monitoring as an option for addiction treatment. 

Medication-assisted treatment (MAT) — The use of specific medications to treat substance use disorders (SUD). MAT, combined with counseling and treatment programming, creates a “whole patient” approach to managing substance use disorders. For many patients, MAT helps sustain recovery.

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Resources +

El Sayed, Abdel-Aziz Y, et al. “Development and Validation of High-Performance Liquid Chromatography–Diode Array Detector Method for the Determination of Tramadol in Human Saliva.” Sohag University, 2011

Hadland, Scott. “OBJECTIVE TESTING – URINE AND OTHER DRUG TESTS.” PubMed Central, 2016

Dadpour, Bita, et al. “Arterial Blood Gas Analysis of Patients with Tramadol-Induced Seizure; a Cross Sectional Study.” Archives of Academic Emergency Medicine, Shahid Beheshti University of Medical Sciences, 1 Mar. 2020

Grond, Stefan, and Armin Sablotzki. “Clinical pharmacology of tramadol.” Clinical pharmacokinetics vol. 43,13 (2004): 879-923
Subedi, Muna et al. “An overview of tramadol and its usage in pain management and future perspective.” Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie vol. 111 (2019): 443-451
Schug, Stephan A. “The role of tramadol in current treatment strategies for musculoskeletal pain.” Therapeutics and clinical risk management vol. 3,5 (2007): 717-23.
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