Updated on December 1, 2023
9 min read

Tramadol Addiction & Abuse

Tramadol is a widely prescribed pain reliever. It has become increasingly popular in relieving moderate to severe physical and psychological distress levels. 

While beneficial to many, some users can easily abuse this medication, leading to dangerous consequences. Tramadol addiction is a serious concern, so it’s essential for anyone considering taking the drug to fully understand what they could be facing. 

This blog post provides insight into tramadol abuse's signs, symptoms, and effects. It also looks at the strategies on how best to address them if you or someone you know may have an issue with tramadol use.

What Is Tramadol?

Tramadol is a synthetic opioid medication that treats moderate to moderately severe pain. The West German pharmaceutical company Grünenthal GmbH patented and released it to the market as “Tramal” in 1963.

In the mid-1990s, the United Kingdom and the United States approved it for medical use. Since then, it has become increasingly popular.

Tramadol is widely used because it's less potent than most opioid drugs. It has about 1/10 of the potency of Morphine.

Is Tramadol Addictive?

Tramadol is addictive. Aside from addiction, these are the most common dangers of opioid use:

  • Addiction
  • Tolerance
  • Dependency
  • Withdrawal symptoms
  • Overdose
  • Death

Tramadol as a Controlled Substance

In 2014, the US Drug Enforcement Administration listed tramadol as a Schedule IV controlled substance. It isn’t as tightly regulated as some other opioids. However, there are still restrictions on how doctors should prescribe and dispense it.


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How Does Tramadol Work?

Tramadol works by attaching to certain opioid receptors in the brain, suppressing the central nervous system (CNS) to block pain signals. 

It exerts its effects by combining weak opioid receptor binding and the inhibition of norepinephrine and serotonin reuptake in the brain.

The drug increases levels of serotonin and norepinephrine. These two neurotransmitters act as natural analgesics (painkillers), improving your mood and alleviating depression, anxiety, and other mental health issues.

Tramadol isn't an anti-inflammatory drug. It primarily focuses on relieving pain but does not address the underlying cause of it. 

Tramadol does not have significant anti-inflammatory properties like other medications, such as non-steroidal anti-inflammatory drugs (NSAIDs).

What Are the Forms of Tramadol?

Your condition and needs will determine the type of tramadol your doctor prescribes. The dosage depends on your age, weight, and other medical conditions.

Tramadol is available in the following forms:

  • Extended-release tablet
  • Immediate-release tablet
  • Capsules
  • Suspension
  • Oral solution

Extended-release (XR) is for those with long-term and chronic pain issues. XR prescriptions come in 200 mg, 300 mg, and 400 mg doses.

Immediate-release (IR) provides fast-acting pain relief for people with short-term pain issues. These pills come in 50 mg doses.

Additionally, there are combination products that include acetaminophen for enhanced pain relief.

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What Are Tramadol Side Effects?

Tramadol has numerous side effects. The most common ones include:

  • Mild-to-moderate headache
  • Dizziness
  • Drowsiness
  • Lethargy or reduced energy
  • Nausea and vomiting
  • Constipation or diarrhea
  • Dry mouth
  • Profuse sweating
  • Changes in mood or behavior
  • Skin rashes or itching
  • Difficulty in breathing
  • Changes in urination
  • Hallucinations
  • Seizures

Severe Side Effects of Tramadol Use

A small percentage of users experience more severe side effects. These include:

  • Slowed breathing
  • Rapid or irregular heartbeat
  • Serotonin syndrome (a combination of elevated body temperature, agitation, profuse sweating, tremors, dilated pupils, and diarrhea)

If you or someone you know experiences any of these severe side effects, seek immediate medical attention. They may progress to severe respiratory distress, coma, and even death.

What Are the Risks of Tramadol Use?

Medical professionals caution against combining tramadol with alcohol or other prescribed or illicit medications. Tramadol is often not prescribed with benzodiazepines, as it can lead to dangerous respiratory depression.

Moreover, they strongly advise women against breastfeeding while using tramadol, as the drug can transfer to the baby through breast milk.

The other risks associated with tramadol misuse are:

Tramadol Dependence

Tramadol use can cause tolerance build-up, particularly with extended-release tablets. As the body becomes dependent on the drug, you need larger doses to achieve the same effect.

The speed and strength of drug tolerance depend on the amount you take, how often you use it, and your biochemistry. Taking a large dose of tramadol can be dangerous and lead to overdose. 

Tramadol Misuse or Abuse

Substance abuse or misuse occurs when you:

  • Take more of the drug than prescribed
  • Consume tramadol without a prescription 
  • Use the drug to get high rather than to treat pain
  • Take the medication to cope with stress, anxiety, depression, or other mental health issues

If you suspect someone is misusing tramadol, try to talk to them about it. Ensure they know that misusing this drug can be dangerous. Additionally, seek help from their doctor and/or a specialist in substance use disorders if you suspect addiction. 

Tramadol Withdrawal

Tramadol is an opioid; like other drugs in this class, it can be habit-forming and lead to drug abuse. Regular use can lead to tolerance and addiction.

It's also hard to stop drug use alone when you get addicted. If you try to quit cold turkey, you may experience unpleasant tramadol withdrawal symptoms, such as:

  • Intense craving for the drug
  • Profuse sweating and clamminess
  • Runny nose
  • Chills and goosebumps
  • Muscle spasms
  • Stomach cramps
  • Nausea and vomiting
  • Psychosis
  • Agitation and irritability
  • Hallucinations
  • Homicidal or suicidal thoughts
  • Insomnia
  • Depression

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What Are the Symptoms of Tramadol Addiction?

Identifying addiction in people with an Oxycodone prescription can be challenging due to the legitimate concern for pain. The legality of the drug may make it challenging to spot subtle symptoms of addiction in others.  

Even those who take tramadol correctly can unknowingly slip into opioid addiction. Nonetheless, the most common symptoms of tramadol addiction include:

  • Depression
  • Neglect of personal relationships and isolation
  • A decline in fulfilling responsibilities at work and home
  • Visible fatigue and drifting off
  • Strong desire to use the drug, particularly with frequent visits to the ER to coax doctors into writing them a prescription
  • Disconnect or indifference
  • Mood swings
  • Apathy
  • Lapses in memory
  • Decreased appetite and weight loss
  • Financial or legal problems
  • Visiting different physicians to obtain tramadol prescriptions, also known as doctor shopping

What Are the Signs of Tramadol Overdose?

A tramadol overdose can cause severe symptoms. In some cases, it can lead to death.

Because it's a central nervous system (CNS) suppressant, large quantities can drastically affect vital systems in the body, especially regarding breathing.

Initial symptoms of overdose include:

  • Vomiting and stomach cramps
  • Slurred speech and loss of basic motor functions
  • Slow pulse and low blood pressure
  • Pin-point-shaped pupils
  • Blue lips and fingertips
  • Feeling cold to the touch
  • Clammy skin
  • Seizure

The Consequences of Tramadol Overdose

During the onset of a tramadol overdose, a person's breathing slows to a dangerously low pace, causing a lack of oxygen to the brain and other vital organs.

In many cases, breathing can stop altogether. This results in permanent, irreversible damage to the brain, coma, and even death. 

If you suspect a tramadol overdose in someone, seek medical help immediately. The sooner you take action, the higher the chances of survival. 

How Do You Treat Tramadol Abuse and Addiction?

Tramadol addiction is a serious condition that requires professional help. The best way to treat tramadol dependence is through an inpatient rehab program. 

Residential tramadol treatment programs provide comprehensive medical and psychological care to help people get off the drug. 

Inpatient treatment includes:

  • Detoxification or medically supervised withdrawal from tramadol and any other drugs being abused
  • Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) to teach people how to combat cravings and relapse triggers
  • Individual, group, and family therapies to address the underlying causes of addiction
  • Social support groups like Narcotics Anonymous (NA) or Alcoholics Anonymous (AA)

The length of treatment depends on your needs. Most inpatient rehab programs last between 30 and 90 days.

In addition, some people may require medication-assisted therapy (MAT), such as buprenorphine or naltrexone, to help manage severe withdrawal symptoms. MAT can also reduce cravings and help prevent relapse. 

Common Questions on Tramadol Addiction

What happens if you take tramadol every day?

Taking tramadol regularly can lead to psychological and physical dependence.  Long-term use can also negatively impact your liver and kidney function.

The more often you take the drug, your risk of developing an addiction increases. It's possible to overdose on the medication if you take it in large doses or combine it with other drugs or alcohol.

How long does it take to get addicted to tramadol?

It depends on various factors, such as age, gender, body weight, and mental health. Generally, addiction can develop after a few weeks of regular use. 

Some people may start to experience signs of dependence sooner than that. If you're using tramadol frequently, be aware of the risks associated with the drug and seek help if necessary. 

Is tramadol a high-risk drug?

Although less potent than other opioid drugs, tramadol carries significant risks when misused. Taking the drug too often or in large quantities can lead to tolerance and dependence.

You may also experience dangerous side effects like slowed breathing if you take it in high doses. Taking the medication as your doctor prescribes is important to reduce your risk of developing side effects or addiction. 

How does tramadol affect you mentally?

Tramadol’s impact on mental health varies among users. Some may feel a sense of bliss or euphoria, while others may manifest symptoms of depression or anxiety. 

These psychological effects can become more pronounced with higher doses and extended periods of use. When prescribing tramadol, monitoring patients for such mental health changes is essential.

What are some alternatives to tramadol?

If you're looking for alternatives to tramadol, your doctor may prescribe other opioid medications. However, many non-opioid pain relievers can be just as effective. These include over-the-counter drugs like aspirin (Bayer), acetaminophen (Tylenol), and ibuprofen (Motrin).


Tramadol is a widely prescribed drug that can be beneficial for treating short-term pain. However, it comes with significant risks when misused.

Those battling tramadol addiction may experience withdrawal symptoms and complications from overdose. Therefore, seeking professional help is important if you or a loved one is struggling with tramadol addiction.

If you or someone you know misuses tramadol, reach out for help. Treatment is available to support and guide you on your recovery journey to a healthier and happier future.

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Updated on December 1, 2023

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