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Updated on March 4, 2022

Tramadol

What is Tramadol?

Tramadol is an opioid prescribed to treat moderate-to-severe pain. Opioids attach to opioid receptors in the brain, suppressing the central nervous system (CNS) to block pain signals.

Examples of opioids include:

  • Oxycodone
  • Morphine
  • Fentanyl
  • Heroin

Tramadol is versatile, able to be prescribed as either immediate-release or extended-release tablets. The type of tablet prescribed is dependent on a patient's specific needs.

Tramadol was patented in 1963 and brought to market under the name "Tramal" in 1977 by the West German pharmaceutical company Grünenthal GmbH. In the mid-1990s, it was approved for use in the United Kingdom and the United States.

In 2014, the U.S. Drug Enforcement Administration listed Tramadol as a schedule IV controlled substance due to the risk of addiction and overdose.

Tramadol is a popular medication because it is less powerful than many other drugs within the opioid category. For example, it has about one-tenth of the potency of Morphine.

However, it's still an opioid, and thus has the same risks as other opioids, including:

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

Tramadol Side Effects

Side effects of Tramadol include:

  • Mild-to-moderate headache
  • Dizziness
  • Drowsiness
  • Lethargy, or reduced energy
  • Nausea and vomiting
  • Constipation or diarrhea
  • Dry mouth
  • Profuse sweating

A small percentage of patients experience more severe side effects.

These may include:

  • Slowed breathing
  • Rapid or irregular heartbeat
  • Serotonin syndrome — a combination of elevated body temperature, agitation, profuse sweating, tremors, dilated pupils, and diarrhea, and can result in coma or even death

If any of these symptoms occur, speak to your doctor immediately.

Immediate-release vs. extended-release tablet form

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

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.

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Tramadol Risks

Doctors warn against drinking alcohol, or taking other prescription or illegal drugs while taking Tramadol. Additionally, women taking it are strongly advised against breastfeeding, as the drug passes through breast milk.

Tramadol also has several risks associated with misuse, such as:

Tramadol Dependence

Tramadol use can cause a build-up of tolerance, particularly with extended or overuse.

Tolerance is when more of a drug is needed to relieve pain than previously used. The speed and strength of drug tolerance depend on the amount taken, duration used, and genetics.

Abuse or misuse of the drug will occur when:

  • A patient takes more of the drug than prescribed
  • A patient takes the drug without a prescription altogether
  • When used in any way other than intended

Once dependent, a person will experience symptoms of withdrawal if they abruptly stop taking the drug.

Though Tramadol is less potent than many other opioids, there is still a risk of withdrawal symptoms, including:

  • An 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

Tramadol Addiction

Because pain is a legitimate concern for people with an Oxycodone prescription, it may be challenging to identify someone as addicted. The drug is legal, so the symptoms of addiction may be subtle and difficult to identify in others.

A patient taking Tramadol can fall into addiction even when using it as prescribed.

The symptoms of 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
  • Seemingly distant or "out of it."
  • Mood swings
  • Apathy
  • Lapses in memory
  • Decreased appetite and weight loss
  • Financial or legal problems
  • Visiting different physicians to obtain codeine prescriptions, also known as doctor shopping

Tramadol Overdose

A Tramadol overdose can cause severe symptoms and even death.

Because it's a central nervous system (CNS) suppressant, large quantities can drastically affect vital systems in the body, especially 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
  • Cold to the touch
  • Clammy skin
  • Seizure

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

In many cases, breathing can stop altogether, resulting in permanent, irreversible damage to the brain, coma, and even death. If you suspect a Tramadol overdose is occurring, immediate medical attention is required.

Treatment Options for Opioid Abuse & Addiction

Opioid use disorder is challenging to overcome. Fortunately, there are several options for help.

These include:

Medication-Assisted Therapy (MAT)

There are three types of medication-assisted therapy for opioid use disorder:

  • Buprenorphine
  • Methadone
  • Naltrexone

Buprenorphine and methadone help manage withdrawal symptoms as you detox.

Naltrexone blocks the receptors that opioids bind to, making it impossible to get high from them.

Medication-assisted therapy (MAT) is most effective when combined with other treatments.

Inpatient Programs 

Inpatient programs are the most intensive addiction treatment options.

These programs guide you through:

  • Medically supervised detoxification
  • Behavioral therapy
  • Other services like medication-assisted therapy

They typically last 30, 60, or 90 days. However, they may be longer if necessary.

Partial Hospitalization Programs (PHPs)

Intensive outpatient programs are the next level of addiction treatment. These programs provide similar services to inpatient programs such as detoxification and behavioral therapy.

The difference is that the patient will return home to sleep. Some programs also include transportation and meals.

PHPs are ideal for new patients and those who have completed inpatient treatment but still need intensive care.

Outpatient Programs

Outpatient programs provide well-rounded treatment for people with a high motivation to recover. These programs are flexible and can be made around your schedule. They can also be customized to work best for you.

These programs work for new patients and those that complete an inpatient or partial hospitalization program.

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Resources

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  1. Shmerling, Robert. “Is Tramadol a Risky Pain Medication? - Harvard Health Blog.” Harvard Health Blog, 14 June 2019.
  2. Tramadol (Oral Route) Description and Brand Names - Mayo Clinic.” Mayo Clinic.
  3. Tramadol Hydrochloride 50 Mg Capsules - Summary of Product Characteristics (SmPC) - (Emc).” Logo for Datapharm, 26 June 2019.
  4. Tramadol - DrugBank.” DrugBank.
  5. Tramadol: Medlineplus Drug Information.” MedlinePlus, U.S. National Library of Medicine.
  6. Cunha, John P. “Tramadol: Generic, Side Effects, Dosages, Interactions & Warnings.” RxList, 9 July 2021.

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