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Can You Get Addicted to Tramadol?

If you or a loved one take tramadol, you may have heard about tramadol addiction. While very effective for pain, tramadol is a medication with addictive properties, so this is a real concern. Read on to learn more about this drug, how it becomes addictive, and what are the treatment options for tramadol addiction.

tramadol addiction

What Is Tramadol?


Tramadol is a synthetic opiate similar to morphine in structure and action, with a potency similar to codeine. Rather than being made from natural ingredients, it was created in a laboratory. Tramadol is prescribed for severe pain when other pain medications are inadequate or not well tolerated. It’s usually given for long-term use.

Many people use tramadol for chronic pain after accidents or for the pain associated with conditions like arthritis or fibromyalgia. It is not formally indicated for fibromyalgia. When a drug is given outside its approved (studied) indications, this is known as “off-label” use. Tramadol is a Schedule IV Controlled Substance in the United States, meaning it has greater restrictions than other medications.

Mechanism of Action

Tramadol works by binding with μ-opioid (pronounced “mew” opioid) receptors, which are pain receptors on neurons (AKA nerve cells). These receptors are present in both the brain and the gut.

Additionally, tramadol has mild serotonin and norepinephrine reuptake inhibition, much like prescription antidepressants. This means it can also reduce anxiety and improve mood in some individuals.


Tramadol is available in several formulations, including an immediate release formulation and an extended-release (ER) version. It is also available in combination with acetaminophen (Tylenol), which has been proven to increase tramadol’s efficacy. It’s normally taken orally, although there is also an intravenous form. The most common tablet form comes in 50 mg doses, however many people take more than that.

While it is available as generic tramadol, this medication is also available under multiple brand (trade) names, including:

  • Ultram
  • Ultram ER
  • Zaldiar
  • Ryzolt
  • Conzip
  • Ultracet
  • Tramapap
  • Tramal

On the street, tramadol may be called by a variety of slang names, including trammies, ultras, and chill pills.


Tramadol is not recommended for pregnant or lactating women because some of the drug may be passed to the child. It is occasionally used in pediatric populations but only under strict supervision. It is metabolized in the liver and eliminated through the kidneys, so it should not be given to people with liver (AKA hepatic) or kidney (AKA renal) impairments. Because it is sedating, tramadol is given with caution to elderly people who may be more susceptible to falls or cognitive issues.


Tramadol can have negative interactions with some other drugs, so it is contraindicated or given with caution in those cases. For example, it may conflict with the same metabolic pathway as some antibiotics (like four traffic lanes merging into a two-lane tunnel), which can reduce the efficacy of those antibiotics. It can also increase the effects of certain antidepressants to a lethal degree (see below).


What Are Tramadol Side Effects?

Tramadol, while effective as a pain reliever, does have some common side effects in some people who use it. These include:

  • Dry mouth
  • Nausea
  • Vomiting
  • Drowsiness
  • Dizziness and vertigo
  • Constipation
  • Indigestion
  • Abdominal pain
  • Headache
  • Tremor
  • Sweating
  • Itching

Why Can Tramadol Become a Problem?

Adverse Events

In addition to the common side effects listed above, tramadol has other more serious problems associated with it. First, tramadol has had a number of adverse events in patients taking it. These are problems beyond basic side effects and include:

  • Respiratory suppression and distress (slowed or stopped breathing)
  • Serotonin syndrome (in combination with antidepressants)
  • Irregular heartbeat (AKA arrhythmia)
  • Numbness
  • Memory loss
  • Immune suppression (inability to fight short-term or long-term conditions)
  • Blurred vision
  • Seizures
  • Panic attacks or increased anxiety
  • Insomnia
  • Extreme cases of side effects listed above
  • Fetal withdrawal when used during pregnancy (see addiction, below)
  • Overdose (see symptoms, below)


When tramadol was first introduced, it was thought to be a less addictive alternative to many opioids. In fact, it was often touted as being non-addictive. However, it has since been shown that tramadol can be as addictive as other opiates (prescription pain medications), including in people with no prior history of substance abuse.

How does addiction happen? In some cases, it’s because people taking tramadol become more and more tolerant of it, which means they need increasing amounts to get the same pain relief. In instances where people take tramadol as an illegal recreational drug, there can also be a tolerance aspect, although some abusers do take intentionally high amounts to start with.

When someone who is addicted to tramadol either goes without the drug or takes too small of a dose, they can go through withdrawal, which is a series of unpleasant physical symptoms when the body craves something it can’t have (see below). Withdrawal involves the brain too because when someone who is addicted to tramadol takes a dose, it activates reward centers in the brain, much like eating a favorite food or winning a video game. When those reward centers aren’t stimulated, the brain starts to crave stimulation.

Signs and Symptoms of Withdrawal

The warning signs of tramadol withdrawal include:

  • Irritability or mood swings
  • Agitation or restlessness
  • Anxiety
  • Depression
  • Sweating
  • Headaches
  • Body aches, abdominal pain, or flu-like symptoms
  • Nausea and vomiting
  • Loss of appetite
  • Diarrhea
  • Insomnia
  • Nightmares
  • Tingling sensations
  • Tremors


A term frequently used with addiction is dependence, and sometimes the two are used interchangeably. When someone is dependent on tramadol, they may show the signs of abuse listed below, which go beyond just physical addition. A dependence on tramadol affects all aspects of the user’s life and includes psychological and logistical factors.


What Are the Signs of Tramadol Abuse?

If you think you yourself or a loved one may have a tramadol addiction, there are multiple signs of abuse to watch for. These include physical addiction, psychological dependence, and overdose. Together, physical and psychological craving for tramadol can cause tramadol abuse (AKA substance abuse): taking too much and/or changing one’s life to get the drug at any cost, often with dangerous consequences. Tramadol abuse can occur at any dose, although it’s more common at high doses.


The symptoms of a tramadol overdose are important to know for anyone taking the drug. (Note that an overdose can happen the first time someone takes tramadol as well as when someone is addicted to this medication.) An overdose is taking too much of any drug, so much so that the side effects or adverse events become potentially fatal.

If you or someone you know has these symptoms of a tramadol overdose, stop reading, and call 911 immediately:

  • Extreme sleepiness
  • Loss of consciousness (blacking out)
  • Seizures
  • Very slow breathing
  • Cessation of breathing
  • Slow heart rate (pulse) or irregular heartbeat
  • Abnormally low blood pressure
  • Heavy sweating and/or clammy skin
  • Weakness or lack of muscle tone
  • Pinpoint pupils (pupils become very small)

When someone overdoses on a drug, they need to be treated in the emergency room to remove the drug from their system and/or block its effects on the body. Once any life-threatening situations have been dealt with, medical professionals can work with the overdose victim to discover if the overdose was related to otherwise normal use of tramadol or if it was because of an abuse problem.

Tramadol Abuse

Besides overdose, watch for these signs and symptoms that could indicate you or someone you know has a problem with tramadol abuse. Remember, some of the signs may be subtle, especially with high-functioning abusers who hide their addiction well; not everyone looks like a stereotypical drug addict when they abuse tramadol. You may notice other strange things not on this list. You will likely see many of these signs simultaneously and some overlap with overdose symptoms:

  • Extreme or ongoing tramadol side effects, as listed above
  • Withdrawal symptoms, as listed above
  • Pinpoint pupils
  • Seizures (nonepileptic)
  • Slurred speech
  • Poor coordination
  • Appetite or weight changes
  • Change in work or school performance
  • Job loss or expulsion from school
  • Chronic tardiness
  • Isolation or hanging out with different people, especially those who may have substance abuse issues
  • Deteriorating relationships with friends and/or family
  • Abrupt changes in habits
  • Failure to remember or attend important appointments or events
  • Making excuses for bad behavior
  • Negative changes in appearance, poor grooming
  • Anhedonia or lack of pleasure in normally enjoyed activities
  • Sleep changes (insomnia or sleeping too late or too long)
  • Car accidents
  • DUI incidents
  • Using tramadol in combination with alcohol or other drugs to enhance its effect
  • Increase or new use of recreational drugs
  • Going through a prescription too quickly
  • Multiple prescriptions for tramadol at different pharmacies
  • Lying about tramadol or other drug use
  • Sneaking tramadol when no one is watching
  • Extreme or unusual secretiveness
  • Frequent trips to the restroom
  • Going outside the US to obtain tramadol illegally
  • Buying tramadol illegally on the street or getting it from friends
  • Stealing tramadol, either from other people or from a pharmacy or health care facility
  • Involvement in criminal activity, incarceration, or unusual interactions with law enforcement
  • Needing more money than normal to buy tramadol
  • Inability to pay rent, basic living expenses, bills, or tuition
  • Signs of withdrawal (as above) when going without tramadol or not taking the normal dose

Can you Treat Tramadol Addiction?

Fortunately, tramadol addiction and abuse can be treated. Dealing with tramadol abuse takes a multifaceted approach. Treatment centers need to help the abuser get over physical addiction (detoxification, AKA “detox”) as well as help them deal with dependency habits and lifestyle changes that have resulted from tramadol abuse.

Sometimes an intervention is necessary to get the substance abuser to agree to try a recovery program. It may also be necessary to educate family members on issues surrounding substance abuse, so they may participate in the individual’s recovery.

If you are seeking a tramadol addiction treatment and recovery center for yourself or someone close to you, look for these signs of an effective facility:

  • Program integrates the spectrum of abuse recovery: intervention, detox, education, treatment, etc.
  • Facility has both inpatient and outpatient capabilities.
  • Staff have representatives onsite 24/7 with separate quarters for men and women.
  • Program provides a thoughtful intake process to take each participant’s unique needs into account.
  • Facility is capable of dealing with tramadol addiction with people who still need ongoing pain management.
  • Center is open to family members visiting or attending sessions when appropriate to provide support to participants. They may also offer educational programs for family members.
  • Treatment involves a transitional program to help ease those in recovery back to normal life. This may include transitional living or “aftercare” programs.
  • Facility has a staff well versed in dealing with all aspects of substance abuse, including both physical and psychological elements.
  • Program accepts insurance or provides their treatment at a cost equal to or less than traditional insurance copays and deductibles.
  • Treatment center has a track record of success with substance abuse, including tramadol addiction.
  • Facility is licensed as required by your location.
  • Program helps participants locate 12-step or similar groups to continue recovery as a lifelong lifestyle change.

Many excellent treatment facilities for tramadol abuse use cognitive behavior therapy for comprehensive recovery. This allows the participant not only to detox from the physical addiction to tramadol but to work through why the addiction started, build self-esteem, and make doable changes to prevent relapse.

Cognitive behavioral therapy, also called CBT, works with belief systems, feelings, and attitudes to help with a range of personal problems. This is an excellent approach when dealing with substance abuse because it can also help with coexisting conditions like depression and anxiety that may have contributed to the abuse problem initially.

Are you looking for more information about tramadol addiction for yourself or someone you know? Contact Clean & Sober Recovery Services, Inc. today for assistance. We are happy to answer your questions and provide treatment should our program meet your needs. We are not part of a chain and can offer you professional recovery help within a pleasant “mom and pop” atmosphere.


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