Tramadol Abuse, Side Effects & Treatment Options

Tramadol was approved for use in 1995 by the US Food and Drug Administration as a safer alternative to more dangerous opioids, such as morphine. Over time, multiple accounts of abuse and addictions started to surface, resulting in tramadol’s shift to a federally controlled substance in 2014.

What Is Tramadol?

Tramadol is a drug that is classified as a synthetic opiate (narcotic) analgesia and used to treat moderate or severe pain.

It is the active ingredient in several brand names, including Ultram, Ultracet, ConZip, Ryzolt and Rybix ODT. This drug is generally taken orally, most commonly in the form of 50 mg tablets. The maximum dosage within a 24-hour period is specified at 400 mg. It is prescribed widely for both acute and chronic pain management.

How Common Is Tramadol Abuse?

An analysis of tramadol abuse between 2002 and 2017 showed that the rates of tramadol abuse are consistently lower than other commonly prescribed opioids such as hydrocodone and oxycodone.

Those who abuse tramadol often have a history of abusing other drugs. According to a 2014 report from the World Health Organization, approximately 95 percent of tramadol abuse cases in one study involved a prior history of other substance abuse.

However, it is certainly possible for someone to abuse tramadol if they have no prior drug use history. For example, someone prescribed the drug may abuse it to experience the pleasurable, reinforcing effects. Like all opioids, tramadol abuse can lead to addiction over time.

What Are the Side Effects of Tramadol?

Tramadol’s side effects include:

  • Headache.
  • Dry mouth.
  • Sleepiness.
  • Dizziness.
  • Constipation.
  • Loss of appetite.
  • Nausea.
  • Vomiting.
  • Insomnia.
  • Joint pain.
  • Sweating.
  • Seizures.
  • Serotonin syndrome.

Higher doses of tramadol or use of tramadol with other drugs such as alcohol or benzodiazepines can trigger life-threatening respiratory depression.

What Are the Signs of Tramadol Abuse?

Abuse of tramadol can take several forms, including:

  • Taking larger and more frequent doses than prescribed
  • Taking the drug for a long duration of time
  • Using it for nonmedical purposes
  • Taking it with other drugs, such as alcohol, sedatives, and other painkillers

As a person regularly abuses tramadol and addiction forms, they may begin showing signs of compulsive use of the drug, such as:

  • An obsession with obtaining and taking tramadol, including hoarding extra prescriptions or pills.
  • Continued use of the drug, despite evidence of ill effects.
  • Inability to quit, even if inclined to do so.
  • Loss of interest in previously enjoyed activities.
  • Placing tramadol above other life priorities, including relationships and work or school responsibilities.

Tramadol Withdrawal Symptoms

When the brain starts to adapt to the constant presence of tramadol, it develops a tolerance to, and then a dependence on, the drug. In order to keep feeling the effects of tramadol, the user will need larger and more frequent doses. Also, the user will need to keep using their normal dose to avoid withdrawal.

The tramadol withdrawal syndrome is slightly different from that of other opioids. Discontinuing or significantly reducing your dose of tramadol may cause symptoms that include both typical and atypical opioid withdrawal symptoms that may include:

  • Dilated pupils.
  • Muscle aches.
  • Restlessness.
  • Yawning.
  • Teary eyes.
  • Runny nose.
  • Sweating/chills.
  • Nausea/vomiting.
  • Stomach pain.
  • Fast heart rate.
  • Hypertension.
  • Rapid breathing.
  • Upper respiratory symptoms.
  • Tremors.
  • Anxiety.
  • Paranoia.
  • Panic attacks.
  • Numbness/tingling of the arms and legs.
  • Hallucinations.

According to the Drug Enforcement Administration, the large majority (90%) of those withdrawing from tramadol will experience only typical opioid withdrawal symptoms such as those that mimic the flu and will not experience atypical symptoms such as paranoia, panic, or hallucinations.

Tramadol Addiction Treatment & Rehab Options

Addiction to any substance of abuse is difficult. When it comes to addiction to opioids like tramadol, the negative effects on one’s life can be substantial. Recovery can seem daunting at first, but addiction is wholly treatable. While there is no cure, with the right help, individuals can go on to lead healthy lives in recovery, effectively managing the disease for life.

Most often, treatment for tramadol addiction involves a combination of medication and therapy. As with other opioids, it is often helpful to use replacement medications during the detox process to slowly wean the person off opioids. The three medications most commonly used in opioid addiction treatment are buprenorphine, methadone, and naltrexone.

Medical detox is very often recommended for opioid withdrawal, due to the risk of severely uncomfortable withdrawal symptoms and the high potential for relapse. Detox, however, does not constitute addiction treatment on its own. It must be followed with a comprehensive therapy program to ensure long-term recovery. If a person merely withdraws from tramadol without participating in further therapy, relapse is highly likely.

The specifics of a rehab program will vary depending on the individual’s needs and the offerings of a particular center; however, most programs offer individual therapy, group therapy, wellness activities, and aftercare planning.

Depending on the severity of the addiction and the needs of the individual, an inpatient or outpatient program may be more appropriate:

  • Inpatient programs allow for complete emersion in the recovery process since clients stay onsite around the clock. These programs are recommended for those with co-occurring disorders, severe or longstanding addictions, and those who have gone through treatment before and then relapsed.
  • Outpatient programs offer similar therapeutic programming but they are often more flexible and can be structured around a client’s work schedule. Outpatient programs often work best for those with familial or work obligations that they must attend to while undergoing treatment.

Tramadol & Co-Occurring Issues

Many individuals suffer concurrently with other mental illnesses in addition to struggling with addiction. When that happens, tramadol may be used to alleviate both the pain and the symptoms of the mental illness. In certain situations, one condition will lead to the onset of the other.

Co-occurring disorders often lead to a toxic cycle. When substance abuse is an issue, it fuels the psychiatric disorder and worsens the symptoms, which in turn compels the continued use of tramadol. When treating tramadol addiction, it is important to address all co-occurring disorders as well. Failure to do so often increases the chance of relapse.

How to Intervene if You Suspect a Loved One Is Abusing Tramadol

Addiction can cause strain on any relationship. While it can be tough to talk to a loved one about their suspected substance abuse, the topic can be approached systematically and empathetically.

Confrontational interventions like those seen on TV tend not to work well and may cause your loved one to resist the idea of treatment. Instead, you can try to have repeated conversations where you express your concern over your loved one’s tramadol use and bring up the idea of getting help. Often, it takes many attempts to reach your loved one before they accept help. While you wait, make sure to take care of yourself. Make time for rest, hobbies, and connection with other loved ones. You can also reach out to mutual support groups for families of addicts, such as Nar-Anon.

If your loved one does accept help, you can assist them in finding treatment programs or call a facility for them. Often, someone who finally agrees to get help may be in crisis mode and need the support from a loved one to take the steps they need to move forward. If you are ready to get help today, you can call us at any time at to speak confidentially to a caring and compassionate admissions navigator today.

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