Tramadol Addiction and Abuse

Tramadol, like other prescription opioids, carries a risk for abuse, physical dependence and addiction. Thankfully, treatment is available for a tramadol use disorder.

Tramadol is a prescription opioid used to treat severe pain. Like other opioids, tramadol carries the risk of abuse, dependence and addiction. It’s important to understand tramadol and the potential risks involved with its use.

What Is Tramadol?

Marketed under the brand names Ultram, ConZip and Qdolo, tramadol has been available in the United States since 1995. Each year, almost five million Americans receive tramadol prescriptions to control their pain. However, the addictive properties of this opioid make it a legitimate concern. Even if it is taken as prescribed by a medical professional, regular tramadol use can result in addiction.

Tramadol must be used under close medical supervision, especially if any other drugs or herbal remedies are used on a regular basis. This medication can interact harmfully with other drugs, such as monoamine oxidase (MAO) inhibitors or selective serotonin reuptake inhibitors (SSRIs). Tramadol also makes it easier for a seizure to occur, so doctors avoid prescribing it to people with a history of seizures.

What Does Tramadol Look Like?

Tramadol is available in tablet, capsule and liquid forms. Tramadol’s appearance can vary from one manufacturer to another. The drug’s dosage forms include:

• Tablet
• Extended-release tablet
• Oral liquid
• Extended-release capsule

Is Tramadol an Opioid?

Tramadol is considered an opioid. Tramadol is a synthetically made medicine that resembles opioids. By definition, an opioid binds to the opioid receptor. Tramadol binds to the opioid receptor and is therefore considered an opioid. However, the way tramadol binds to the opioid receptor is not the same as most other opioids. Tramadol binds weakly to opioid receptors, and it is considered to be a weak opioid rather than a classic opioid.

In addition to being a weak opioid, tramadol has a slightly different mechanism of action than classic opioids. Tramadol affects two neurotransmitters, serotonin and norepinephrine. Tramadol inhibits their reuptake, which causes the neurotransmitters to be more available for use in the brain. Both norepinephrine and serotonin are involved in feeling pleasure, so increasing their availability can lead to a euphoric high. Drugs aimed at inhibiting the reuptake of norepinephrine and serotonin are used to treat depression and other mental health conditions.

Is Tramadol a Controlled Substance?

Tramadol is a Schedule IV controlled substance because of its addictive properties. When tramadol first entered the U.S. market in 1995, however, the drug was not controlled. In 2014, after years of exploration and research into tramadol, the Drug Enforcement Administration (DEA) decided to reclassify the drug as a Schedule IV controlled substance due to its addictive nature. Schedule IV drugs include Xanax, Ambien, Valium, Ativan and many others. Although Schedule IV drugs like tramadol carry a lower risk for dependency than more strictly controlled substances, excessive tramadol use can still lead to addiction.

Is Tramadol Addictive?

Yes, tramadol can be addictive, just like other opioids. In fact, tramadol’s biggest danger lies in its habit-forming potential. When a person takes tramadol, it affects serotonin, norepinephrine and mu-opioid receptors in the brain. This reduces sensations of pain, which is why the drug is used as a painkiller. As people start relying on the drug to relieve pain, however, they can build up a tolerance that requires them to take higher doses to experience the same amount of relief.

Over time, the brain becomes dependent on the presence of tramadol. If a person with tramadol dependence suddenly stops taking the drug, their brain and body will start going through opioid withdrawal. This is why it is so difficult to stop using tramadol but so easy to develop an addiction. The length of time it takes to develop tramadol addiction varies from person to person. A key sign of opioid addiction is when someone uses the drug without caring about the negative side effects and how it impacts their overall well-being.

How Long Does It Take To Get Addicted to Tramadol?

The amount of time between taking a drug casually to developing an addiction can vary from person to person. For some people, it might take a few days or weeks, while it might take months or years for others. This is because addiction is a complicated psychosocial phenomenon in which a person compulsively takes a drug despite knowing that doing so is causing them harm. It can take different people varying times to get to that point.

Tramadol Addiction Prevalence

Overall, about 4% of people prescribed tramadol misuse the drug, meaning they do not take the drug as prescribed. This is lower than other opioids, which are often misused by up to 8% of those who take them. Among all Americans, about 1.5% have misused the drug at some point in their lives.

Tramadol High

Like other opioids, tramadol triggers the brain’s reward system. This causes a surge of the neurotransmitter dopamine in the brain, leading to a high. Misusing tramadol to get high can increase your risk of addiction and overdose. For this reason, it’s important to only take tramadol exactly as prescribed and avoid taking it without a prescription.

The recommended tramadol dosage varies based on a variety of factors, including age, existing medical conditions and the type of pain experienced. However, doctors usually recommend that adults take 50 mg to 100 mg every four to six hours as needed. If a patient has a condition that causes long-term pain, the prescribing doctor may administer up to 400 mg of tramadol per day.

When combined with other substances and medications, tramadol can cause significant problems. For example, the drug carries an FDA Black Box Warning against taking the drug with a benzodiazepine, as this can increase the risk of overdose.

Tramadol Overdose

If someone takes too much tramadol, an overdose may occur. The symptoms of a tramadol overdose, such as slowed breathing and seizures, can be very severe and even result in death. The opioid overdose reversal medication naloxone may help in some cases, but it cannot always prevent tramadol overdose death. Unlike other opioids, naloxone is only partially effective against tramadol. Further, naloxone can also increase the risk of seizures, which is already a symptom of a tramadol overdose.

Do I Have a Tramadol Addiction Problem?

If you suspect you might have a problem with tramadol, it is important to determine whether or not an addiction is taking hold. A tramadol addiction questionnaire can help you figure out whether you are struggling with an addiction to the drug. If the results show that you are developing a tramadol addiction, an expert recovery center like The Recovery Village can help.

Signs and Symptoms of Tramadol Addiction

Tramadol abuse is often among the earliest stages of addiction. If you cannot stop taking the medication—despite negative life consequences and efforts to quit—then you’re seeing the most telling sign that abuse has grown into a bigger problem. Taking a self-assessment quiz about your tramadol use may give you insight into whether you are at risk for abuse and addiction. Further, you and your loved ones may notice behavioral, psychological and physical signs that commonly develop when someone begins to struggle with a substance like tramadol.

Behavioral Signs of Tramadol Abuse

Often, substance abuse is accompanied by some changes in behavior. Even if you do not notice behavioral symptoms, loved ones may notice symptoms like:

• Nonmedical use of tramadol
• Visiting multiple doctors to get more tramadol prescriptions
• “Drug-seeking” behaviors, such as emergency doctor visits and lying about losing prescriptions
• Continued use of tramadol despite negative consequences

Psychological Signs of Tramadol Abuse

When you struggle with tramadol, you may notice that your own thought processes increasingly revolve around the drug. This can translate into a variety of psychological signs of tramadol abuse, including:

• The belief that tramadol is necessary to get through the day
• Craving tramadol
• Lack of control over tramadol use

Physical Signs of Tramadol Abuse

Substance abuse is very stressful on your body. You may notice a variety of physical symptoms when you are between tramadol doses. These withdrawal symptoms can be unpleasant and may drive you to consume more of the drug.

Withdrawal symptoms include:

• Anxiety
• Sweating
• Trouble sleeping
• Rigors
• Pain
• Nausea
• Tremors
• Diarrhea
• Upper respiratory symptoms
• Goosebumps
• Hallucinations

Side Effects of Tramadol Addiction

Tramadol addiction can cause a variety of side effects in both the short and the long term. While some side effects may show up immediately, others reflect changes in your body and brain that take longer to evolve. These side effects can be among the first signs that a person is struggling with tramadol.

Immediate Side Effects

Immediate side effects of tramadol addiction can be similar to the drug’s side effects, which include:

• Weakness
• Wakefulness or sleepiness
• Constipation or diarrhea
• Dizziness
• Dry mouth
• Indigestion
• Flushing
• Headache
• Nausea or vomiting
• Itching
• Weight loss
• Sweating

Long-Term Side Effects

Over the long term, side effects of tramadol addiction can include:

• Chronic constipation
• Sleep-disordered breathing
• Heart attack
• Heart failure
• Falls and fractures
• Hormonal abnormalities
• Sexual dysfunction, including infertility
• Immunosuppression

Tramadol Addiction Withdrawal

The severity and duration of tramadol withdrawal can be directly affected by the length and severity of the addiction. Opioid withdrawal typically has two phases: early withdrawal and late withdrawal. Early withdrawal begins when the drug leaves the bloodstream, while late withdrawal occurs later. The symptoms of opioid withdrawal vary depending on the stage:

• Early withdrawal: This phase usually begins within 6 to 12 hours after the last dose of tramadol. Symptoms can include anxiety, restlessness, sweating, nausea, vomiting, diarrhea, muscle cramps and insomnia.
• Late withdrawal: This phase typically begins two to three days after the last dose of tramadol and can last for several weeks. Symptoms can include depression, anxiety, fatigue, difficulty concentrating and sleep disturbances.

If you are experiencing tramadol withdrawal, it is important to seek medical help. There are medications and therapies that can help manage the symptoms and make the withdrawal process more bearable.

Tramadol Addiction Treatment

When someone has a tramadol addiction, they need medical attention, expert knowledge and ongoing support. While in rehab for tramadol addiction at The Recovery Village, our team teaches clients how to:

• Understand their addiction
• Cope with the stressors of life that may have triggered their substance misuse
• Prevent tramadol dependency from taking hold again once they are in recovery

Recovery is a lifelong process, so it’s essential to invest in a quality tramadol treatment program that will provide the skills needed to maintain long-term sobriety.

What To Expect During Addiction Treatment

Unfortunately, some people do not realize that addiction is a disease. Nobody intends to develop a drug addiction, and very few people with severe addictions are able to “just stop” using drugs. In fact, suddenly stopping the use of opioids like tramadol can be dangerous in some cases. The Recovery Village is staffed with experienced medical and clinical professionals who fully understand the challenges that people with addiction face.

Our facility offers individualized tramadol addiction treatment options to suit each client’s unique needs. To plan a path to recovery, our intake coordinators work with clients to determine which types of treatment may be needed. A treatment plan may include:

• Medically supervised detoxification
• Residential inpatient treatment
• Partial hospitalization
• Intensive outpatient treatment
• Outpatient treatment
• Dual diagnosis treatment
• Aftercare planning and relapse prevention

Your Unique Tramadol Addiction Treatment Plan

Treatment for tramadol addiction is unique to each person. At our facility, the treatment approach is holistic in nature and personalized to address each client’s addiction, mental health, life situation and overall needs. Treatment usually includes the following components:

• Evaluation: During evaluation, our team conducts medical and psychiatric tests to determine the extent of a client’s addiction. They also screen for any co-occurring mental health conditions that require treatment. The team then begins building a customized tramadol treatment plan that the client will follow throughout their recovery.
• Medical detox: Following the evaluation, the next step is typically detoxification. Detox is when the body eliminates toxic substances like drugs and alcohol from its system. Clients in a medical detox program are monitored around the clock and treated for any uncomfortable or dangerous withdrawal symptoms that may arise.
• Inpatient or outpatient programming: Once tramadol is out of a client’s system, therapy can begin. Each client participates in a variety of therapies, including individual counseling, group therapy and non-traditional or alternative therapies. Some clients may even participate in family therapy sessions. Clients typically begin this stage of treatment in an inpatient setting and gradually step down to outpatient care.
• Aftercare: Following personal therapy, clients leave The Recovery Village with an aftercare plan to ensure that they have a support system in place. This aftercare plan may include relapse prevention strategies, doctor appointments, drug testing with a primary care physician, sessions with a counselor and support group meetings.

The cost of rehab for tramadol addiction varies based on the type of treatment a person receives and how long they are enrolled in the program.

Medical bills can be daunting, but even if a person doesn’t have insurance, there are several options for rehab coverage. Everyone deserves to benefit from the best care available and live a healthy, sober life. For this reason, many facilities offer flexibility with payment plans and other rehab payments.

Get Help for Tramadol Addiction Today

The Recovery Village offers a full continuum of care that treats a variety of addictions and co-occurring mental health conditions. Our inpatient treatment programs help clients learn the skills needed to live without the burden of tramadol addiction. Afterward, our outpatient and aftercare programs allow clients to practice their newly learned skills as they transition back to their everyday lives. To help ensure long-term sobriety, clients may also be encouraged to live in a sober living community, attend regularly scheduled therapy sessions or participate in a 12-step program.

We have several rehab facilities located throughout the country, allowing people to find a center that best fits their needs and recovery. If seeking treatment through The Recovery Village is not an option, our online facility locator can help you find a center that works well for you.

Tramadol addiction is not a life sentence. You can take a step toward recovery today.

Editor – Abby Doty

Abby Doty graduated from Hamline University in 2021 with a Bachelor's in English and Psychology. She has written and edited creative and literary work as well as academic pieces focused primarily on psychology and mental health. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more