Tramadol: Effects and Risk of Addiction

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What is Tramadol & What is it Prescribed For?

Tramadol is an opioid medication prescribed for the treatment of moderate to severe pain. Additionally, doctors may prescribe extended-release capsules or tablets for chronic pain management, such as osteoarthritis. Some brand names for tramadol include Conzip, Qdolo, and Ultracet (tramadol and acetaminophen).^1,2

Like other opioid medications, such as oxycodone and hydrocodone, many people abuse tramadol for its euphoric and relaxing effects, but abusing tramadol can have harmful consequences, including harmful side effects, dependence, withdrawal, addiction, and overdose.

Tramadol Side Effects

Even if you take your tramadol as prescribed, you may still experience many common side effects. Abusing tramadol can increase the risk of adverse effects, such as:¹

Mood changes
Muscle tightness
Uncontrollable shaking
Nervousness
Sleepiness
Sleep disturbances
Dry mouth
Indigestion or heartburn

Some tramadol side effects are dangerous and require immediate medical attention. Serious side effects of tramadol use include:¹

Blisters
Rash
Seizures
Hives
Difficult breathing or swallowing
Swelling of the face, throat, tongue, lips, eyes, or extremities
Hallucinations
Agitation
Fever and sweating
Rapid heart rate
Nausea, vomiting, or diarrhea
Loss of coordination
Confusion
Loss of consciousness

If you experience any of these dangerous tramadol side effects, make sure to call 9-1-1 right away. In the event of a tramadol overdose, medical professionals may administer naloxone, a life-saving medication that reverses the effects of an opioid overdose.³

How Addictive is Tramadol?

In 2014, the U.S. Drug Enforcement Administration (DEA) listed tramadol as a Schedule IV controlled substance, which means that it has the potential for abuse or addiction, however, the risk is relatively low.^2,4

Although tramadol doesn’t have the same addiction potential as other opioid medications like Vicodin, Percocet, and Oxycontin, users can still develop a problematic pattern of abuse known as a substance use disorder.

The risk of tramadol addiction increases if you misuse or abuse tramadol by:

Taking a larger tramadol dose than prescribed.
Taking tramadol more often than prescribed.
Taking tramadol for a longer period than prescribed.
Taking tramadol without a prescription.

Misusing or abusing tramadol can increase the risk of developing tolerance, which means you require higher doses of tramadol in order to experience the same desired effects.

As tolerance develops and you take higher and higher doses, a physical dependence can subsequently occur. Once you are physically dependent on tramadol, you will experience unpleasant withdrawal symptoms when you abruptly stop or reduce your dose.

Tramadol Withdrawal Symptoms

Common tramadol withdrawal symptoms include:⁵

Profuse sweating
Insomnia
Pain
Nausea and diarrhea
Anxiety
Panic attacks
Tremors
Upper respiratory symptoms
Goosebumps
Tingling sensations

In rare occurrences, tramadol-dependent users have reported hallucinations when they have suddenly stopped taking this opioid medication.⁴ Because tramadol withdrawal symptoms can be distressing and painful, many users will take tramadol in order to alleviate or prevent these symptoms.

This cycle of tramadol abuse and withdrawal contributes to the development of a tramadol addiction, a pattern of problematic tramadol abuse despite negative consequences.

Signs of Tramadol Addiction

A tramadol addiction, or substance use disorder, is characterized by a set of behavioral signs that indicate a pattern of compulsive tramadol use regardless of detrimental consequences. It is this uncontrollable use that differentiates tramadol addiction from tramadol dependence or abuse.

If you demonstrate at least two of the following behavioral signs within a one-year period, you may be struggling with a tramadol addiction:⁶

Obtaining tramadol illegally or “doctor shopping” for new physicians to prescribe the medication.
Using tramadol in dangerous situations, such as while driving a car.
Spending a considerable amount of time obtaining and using tramadol, as well as recovering from use.
Failing to control or quit tramadol use, despite efforts to do so.
Using increasing tramadol doses in order to experience the same effect (tolerance).
Combining tramadol with other drugs or alcohol.
Neglecting important responsibilities and hobbies in favor of tramadol use.
Continuing to abuse tramadol despite negative occupational and interpersonal consequences.
Engaging in dishonest or secretive behaviors.

In addition to behavioral signs, there are also some physical signs of tramadol addiction, including:⁶

Constricted pupils.
Bloodshot eyes.
Drowsiness
Slurred speech.
Mood swings.
Memory or attention problems.
Neglected personal hygiene.
Changes in appetite resulting in sudden weight gain or loss.

If you or someone you know demonstrates these signs of tramadol addiction, don’t hesitate to seek help—call 800-681-1058 (Who Answers?) to speak to a treatment specialist about finding a tramadol addiction treatment program.

Treatment for Tramadol Addiction

There are several types of treatment for tramadol addiction, including:⁷

Outpatient treatment: You’ll attend a rehab center during the day to receive individual and group counseling, as well as medical care, and then return home after your treatment for the day is complete. This type of tramadol addiction treatment is beneficial for people who still need to attend school or work while recovering.
Inpatient rehab: You will live at the addiction treatment center for the duration of your treatment, which may last 30, 60, 90 days, or more, depending on your individual needs. During inpatient treatment, you’ll attend group and individual therapy sessions and have access to medical care—in some cases, that medical care includes medically-supervised detox.
Dual diagnosis: You’ll receive treatment for both your tramadol addiction and a co-occurring mental health condition, such as anxiety, depression, or bipolar disorder. Co-occurring addictions and mental health disorders tend to exacerbate each other, which is why it’s necessary to receive comprehensive treatment for both.

12-step programs, such as Narcotics Anonymous (NA), are also extremely common support systems for people recovering from an addiction to tramadol. These free programs meet on a regular schedule and members provide each other with mutual support and encouragement to help each other stay sober.

New members also receive sponsors, people are further along in their recovery journey.

Keep in mind, 12-step programs are not run by mental health or addiction professionals but rather by individuals who have also struggled with addiction. While they may work for some people, others may require more formal treatment, such as an inpatient or outpatient program.

Tramadol Detox

Because tramadol can cause distressing and unpleasant withdrawal symptoms, many people may benefit from receiving medically-supervised detox before treatment.

During detox, which can occur in an inpatient or outpatient setting, a physician may create a tapering schedule in which your tramadol dose is gradually reduced over a predetermined period of time. This slow tapering allows you to quit tramadol while preventing the emergence of withdrawal symptoms.

If tramadol addiction is severe, you may be prescribed opioid withdrawal medication, such as buprenorphine or methadone. These medications, which are given on a short-term basis, can help alleviate tramadol withdrawal symptoms while the tramadol detoxes from your system.

Another common medication used during opioid detox is clonidine, which can help treat some symptoms like rapid heart rate and anxiety.⁸

What Does Tramadol Addiction Treatment Entail?

Once you’ve detoxed from tramadol, then you can begin addiction treatment, which may include interventions, such as:

Individual therapy: You work closely with a therapist to identify and rectify the maladaptive thoughts, feelings, and behaviors that contribute to tramadol abuse.
Group counseling: You share your feelings and experiences with a group of individuals struggling with addiction. Facilitated by an addiction or mental health professional, these groups may also teach various skills, such as anger management and coping skills.
Family therapy: You and your family members meet with a therapist whose aim is to promote healing, facilitate healthy communication, and teach boundary-setting.
Complementary or alternative therapies: Some treatment programs include holistic treatment interventions, such as yoga, meditation, acupuncture, music therapy, and art therapy. These interventions are intended to help heal the “whole person.”
12-step meetings: Depending on the treatment program’s philosophy, you may also attend 12-step meetings during your tramadol recovery program.

Not everyone’s treatment plan looks the same, though. When you enter a treatment program, an addiction or mental health professional will first conduct an intake evaluation in order to create an individualized treatment plan that addresses your specific needs.

An intake evaluation typically assesses:⁹

Medical history.
Mental status.
Neurological functioning and physical status.
Vital signs, such as pulse and temperature.
Demographics
Living conditions, financial situation, legal status.
Patterns of tramadol abuse.
Risk of suicide or violence.
Previous detox or treatment experiences.

When you’re comparing tramadol rehab facilities, you’ll want to make sure to ask if they create individualized treatment plans. The best addiction treatment program for you is one that takes all of your unique needs into account.

Find a Tramadol Rehab Program

If you are struggling with tramadol addiction or abuse, help is just a phone call away. Call 800-681-1058 (Who Answers?) to speak to a recovery support specialist who can provide you with information about your tramadol addiction treatment options.

References

U.S. National Library of Medicine. Medline Plus: Tramadol.
Robert H. Shmerling, M. (2020, December 07). Is tramadol a risky pain medication?
National Institute on Drug Abuse. (2020). Opioid Overdose Reversal with Naloxone (Narcan, Evzio).
United States Drug Enforcement Administration. Drug scheduling.
Food and Drug Administration. (2010). Tramadol hydrochloride extended-release capsules.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.
Ries, R. K., Miller, S. C., Fiellin, D. A., & Seitz, R. (2009). Principles of addiction medicine(4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Kleber, H. D. (2007). Pharmacologic treatments for opioid dependence: Detoxification and maintenance options. Neuropsychiatric Manifestations of Neurodegenerative Disease Dialogues in Clinical Neuroscience, 9(2), 455-470. doi:10.31887/dcns.2007.9.2/hkleber
Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol, TIP 45.