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Tramadol Abuse Signs, Symptoms and Addiction Treatment

  1. Table of ContentsPrint
  2. Tramadol Abuse: Key Facts
  3. Signs and Symptoms
  4. Effects of Tramadol Abuse
  5. Tramadol Abuse Treatment
  6. Resources, Articles, and More Information

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Tramadol Abuse: Key Facts

If you're abusing tramadol and/or other opiates, you don't have to suffer alone. Learn about treatment now.

Tramadol (brand name: Ultram) is an opioid analgesic (painkiller). It is prescribed to treat moderate to moderately severe pain and is considered a safer alternative to other narcotic analgesics like hydrocodone (Vicodin, Lortab) and methadone.

Additional medications containing tramadol include Ultram ER, an extended release formulation for round-the-clock pain relief, and Ultracet, a combination of tramadol and acetaminophen (Tylenol).

Tramadol was originally considered to have a much better safety profile than other opioid analgesics like morphine or hydrocodone, so the US Food and Drug Administration (FDA) originally approved tramadol for use in 1995 and recommended it not be classified as a controlled substance. However, due to mounting evidence of abuse among the general public, as well as evidence of withdrawal symptoms upon cessation, the Drug Enforcement Administration (DEA) published revised rules in 2014 making tramadol a federally controlled drug.

When taken orally in pill form, the liver metabolizes tramadol into several chemicals including O-desmethyltramadol, which produces much more potent effects than tramadol itself. Taken orally at high doses, tramadol can produce a euphoric high similar to another commonly abused opiate medication, oxycodone (OxyContin).

Tramadol Statistics

Tramadol Statistics

Although tramadol abuse is smaller in scope compared to other opiate painkillers, the number of people using this drug for nonmedical purposes and the consequences of that use are still significant. Some key tramadol statistics from the National Survey on Drug Use and Health and the Drug Abuse Warning Network include:drugabuse-shutterstock1055120-teens_sharing_pills

  • Over 7 million Americans over the age of 12 used tramadol for recreational purposes in 2013, an increase of over 500,000 from 2012.
  • In 2013, the highest rate of tramadol abuse was found in young adults, with 2.8% of all people aged 18 to 25 taking it at some point for nonmedical reasons.
  • Emergency room visits due to adverse reactions to tramadol increased from 10,000 in 2005 to nearly 27,500 in 2011.

Teen Tramadol Abuse

Tramadol abuse has also been documented among adolescents in high school, where the drug is also known by the slang name “ultras.” Though there are few data on national teen tramadol abuse, the Monitoring the Future survey reported that 9.5% of high school seniors had ever taken a narcotic other than heroin, including tramadol, for nonmedical reasons.

Furthermore, the availability of tramadol and other drugs from sources like Internet websites or friends with legitimate prescriptions mean parents should make sure their children are informed about the dangers of abusing any drug not prescribed to them specifically.

Signs and Symptoms

There is a risk of seizures and convulsions in some patients taking tramadol.

When prescribed by a doctor, the desired effect of taking tramadol is consistent pain relief. However, like most medicines, Ultram can have undesired side effects. These are similar to other opioid drugs and include:

  • Nausea.
  • Vomiting.
  • Constipation.
  • Lightheadedness or dizziness.
  • Drowsiness.
  • Headache.
  • Loss of appetite.
  • Dry mouth.

In individuals who use tramadol for nonmedical purposes, these side effects can be a warning sign of abuse. There is also a risk of seizures and convulsions in some patients taking tramadol, and this risk is elevated in abusers seeking the euphoric effects, or “high,” produced by taking large doses of the drug.

Effects of Tramadol Abuse

In addition to its opioid-like effects, tramadol also increases brain levels of the neurotransmitters serotonin and norepinephrine, similar to the changes induced by antidepressant drugs including venlafaxine (Effexor).

Users have reported that such mood-elevating properties caused them to take higher doses of the drug, or take it more often, than had been prescribed.

In addition to the euphoric and mood-enhancing effects sought by tramadol abusers, taking this drug for nonmedical purposes, or taking it in a manner different from that prescribed by a doctor, can have negative and sometimes dangerous results. These include disturbed sleep patterns resulting in insomnia, and increased risk of convulsions or seizures.


Additionally, abusing tramadol can lead to tolerance and dependence. Habitual users who become tolerant of tramadol need to increase the amount or frequency of the doses they take in order to achieve the desired effects. This puts them at risk of accidental overdose, symptoms of which include:

  • Decreased size of the pupils of the eyes.
  • Slow breathing or difficulty breathing.
  • Extreme drowsiness.
  • Cold, clammy skin.
  • Slow or irregular heartbeat.
  • Loss of consciousness.
  • Coma.
  • Seizure.

Psychological Dependence

Individuals who abuse tramadol for an extended period of time and develop psychological dependence may begin to experience compulsive cravings to take the drug and to feel that they need it to cope with everyday problems. People who are psychologically addicted to tramadol can feel anxiety if they do not have access to the drug and will engage in behaviors such as doctor shopping or prescription forgery in order to maintain their supply.

Physical Dependence

Abusers who continue to take tramadol long enough and at high enough doses will eventually develop a physical dependence on the drug and experience unpleasant, or even dangerous, symptoms of withdrawal if they stop taking the medication.

The withdrawal symptoms caused by tramadol overlap with both opiate and anti-depressant withdrawal syndromes and include:

  • Gastrointestinal pain.
  • Depression.
  • Diarrhea.
  • Agitation.
  • Numbness in the extremities.
  • Ringing in the ears.
  • Hallucinations.
  • Paranoia.
  • Agitation.
  • Confusion.

Treatment facility admissions for tramadol

United States, admissions for treatment, age 12+


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Tramadol Abuse Treatment

Tramadol abuse and dependence present many of the same challenges as addictions to other opiate drugs, and can be addressed by the same facilities and services. Medically supervised detoxification from tramadol is recommended to minimize the dangers presented by withdrawal syndrome.

Following detoxification, a range of rehabilitation facilities is available to help abusers get on the road to recovery.

  • Inpatient treatment centers offer round-the-clock supervision and intensive care to patients for 28 days or more.
  • Outpatient programs allow those who are able to continue living at home while attending therapy sessions multiple nights per week.
  • Peer recovery organizations such as SMART Recovery, LifeRing Secular Recovery, and 12-step groups provide a forum for people in recovery to share their experiences and offer support to one another.

If you or someone you love is abusing tramadol, there is help available. Please call 1-888-747-7155 for immediate assistance.

Resources, Articles, and More Information

For more information, check out the following articles:

You can also visit our Forum to join the conversation about prescription drug abuse.

Need Help Understanding Your Addiction Treatment Options? Call 1-888-747-7155.