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Tramadol Addiction Symptoms, Side Effects, and Treatment

If you or a loved one are misusing the opioid medication tramadol, this article will help you understand:

  • What tramadol is.
  • Signs of tramadol abuse.
  • Symptoms of tramadol withdrawal and overdose.
  • Treatment for tramadol addiction.

What Is Tramadol?

Tramadol is an opioid analgesic medication prescribed for pain relief.1 When it is used as prescribed, tramadol can be effective in managing moderate-to-moderately severe pain.1 Like other prescription opioid painkillers, tramadol can be easily abused, which could lead to potentially adverse health effects or even tramadol addiction.2

What Is Tramadol Used For?

Tramadol is prescribed to help manage pain. It is available in various generic formulations, in addition to being marketed under several brand names, including Ultram.

Though tramadol is in the same family of drugs as medications like oxycodone and hydrocodone, it works in a somewhat unusual way compared to more standard opioid painkillers.2 Like other opioid analgesics, tramadol changes how the body responds to pain through its interaction with opioid receptors. Opioid receptor activation is also associated with increased dopamine activity, which can reinforce the repeated use of tramadol.3

Tramadol was not initially considered a controlled substance when it was approved by the Food & Drug Administration (FDA) in 1995. In 2014, after years of reports of people diverting the drug for illicit misuse, tramadol was revised to be a Schedule IV controlled substance—meaning that it has a recognized potential for abuse and dependence.2

Is Tramadol Addictive?

Use of tramadol—like all opioid analgesics—presents a high risk of misuse and addiction. While it is considered to have a lower potential for dependence than opioids like morphine, tramadol dependence can still occur, particularly if it is used for long periods of time.4

With long-term tramadol use, a person’s brain can get used to its effects. This is known as tolerance. As a person develops tolerance, they may begin to need higher doses of the drug to experience the same effects as before.3

With repeated tramadol use, people may develop physiological dependence. When dependence develops, should tramadol use abruptly cease, a person may experience a range of potentially uncomfortable withdrawal symptoms.3

Neither tolerance nor physical dependence alone means that someone is addicted to tramadol. However, both tolerance and dependence may, in some cases, contribute to compulsive patterns of use that are common to opioid use disorders. Tramadol addiction and other opioid use disorders are characterized by compulsive or uncontrolled use that can lead to potentially harmful consequences and/or long-lasting changes to the brain.3

Signs of Tramadol Misuse and Addiction

Substance use disorders—like those involving tramadol—are not always easy to recognize. Thus, diagnosis is best left to a medical professional. However, if, within a 12 month period, you or a loved one shows 2 or more of the following examples of problematic tramadol use, you may meet the criteria for diagnosis of a substance use disorder involving tramadol.

The Diagnostic and Statistical Manual of Mental Disorders (5th edition) criteria for an opioid use disorder involving tramadol include:5

  • Using more tramadol than was originally intended.
  • Taking tramadol even though you know it makes a physical or emotional issue worse.
  • Spending a good deal of your day looking for tramadol, using tramadol, and recovering from using tramadol.
  • Increased conflict with loved ones over using tramadol.
  • Failing to meet expectations at work, school, or home due to your use of tramadol.
  • Giving up hobbies that you used to enjoy to keep using tramadol.
  • Using tramadol in high-risk situations—e.g. driving under the influence of tramadol.
  • Making unsuccessful attempts to cut back or stop taking tramadol.
  • Cravings to use tramadol.
  • Developing a tolerance to tramadol, so that you need to keep taking more of it to feel its effects.
  • Experiencing physical withdrawal when you stop taking tramadol.

It is important to note that tramadol abuse may be more likely in people who have a personal or family history of substance abuse and/or mental illness.4,6

Symptoms of Tramadol Overdose

If you suspect a tramadol overdose, call 911 immediately.

It is possible to overdose on tramadol, though it does not happen frequently when it is taken as prescribed by a doctor. Overdose is more likely to occur when tramadol is taken inappropriately, such as by taking more than the prescribed dose, taking someone else’s medication, or taking tramadol illicitly.4

Mixing tramadol with other opioids, with alcohol or other central nervous depressants, and with some types of illicit drugs can dangerously increase a person’s risk of oversedation, respiratory depression, coma, and even death.6 Symptoms of tramadol overdose include:1,7

  • Slow or shallow breathing.
  • Extreme sleepiness.
  • Oversedation that could progress to stupor or coma.
  • Constricted or pinpoint pupils.
  • QT prolongation on EKG.
  • Slow heartbeat.
  • Low blood pressure.
  • Muscle weakness.
  • Clammy, cold skin.
  • Seizures.

Side Effects of Tramadol Addiction or Misuse

Tramadol use is associated with certain side effects, the severity of which may increase when the drug is used nonmedically. Some of the health risks and side effects of tramadol use include:7

  • Sedation.
  • Dizziness
  • Nausea.
  • Vomiting.
  • Constipation.
  • Risk of serotonin syndrome—a potentially life-threatening condition.
  • Increased risk of seizures (risk may be further increased when tramadol is used with other drugs).
  • Increased risk of abuse in people with addiction history.

Tramadol Withdrawal Symptoms

When a person is physically dependent on tramadol and stops taking it or drastically reduces their use, they may experience tramadol withdrawal symptoms, which can include:7

  • Insomnia.
  • Restlessness.
  • Irritability.
  • Excessive yawning.
  • Runny nose.
  • Sweating.
  • Chills.
  • Weakness.
  • Joint and muscle pain.
  • Loss of appetite.
  • Nausea.
  • Vomiting.
  • Stomach cramps.
  • Diarrhea.
  • Increased respiratory rate.
  • Elevated blood pressure.
  • Rapid heart rate.

Treatment for Tramadol Addiction

Getting treatment for a substance use disorder can feel scary, but it’s a courageous step toward making positive changes in your life and beginning the life-long journey of recovery.8

Effective treatment plans can be tailored to your individual needs.9 Individualized treatment may be particularly important if you have another medical condition or co-occurring mental health diagnosis.

Medical Detox for Tramadol

Medical detox at the start of treatment can be helpful because suddenly quitting tramadol may lead to extremely uncomfortable withdrawal symptoms.7 Supervised medical detox and withdrawal management can provide you with the oversight needed to keep you safe and comfortable while detoxing from tramadol.

Withdrawal from opioids like tramadol is not often life-threatening, but it can be very hard to cope with on your own. Medical detox during early recovery is increasingly becoming the standard of care when managing opioid use disorders, as non-pharmacologic withdrawal management can lead to unnecessary discomfort.10

In rare cases, opioid withdrawal may be associated with certain medical complications, such as dehydration and electrolyte disturbances in people who experience severe gastrointestinal symptoms. Additionally, people with pre-existing cardiac disease could experience a worsening of their heart issues as a result of an increased heartbeat or high blood pressure.10

Some medications can be used to assist with tramadol withdrawal. These include:11

  • Buprenorphine—a partial opioid agonist which can help to manage opioid withdrawal symptoms and reduce cravings.
  • Methadone—a long-acting full opioid agonist. Like buprenorphine, methadone can help to reduce withdrawal symptoms and control cravings for tramadol.

Behavioral Therapy for Tramadol Addiction

There are several behavioral approaches used to help treat substance use disorders. Effective treatment strategies for opioid use disorders often combine behavioral therapies with medication. Commonly used behavioral therapeutic approaches include:

  • Cognitive behavioral therapy (CBT): used to help identify and change problematic behavior patterns through learning and applying new skillsets, like developing more positive coping strategies and avoiding relapse triggers.12
  • Motivational enhancement: a commonly used approach that uses motivational interviewing techniques that help people overcome any hesitance they may have to better engage with treatment efforts. Some programs use motivational enhancement with CBT.13
  • Family behavioral therapy (FBT): primarily used for adolescents and their families. FBT is used with substance abuse as well as behavioral problems and family conflict. FBT can also be used with adults, as long as there is another family member to work with the person in therapy.14

If you or someone you care about is struggling with tramadol addiction, know that help is available. American Addiction Centers (AAC) is a leading provider of addiction treatment programs and has trusted rehab facilities across the country. We offer a free, 24/7 helpline. You can contact us at . Call us today to speak to a caring admissions navigator who can provide information about addiction treatment options and help you quickly verify your benefits to start your recovery journey today.

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