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Adverse Effects of Tramadol Use

Tramadol is a synthetic opioid that is prescribed for managing pain.1 Tramadol is a somewhat atypical painkiller due to its activity within noradrenergic and serotonergic neurotransmitter systems, in addition to its effects as a weak opioid agonist.1,2 This page discusses adverse side effects of tramadol, tramadol addiction, withdrawal symptoms, factors that influence tramadol withdrawal, and tramadol detox and addiction treatment.

Side Effects of Tramadol

The following are some potential adverse short-term and long-term side effects of tramadol:2

  • Drowsiness
  • Dizziness
  • Nausea and Vomiting
  • Constipation
  • Headache
  • Decreased seizure threshold
  • Serotonin syndrome (a potentially fatal condition that occurs when you take drugs that affect serotonin levels)
  • Very low blood pressure
  • Slowed breathing rate

With both short- and long-term tramadol use, concurrent use of alcohol, benzodiazepines, or other central nervous system (CNS) depressants can increase some of these adverse effects. Such combinations can increase the risk of oversedation, respiratory depression/arrest, coma, and death.2 There are both long-term effects of tramadol use and short-term effects, so adverse effects can be both short term and lasting.

Tramadol Dependence

Long-term use or misuse of opioids like tramadol may lead to physical dependence.3 Dependence occurs when the brain adapts to the presence of the drug so the person can function normally only when tramadol is present in the body.3

When the dose of the tramadol is reduced, or if the drug is stopped completely, uncomfortable tramadol withdrawal symptoms may result.3

Tramadol Withdrawal Symptoms

Withdrawal symptoms can occur as soon as a few hours after taking the last dose of opioid like tramadol.3 Abrupt discontinuation of tramadol has been linked to two types of withdrawal syndromes.4

One syndrome includes symptoms typical of opioid withdrawal, including: 3

  • Sleep disruptions.
  • Intense cravings.
  • Involuntary leg movements.
  • Nausea and vomiting.
  • Diarrhea.
  • Muscle and bone pain.

This type of withdrawal syndrome occurs in about 90% of people withdrawing from tramadol.4

Another withdrawal syndrome that is atypical of opioids and occurs in about 10% of people withdrawing from tramadol includes symptoms such as:4

  • Severe anxiety.
  • Panic attacks.
  • Confusion.
  • Numbness and tingling in arms and legs.
  • Paranoia.
  • Hallucinations.

Tramadol Addiction Treatment & Detox

Though it seldom presents immediate medical dangers, acute opioid withdrawal can cause intensely uncomfortable and distressing.5 Some medical complications are associated with severe opioid withdrawal, including dehydration and electrolyte disturbances from the accompanying gastrointestinal distress. However, even without such relatively rare complications, opioid withdrawal is unpleasant enough that some form of supervised medical care would provide the ideal setting for detoxification during this challenging period of early recovery.5

Medical detox provides care and monitoring for patients as their bodies cleanse themselves of any substances. The goal of any detox is for the patient to become medically stable and abstinent from substances.5 Opioid agonist medications such as buprenorphine may be used to stabilize someone in opioid withdrawal—helping to alleviate cravings and other discomfort.5 Completing detox won’t cure a tramadol addiction, but it can serve as an important first step toward recovery by helping to encourage patients to continue with substance use disorder treatment.5

After successful withdrawal management and the completion of a medical detox program, patients may continue with various forms of rehabilitative care and recovery work, including addressing long-term use of tramadol. Treatment settings and various levels of care for addiction treatment include:6

  • Inpatient. Inpatient treatment provides care 24 hours a day for those with substance use disorders. Inpatient programs can be connected to a hospital or in a substance use treatment facility.
  • Outpatient. In outpatient programs, people live at home and receive services such as individual therapy, group therapy, and substance misuse education, at a treatment facility.
  • Intensive outpatient program (IOP). IOP is similar to outpatient programs in the services provided but takes places a lot more times throughout the week.
  • Aftercare. Aftercare is the continuing care someone receives after completing substance use treatment, such as case management or 12-Step groups to help prevent relapse.
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