Concurrent Alcohol and Ultram Abuse

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The Problem of Alcohol and Ultram Abuse

Abusing Ultram and alcohol together can have harmful effects on one another, leading to increased risk of serious side effects.

The prescription drug Ultram (generic name: tramadol) is a pain reliever with opiate-like effects. It is used to treat moderate-to-severe long-term pain, and was originally said to have a lower addictive potential than opiates.

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It is, however, becoming increasingly abused and its effects are shown to be similar to those of other opiate painkillers–such as hydrocodone and oxycodone–some of the most prevalent prescription drugs of abuse. It is especially dangerous when combined with alcohol.

Ultram works by:

  • Binding with opioid receptors, similarly to other opiate analgesics .
  • Inhibiting neurotransmitter reuptake – effectively increasing the amount of norepinephrine (related to concentration and stress).
  • Increasing serotonin (also via the process of reuptake blockade) – serotonin mediates a wide range of effects, but is thought to be related to well-being and happiness.

The danger that accompanies co-ingestion of both drugs is rapid absorption of too much Ultram. Essentially, when you take Ultram with alcohol, you alter the way each drug is processed and metabolized in the body. This is dangerous because you actually will feel the effects of Ultram more quickly than if you’d taken it alone. This phenomenon is referred to as “dose dumping” and is seen even with low levels of alcohol ingestion.

Effects of Abuse

The recreational use of Ultram and alcohol together can lead to a number of different sensations in the user. When taken together, users report:

Both drugs depress the central nervous system and have additional negative effects.

  • Extreme relaxation.
  • A sense of euphoria.
  • Greatly increased drowsiness.
  • Numbness of the body.
  • Hallucinations.

It is important to remember that these recreational experiences are accompanied by greatly increased risk of more serious side effects, including Ultram overdose. Both drugs depress the central nervous system and can synergize additional negative effects.

Most people cannot tolerate their usual alcohol intake when also taking Ultram.

Signs and Symptoms of Abuse

Ultram Abuse

  • Constipation.
  • Itchiness.
  • Nausea/vomiting.
  • Dizziness.
  • Drowsiness.
  • Lethargy
  • Agitation.
  • Abnormally rapid heart rate.
  • High blood pressure.
  • Difficulty breathing.
  • Seizures.
  • Coma.

Alcohol Abuse

  • Drowsiness.
  • Nausea and vomiting.
  • Disrupted sleep patterns.
  • Temporary loss of consciousness.
  • Brain damage (specifically to areas related to muscle coordination).
  • Liver disease.
  • Damage to the myocardium (heart muscle).
  • Coma.
  • Death.

Simultaneous Use

  • Increased risk of depression and mood disorders.
  • Nausea, vomiting, or gastrointestinal upset.
  • Lack of coordination.
  • Sedation.
  • Vertigo.
  • Shallow breathing.
  • Increased risk of liver damage, higher than either drug alone.
  • Kidney dysfunction or failure.
  • Seizures.
  • Loss of consciousness.
  • Coma.
  • Death.

Because alcohol changes the pharmacokinetics of Ultram, and subsequently increases the bioavailability and activity of the drug, users face higher risks of more serious symptoms – particularly seizures. If you are worried about your use of one or both of these substances, there is help.

Concurrent Alcohol and Ultram Abuse Treatment

Treatment for concurrent Ultram and alcohol abuse will need to address not only the detoxification of the body, but the underlying cause of the abuse. If the patient suffers from a pain disorder (necessitating the Ultram prescription in the first place), alternative methods of pain management will need to be considered.

Typically, when you seek treatment for substance abuse, you will have an initial assessment by an addiction treatment professional and, afterwards, will enter a period of supervised detoxification.


It is vital that an individual seeking help with concurrent Ultram and alcohol abuse receive professional assistance and supervision, as detox from alcohol can have severe symptoms that can sometimes be life-threatening.

Many inpatient treatment centers offer monitored detox as part of treatment.


Multiple treatment options are available to address the root of the addiction and find effective ways to cope with the stress of recovery:

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  • Residential or inpatient treatment provides 24-7 care as you live in the facility and focus completely on your recovery and your mental and physical health
  • Post-rehab Aftercare includes resources for recovery after treatment ends, such as sober-living facilities that provide skills training to prevent relapse upon integration back into your daily life.
  • Outpatient care allows you to seek care and therapy on an outpatient basis, meaning you can continue living and working at home as you get healthy.
  • Medication assistance, if indicated, may be used in the treatment process to address withdrawal issues. Additionally, some programs utilize various pharmaceuticals in the treatment of alcohol abuse.
  • Drug Abuse Therapy will address the reasons for the substance abuse and help with behavior modification and relapse prevention education.

If you are not sure what kind of treatment might be right for you, call us at 1-888-708-0796 to speak with a treatment support specialist about finding the perfect recovery program for you.

Teen Abuse

Studies have shown that tramadol abuse may be related to:

  • The development of adolescent addictive behaviors.
  • Concurrent use of other substances, including alcohol, marijuana, and ecstasy.

Ultram has multiple different effects on the central nervous system, and alters multiple neurotransmitter systems. Effects on a still-developing brain can be difficult to quantify, but Ultram may be especially risky for teens.

Talking with your teen about the dangers of abuse, discussing alternative options for pain treatment, and emphasizing the importance of following prescription doses will help them better understand the risks associated with abuse and co-abuse.

Resources, Articles and More Information

To learn more, check out the following articles:

Also, join the conversation about Ultram and alcohol abuse today by visiting our Forum.

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Amanda Lautieri is a Senior Web Content Editor at American Addiction Centers and an addiction content expert for She holds a bachelor's degree and has reviewed thousands of medical articles on substance abuse and addiction.
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