Tramadol Side Effects and Addiction

Written by Thomas Christiansen

& Medically Reviewed by Dr. Trisha Sippel, PhD

Medically Reviewed

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Last Updated - 12/29/22

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Key Takeaways

  • Tramadol has the potential to be addicting if it is used in ways other than recommended
  • Chronic tramadol use can cause liver problems
  • The side effects of tramadol addiction are different from the side effects of normal use due to the long-term use by people who have a tramadol addiction
  • There are a variety of treatment options available for a person to overcome a tramadol addiction

Tramadol is used to treat chronic pain, but can also be addictive. Learn about the side effects of tramadol use and the signs of tramadol addiction.

Tramadol is a pain medication that is commonly given to people with ongoing moderate or moderately-severe pain. Due to its opioid-like effects, when tramadol is used inappropriately or other than intended, it can be addictive. It is therefore important to understand tramadol side effects and tramadol addiction.

How is Tramadol Abused?

Tramadol abuse occurs when an individual uses tramadol in ways other than its intended use. Tramadol is a pain-relieving medication that can have euphoric effects when taken at doses higher than the recommended daily use. When people are seeking this euphoric effect, they may use alternate routes of administration of the drug including direct injection and snorting the powder from crushed pills. Both of these routes are dangerous and tramadol should never be taken this way.

Becoming Addicted to Tramadol

Tramadol is considered an addictive substance due to its effects on the brain. When taken in amounts larger than intended, it can cause a euphoric sensation, or “high.” A person seeking that high feeling may use increasing amounts of the drug to achieve it. When this happens, they are at risk of becoming addicted to tramadol.

Two common questions about tramadol addiction are:

  • Can you get addicted to tramadol? Yes, tramadol is considered an addictive drug due to its effects on the brain. Tramadol is classified as a Schedule IV by the Drug Enforcement Administration (DEA), meaning that it has a low potential for abuse.
  • How long does it take to get addicted to tramadol? This factor depends on a variety of elements, including the demographics of the person using the drug (age, weight, health, family history, etc.), how much tramadol they are using at once and the route of administration they are using. A person that already has another kind of substance use disorder may also be at increased risk of becoming addicted to tramadol.

Side Effects of Tramadol Addiction

The side effects experienced by someone addicted to tramadol will vary from the normal side effects of the drug. The difference in side effects is due to long term use of tramadol. Side effects of tramadol addiction can include:

Tiredness

Tramadol itself doesn’t usually make you sleepy, but one of the side effects is insomnia, which can lead to tiredness.

Seizures

Tramadol can cause seizures. This is usually associated with an overdose of tramadol.

Constipation

Tramadol causes constipation. It is one of the side effects of tramadol use and can also be a sign of tramadol abuse.

Itching

Tramadol does not normally cause itching, however, this can be a sign of an allergic reaction to tramadol. If a rash appears after tramadol use or there is swelling and difficulty breathing, get medical help immediately. A severe rash is also associated with an overdose.

Drowsiness

When used in excess, tramadol makes you drowsy. Drowsiness can also be a sign of an overdose of tramadol.

Weight Loss

Tramadol can cause a loss of appetite and gradual weight loss over time. Contrary to common belief, tramadol does not cause weight gain.

Euphoria

Tramadol euphoria occurs due to its effects on neurotransmitters in the brain. This factor is what makes tramadol so addictive.

Liver Problems

Tramadol addiction can lead to liver problems. A study in rats showed significant liver damage with chronic tramadol treatment.

Stomach Pain

Tramadol can cause stomach pain. However, it is not associated with gastrointestinal bleeding that can occur with some pain relievers (such as NSAIDs) and therefore can be an attractive alternative for those with chronic pain.

Tramadol Abuse Facts and Statistics

As tramadol use has become more common, misuse of tramadol has increased. In 2017, it was estimated that 0.6% of individuals over the age of 12 misused tramadol in the past year. This number has been increasing in recent years due to the increased availability of the drug from an increase in the number of prescriptions written. The use of tramadol among different groups includes:

Prevalence in Men

Tramadol misuse leading to emergency room visits are less common among men than women. Tramadol side effects may sometimes be beneficial in men, as it can be used to treat premature ejaculation.

Prevalence in Women

Women account for the majority of emergency room visits related to tramadol misuse. In 2011, 70% of emergency room visits resulting from adverse effects of tramadol were for women. Tramadol side effects can vary in women, especially in women who are pregnant. A woman should always speak to her doctor before using tramadol while pregnant.

Teen Abuse

The exact extent of use in teens is unknown, though this group made up less than 2% of emergency room visits in a study. Since tramadol could be easily accessed by teens through friends with prescriptions or through availability online, it is wise for parents to be aware of the possibility for misuse.

Senior Abuse

Patients over the age of 65 made up 35% of emergency department visits in 2011 and over half of the people admitted to the hospital from unwanted reactions to tramadol. In elderly people, tramadol side effects can be less severe than some NSAID pain relievers, making it an attractive option for addressing chronic pain. However, tramadol can suppress respiratory function, so it should be used with caution in elderly patients who have breathing issues.

Tramadol Abuse and Treatment Trends in South Florida

There has been a growing trend of drug abuse in South Florida. In 2010, there was a sharp increase in prescription drug abuse, with 5,647 drug-related deaths. Prescription opioids were the drug most often detected in the deceased. The rate of non-medical use of prescription drugs, particularly oxycodone, was significantly increased in Florida compared to the rest of the United States — especially among 21 to 29-year-olds.

Within prescription opioids, tramadol is one of the most prescribed, with the number of prescriptions consistently increasing from year-to-year among Floridians. From 2012 to 2013, there was an 8% increase in the number of drug-related deaths where tramadol was detected in the deceased. In an effort to reduce the prescription of opioids and therefore make them less accessible, the Florida government passed a law in 2018 limiting the number of pills a doctor can prescribe at once. Unless a patient has a proven chronic condition, doctors are limited to writing only three- or seven-day prescriptions.

Tramadol Overdose

Tramadol overdose can occur when a person uses very high doses of tramadol. This event is more likely to occur with chronic use and when the person requires higher doses of tramadol in order to feel its euphoric effects. When a person becomes dependent on tramadol, they may no longer experience a “high” with its use. This change may lead them to try taking more and more of the drug to feel the euphoric effect again. If a person takes too much tramadol, they may overdose.

Tramadol overdose can cause seizures and respiratory depression, to the point where a person may stop breathing. Tramadol overdose is often associated with the use of other substances, but tramadol overdose alone can be fatal.

How to Treat Tramadol Addiction

Treating tramadol addiction involves a series of steps to get the person to stop using tramadol and then have them avoid using it again in the future. Common treatment plans for tramadol addiction can include:

Tramadol detox is a process of weaning a person off of tramadol until they are no longer using the drug. This process can be done gradually or with the help of medication to ease the withdrawal effects.

Residential treatment for tramadol involves staying at a facility during the detox and recovery process. This method will incorporate professional medical help with the withdrawal symptoms, which may involve medication, along with therapy sessions to address any underlying causes that may have lead to the misuse of tramadol.

A person that is not at risk for suicide may be treated for tramadol addiction in an outpatient setting. This element will involve regular visits to a therapist or counselor who will monitor their progress and help keep them on track to recovery. They may also choose to attend a substance use disorder support group.

If a person is co-diagnosed with tramadol addiction and another substance use disorder or mental health disorder, they will have the most success at treatment if they are treated for both co-occurring conditions. This usually involves medication along with therapy and psychological support.

View Sources

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Drug Enforcement Administration “Tramadol.” October 2018. Accessed July 26, 2019.

Ryan, N.M.; Isbister, G.K. “Tramadol overdose causes seizures and respiratory depression but serotonin toxicity appears unlikely.” Clinical Toxicology, July 2015. Accessed July 26, 2019.

Atici, S.; Cinel, I.; Cinel, L.; Doruk, N.; Eskandari, G.; Oral, U. “Liver and kidney toxicity in chronic use of opioids: an experimental long term treatment model.” Journal of Biosciences, March 2005. Accessed July 26, 2019.

Bose, Jonaki; Hedden, Sarra L.; Lipari, Rachel N.; Park-Lee, Eunice. “Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration, 2017. Accessed July 26, 2019.

Bush, Donna M. “Emergency Department visits for adverse reactions involving the pain medication tramadol.” Substance Abuse and Mental Health Services Administration, May 14, 2015.  Accessed July 26, 2019.

Martyn-St James, M.; Cooper, K.; Kaltenthaler, E.; Dickinson, K.; Cantrell, A.; Wylie, K.; Frodsham, L.; Hood, C. “Tramadol for premature ejaculation: a systematic review and meta-analysis.” BMC Urology, January 30, 2015. Accessed July 26, 2019.

Hall, James. “Trends of Nonmedical Prescription Drug Misuse in Miami-Dade, Broward, Palm Beach Counties, and the State of Florida: 2010.” Epidemiologic Trends in Prescription Drug Misuse. Accessed July 26, 2019.

Scott, Rick; Philip, Celeste; Poston, Rebecca. “2016-2017 Prescription Drug Monitoring Program Annual Report.” Florida Health E-FORCSE Electronic-Florida Online Reporting of Controlled Substances Evaluation, December 1, 2017. Accessed July 26, 2019.

Hall, James. “Drug Abuse Trends in Miami-Dade County Florida: June 2014.” The Miami Coalition. Accessed July 26, 2019.

Gioia, S.; Lancia, M.; Bacci, M.; Suadoni, F. “Two Fatal Intoxications Due to Tramadol Alone: Autopsy Case Reports and Review of the Literature.” The American Journal of Forensic Medicine and Pathology, December, 2017. Accessed July 26, 2019.

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