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Tramadol Addiction

Tramadol is a prescription medication the U.S. Food and Drug Administration (FDA) approved for pain relief. It should only be used when other drugs, including opioids like Vicodin, aren’t enough to keep discomfort under control.[1]

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Doctors limit tramadol use because it’s a strong drug that can lead to abuse and addiction. People with these issues can get help through a formal treatment program. 

Key Facts About Tramadol

Key Facts

  • More women than men visit the emergency room due to tramadol use and misuse. In 2005, women accounted for 63% of those visits.[2]
  • In emergency room visits involving tramadol, 26% involved two other drugs, and 26% involved three or more drugs.[2]
  • Tramadol is a fully synthetic drug.
  • Tramadol latches lightly to opioid receptors, and it inhibits the reuptake of serotonin and norepinephrine.[1]
  • People with a tramadol addiction are less likely to complete treatment programs than those with addictions to other opioids.[3]

Tramadol Uses: Why Is It Prescribed?

Tramadol is prescribed to address pain that hasn’t responded to other forms of medication. Since it impairs breathing less than other opioids, tramadol might also be used in people who can’t handle solutions like Vicodin.[4] Tramadol’s use is limited, but that wasn’t always true.

Years ago, most doctors believed that tramadol was safe for almost everyone. They reasoned that while tramadol is a narcotic, it didn’t work the same as medications like Vicodin, so almost anyone could use it. 

Now, medical professionals understand that tramadol can cause persistent brain changes. People who use the drug for long periods or at high doses can lose control and abuse the drug.

Unlike other opioids, tramadol has no clinically relevant effects on respiratory or cardiovascular parameters. Tramadol may prove particularly useful in patients with poor cardiopulmonary function, including the elderly, the obese, and smokers, in patients with impaired hepatic or renal function, and in patients in whom nonsteroidal anti-inflammatory drugs are not recommended or need to be used with caution.

Common Street Names for Tramadol 

Tramadol is sold under the brand names Ultram and ConZip. But people with addictions might use an entirely different vocabulary to discuss substance abuse. 

Common slang names for tramadol include the following:

  • Chill pills
  • Tramal
  • Trams
  • Trammies 
  • Ultras

Risk Factors 

Researchers say tramadol abuse is evolving into a public health crisis.[5] Anyone who uses this medication should be aware that it can cause both drug dependence and addiction. But people who share the following characteristics may be at an even higher risk. 

Common risk factors include the following:[9]

  • Genetics: The more opioid receptors you have, the larger your tramadol high. Some people spend the rest of life trying to recreate their introduction to this drug. 
  • Patterns: People who abuse tramadol to enhance their sexual performance are four times more likely to develop more intense abuse patterns later on.[5]
  • Age: Using any type of drug during adolescence is dangerous. Brain cells are still growing and changing. Adding drugs can allow an addiction to develop quickly. 
  • Connections: Spending time with people who abuse drugs can normalize the behavior and make maintaining an addiction easier. 
  • Underlying conditions: Chronic pain and untreated mental illness are both associated with drug addiction. 

Addictiveness: How Addictive Is Tramadol?

Researchers say that tramadol isn’t as addictive as other opioid drugs. But people who have never used other opioids (like painkillers or heroin) can get a big reaction from tramadol and develop an addiction quickly.[6]

Tramadol latches loosely to opioid receptors inside the brain. Feel-good chemicals like dopamine are released, producing euphoria. In time, the brain won’t release these chemicals without drugs. People will feel depressed without it, and they’ll crave drugs too. 

Drug Interactions 

Tramadol is powerful, and it can connect with several different types of substances, including prescription drugs and over-the-counter therapies. Some of these interactions can be life-threatening. 

These are some tramadol interactions to be aware of:[1]

Medications that affect tramadol metabolismDepressantsMedications that raise serotonin levelsOpioid antagonists
WellbutrinBenzodiazepinesMonoamine oxidase inhibitors (MAOIs)Narcan
ProzacOpioidSelective serotonin reuptake inhibitors (SSRIs)Vivitrol
St. John’s wortAlcoholSt. John’s wort
Muscle relaxersTricyclic antidepressants

Signs & Symptoms of Tramadol Addiction 

Understanding what tramadol addiction looks like can help you step in when a person you love is struggling. Your symptoms can be physical, behavioral, or social.[10] 


Like all opioids, tramadol can cause sedation. People who abuse the drug recreationally may become incredibly tired when they’re high.[1] But in time, they may seem simply “normal” when they’re high and restless between doses.


It’s time-consuming to support a tramadol addiction. People may withdraw from family and friends and prioritize their relationships with doctors and drug dealers. They may perform poorly at work or school. And they may steal drugs or money to buy tramadol pills. 


An increasing need for isolation is common in people with addictions. They may not talk to their loved ones about their addiction at all. But any tramadol conversations they may have may take an aggressive turn. 

Tramadol Addiction: Short-Term & Long-Term Effects 

Like most prescription medications, tramadol can cause both physical and psychological problems. These issues can be split into short-term and long-term versions. 

Short-Term Effects 

More than 1 in 10 people feel sick or dizzy while taking tramadol.[7] Less common side effects of tramadol include the following:[1]

  • Constipation
  • Dry mouth 
  • Fatigue
  • Headaches
  • Mental fog
  • Nausea
  • Sweating

Serious side effects that merit a visit to the emergency room include the following:[1]

  • Allergic reactions, which could give you rashes, difficulty breathing, and throat or mouth swelling
  • Difficulty with urination
  • Hallucinations
  • Low blood pressure, which can feel like dizziness and extreme fatigue
  • Severe confusion

If you’re not sure if you’re sick or facing a side effect, call your doctor and ask.

Long-Term Effects 

With continued use, your body becomes accustomed to tramadol. You will need more of the drug to produce the same effect. You may also feel sick between doses and experience very uncomfortable symptoms when you try to quit. Constipation is also common in people who abuse opioids for long periods. 

Short-Term EffectsLong-Term Effects
DizzinessDrug tolerance 
Nausea Drug dependence 
Constipation Increased overdose risks 
Confusion Constipation 
Sources: [1,10]

Tramadol Withdrawal Symptoms

Like all opioids, tramadol can cause deep discomfort when regular users quit the drug abruptly. Sometimes, symptoms are so severe that people return to tramadol abuse to get relief. 

Common tramadol withdrawal symptoms include the following:[1,10]

  • Agitation
  • Anxiety
  • Depression
  • Cravings
  • Nausea and vomiting
  • Headaches
  • Confusion
  • Loss of appetite
  • Sweating
  • Muscle pain
  • Blurred vision
  • Insomnia
  • Mood swings
  • Diarrhea
  • Nightmares
  • Abdominal cramps
  • Psychosis

Tramadol Addiction Treatment Options 

Quitting any opioid, including tramadol, is challenging. Drug cravings and physical discomfort are often impossible to ignore. 

Tramadol treatment programs can give you the tools and support you need to stay sober for a lifetime. Your program may include the following components:

Medical Detox 

All opioids cause flu-like symptoms during withdrawal. Severe vomiting and diarrhea can lead to life-threatening dehydration, making at-home quitting unsafe. 

Tramadol withdrawal can also cause psychosis.[8] You may hurt yourself or others while getting sober. 

Medical detox ensures you get sober without severe complications.

Doctors use medications to ease withdrawal symptoms. Nutrition therapy helps your body heal. And counselors prepare you for the next stage in your sobriety journey. 


Detox programs can help you get sober, but rehabilitation programs can help you stay that way. You’ll move into a facility staffed with addiction treatment professionals dedicated to your long-term recovery. Spend every day in counseling sessions, support group meetings, and therapeutic activities. You’ll emerge with the tools you need to fight your addiction while living at home. 

Medication-Assisted Treatment 

Some people need a few weeks of medications to quit using tramadol. Others struggle with cravings and unpleasant symptoms for months or even years after they quit. 

Medication-assisted treatment (MAT) involves using medications like buprenorphine as long as is needed to keep you sober. Some people stay on these therapies indefinitely.

MAT prescriptions won’t get you high. They can help you keep your addiction under control, so you don’t relapse to drug misuse due to ongoing pressures and stress. 

Behavioral Therapy 

Counseling is a powerful tool your team can use to break the link between negative thoughts and tramadol abuse. 

In cognitive behavioral therapy (CBT) sessions, your doctor helps you unpack your drug use triggers. Together, you develop techniques to combat those pressures. The result is a toolkit you can use to stay sober for good. 

Frequently Asked Questions About Tramadol Addiction 

We’ve compiled some of the most frequently asked questions about tramadol addiction. 

How long does tramadol stay in your system?

The immediate forms of tramadol stay in your system for about 24 hours. Extended-release versions can stay in your body for about 48 hours.[1]

Is tramadol an opioid?

Yes. Tramadol is a painkiller in the opioid class, but it works a little differently from traditional medications like Vicodin or OxyContin. In addition to altering opioid receptors, tramadol can interact with the serotonin system too. 

What is tramadol used for?

Doctors use tramadol to treat pain that hasn’t responded to other therapies. 

Is tramadol addictive?

Yes. Like all opioid drugs, tramadol can cause brain changes that lead to compulsive use. 

How does tramadol make you feel?

People who abuse tramadol report euphoria and relaxation. These pleasant sensations may be harder to achieve as drug abuse continues. The body becomes accustomed to the drug, so you’ll need a higher dose to get the effect that smaller doses once produced. 

Does tramadol cause constipation?

Yes. Like all opioids, tramadol slows food’s movement through the gut. The stool becomes hard and compacted, so it’s harder to pass. 

Can I take tramadol with Tylenol?

Talk to your doctor before mixing your tramadol dose with anything, including over-the-counter drugs like Tylenol. While this combination can be an effective pain reliever for some people, never experiment with these therapies without talking to your doctor first. 

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated January 17, 2024
  1. Tramadol. Dhesi M, Maldonado KA, Maani CV.Stat Pearls. Published January 2023. Accessed July 20, 2023.
  2. Emergency department visits for drug misuse or abuse involving the pain medication tramadol. Bush D., Substance Abuse and Mental Health Services Administration. Published May 14, 2015. Accessed July 20, 2023.
  3. Herrnsdorf E, Holmstedt A, Håkansson A. Tramadol misuse in treatment-seeking adolescents and young adults with problematic substance use – Prediction of treatment retention. Addictive Behaviors Reports. 2022;16. ISSN 2352-8532.
  4. Tramadol. Scott, L.J., Perry, C.M. Drugs. 2000;60:139–176.
  5. “With tramadol, I ride like a Jaguar:” A qualitative study of motivations for non-medical purpose tramadol use among commercial vehicle operators in Kumasi, Ghana. Peprah, P., Agyemang-Duah, W., Appiah-Brempong, E. et al. Subst Abuse Treat Prev Policy. 2020;15
  6. A systematic review of laboratory evidence for the abuse potential of tramadol in humans. Dunn K, Bergeria C, Huhn A, Strain E. Front. Psychiatry. 2019;10.
  7. Side effects of tramadol. NHS. Published January 19, 2022. Accessed July 20, 2023.
  8. Sidana A, Domun I, Arora P. Tramadol withdrawal psychosis. Indian J Psychiatry. 2019;61(6):655-656. doi:10.4103/psychiatry.IndianJPsychiatry_11_19
  9. Burcher KM, Suprun A, Smith A. Risk factors for opioid use disorders in adult postsurgical patients. Cureus. 2018;10(5):e2611. Published 2018 May 11. doi:10.7759/cureus.2611
  10. Dydyk AM, Jain NK, Gupta M. Opioid use disorder. StatPearls. Published January 2023. Accessed July 20, 2023.
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