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Signs of Tramadol Addiction

If someone you love is abusing tramadol, you may notice they were withdrawing from you and others, being secretive, and doctor shopping to get extra prescriptions. You may find empty pill bottles and several prescriptions as well as paraphernalia for snorting or injecting it.

Struggling with Opioid Addiction? Get Help Now

Sometimes, it will be obvious if a person is struggling with tramadol misuse. They may exhibit physical changes (like weight loss and declining hygiene), or they may neglect relationships and responsibilities to use tramadol instead. 

However, addiction can manifest in different ways. Generally, if a person misuses opioids like tramadol and struggles to stop on their own, they likely have an addiction.  

Key Facts

Key Facts

  • A tramadol addiction is an opioid use disorder (OUD).
  • Regular tramadol use leads to physical dependence. When misuse occurs, this leads to addiction.[1]
  • Signs of tramadol addiction include declining performance at work or school, relationship problems, deteriorating physical appearance, and personality changes.[2]
  • Tramadol addiction is treatable, often with medications and behavioral therapy.[3]

What Is Tramadol?

Tramadol is an opioid, a group of addictive painkillers that bind to opioid receptors in the brain and some other parts of the body and activate those receptors. This blocks pain signals from reaching the brain and can cause a sense of euphoria in a user, especially if the person misuses these drugs.

The U.S. Food and Drug Administration (FDA) approved tramadol to treat moderate to severe chronic pain in adults who need around-the-clock care for a long period.[14]

Tramadol works by latching to opioid receptors in the brain, reducing pain. It also blocks the body from processing the chemicals norepinephrine and serotonin. These neurotransmitters are involved in key body functions like mood regulation and sleep. By keeping them circulating longer, tramadol could indirectly influence how you experience pain.[14]

What Does Tramadol Addiction Look Like?

A person who develops an addiction to tramadol has an opioid use disorder (OUD). This generally means they have a psychological and physical dependence on the way opioids affect their body and brain. They will experience intense cravings to misuse opioids like tramadol to essentially chase how it makes them feel. 

Many people who have an opioid addiction feel like they need to misuse opioids to function. Additionally, they will likely feel actively worse than normal when not under the effects of opioids, a condition known as withdrawal, and this further drives them to misuse opioids.

We discuss the symptoms typically associated with an addiction to tramadol and other opioids in the next section, but some common signs to look out for include the following:[2]

  • Regularly misusing tramadol or other opioids, especially if using them to feel euphoric or less anxious, rather than to treat pain
  • Continuing to misuse tramadol even when it becomes clear it is causing serious harm in various areas of life
  • Using tramadol or other opioids in a way that is different than intended, such as crushing them into a powder and snorting them

Paraphernalia associated with tramadol abuse include the following:

  • Empty tramadol (or other types of opioids) prescription bottles
  • Small straws or dollar bills used to snort crushed pills
  • Powder residue on items that were used to snort the drug

What Are the Symptoms of a Tramadol Addiction?

At Boca, we regularly treat addiction to opioids like tramadol. With evidence-based treatment, we help people manage their OUD and build productive lives in recovery. The first step is identifying the addiction. 

Symptoms vary somewhat by individual, but they generally fit into categories of physical, behavioral, and mental health.

Physical Effects of Tramadol Abuse

Repeated abuse of tramadol and other opioids will physically wear on the body. Regular use will cause a person to become dependent on opioids, meaning that they will go through withdrawal if they go without them.[4] This can make quitting tramadol very difficult.

Tramadol is also associated with a variety of side effects, including these:[2]

  • Sleepiness
  • Headache
  • Nervousness
  • Uncontrollable shaking 
  • Mood changes 
  • Heartburn
  • Indigestion
  • Dry mouth

The more someone misuses tramadol, the more severe these symptoms are likely to be.[2]

The more someone misuses tramadol, the more severe these symptoms are likely to be.[2]

People taking tramadol can also experience seizures, even if they’re using the medication at the recommended dose. People with epilepsy or a history of seizures should not use this medication.[14]

Combining tramadol with other drugs can also cause serious health issues. For example, mixing tramadol with medications like ketoconazole or erythromycin can lead to serotonin syndrome, characterized by high body temperatures and heart problems.[14]

Dangers by Drug Use Type

Some signs of repeated drug use are specific to how a person abuses drugs.

People who abuse tramadol by injection can face the following health issues:

  • Track lines
  • Collapsed veins
  • Puncture marks
  • Abscesses
  • Cellulitis
  • Scarring

Snorting can damage or even destroy the septum. This damage can cause a variety of issues, including increasing the frequency of nosebleeds, causing significant irritation, and increasing the risk of contracting blood-borne diseases.

Behavioral Changes From Tramadol Abuse

Addiction is perhaps most associated with the behavioral changes it can cause. It can start to feel to both an individual struggling with addiction and those around them that their addiction controls how they act. 

Tramadol addiction is going to be characterized by compulsive (uncontrollable) behaviors in which a person engages in drug seeking and drug use despite the consequences of those actions.[2] They may neglect important responsibilities, including those at school and work, damage relationships they view as important, and spend large amounts of time engaging in drug use, seeking out drugs, or recovering from opioid use.[2]

Mental Effects of Tramadol Abuse

Fundamentally, addiction is a mental health issue. It causes many different changes to the brain and can significantly impact mood and overall quality of life. Many people who have an addiction also have co-occurring mental health problems, such as severe anxiety or depression.[5]

Even for people who don’t abuse tramadol, the drug has been shown to have effects on mental health. While some studies show that low-dose tramadol can have a positive impact on depression and mental health, the amount used when abusing the drug doesn’t fit this model.[6] 

People who use opioids have been shown to have an elevated risk of changes to their mood and anxiety compared to those who don’t use prescription opioids. Other studies have also reported opioids can increase depression symptoms if use increases or lasts for a significant period.[7] Patients with a history of depression, anxiety, and other mental health issues are at increased risk if they misuse opioids like tramadol.[2]

Long-Term Risks of Tramadol Abuse

Long-term abuse of any opioid can do significant harm.[8] Although tramadol is often considered to have less abuse and addiction potential than other opioids, it is just as likely to be taken long-term, and this can result in many issues.[9]

With long-term use, the potential for addiction rises substantially. Tolerance increases, and dependence forms. When coupled with misuse, addiction is present. Like any OUD, it generally takes professional, evidence-based treatment to stop abusing tramadol.

Overdose is even more likely when tramadol is combined with other substances of abuse like alcohol.

Other long-term risks of tramadol abuse include the following:[2,11-13]

  • Gastrointestinal problems, including severe constipation
  • Damage to the endocrine system
  • Mental health issues, such as depression and anxiety
  • Increased risk of accidents and injuries
  • Reduced immune system function
  • Increased pain sensitivity

What to Do During a Tramadol Overdose

Because a person is repeatedly misusing tramadol, their risk of a dangerous opioid overdose increases. Tramadol and other opioids cause respiratory depression, which can be life-threatening. The body can become so weak under the effects of opioids that it can’t draw in enough oxygen, which can cause a person to lose consciousness, develop potentially permanent brain damage, or even die.[10]

Signs and symptoms of an opioid overdose can include the following:[15]

  • Slow or shallow breathing
  • Snoring or gurgling sounds
  • Blue-tinged skin or fingernails
  • Inability to talk
  • Disorientation
  • Pinpoint-sized pupils
  • Unconsciousness

If you see these signs, take the following steps:[15]

  • Call 911 immediately. Tell the operator where you are and what symptoms you see.
  • Try to get the person to respond to you. Rub your knuckles on their breastbone to see if that awakens them.
  • Administer naloxone (Narcan) per the package instructions. If they don’t awaken in a minute or two, administer another dose.
  • If the person still doesn’t wake up, administer CPR if you’re trained to do so.
  • Stay with the person until help arrives.

Overdose is even more likely when tramadol is combined with other substances of abuse like alcohol.

Get Help for Tramadol Addiction

It’s important to get help for an addiction to tramadol or any other opioid as soon as possible. It can be difficult to admit you have a problem, but this is the first step to getting better. 

If your loved one has been abusing tramadol, talk to an addiction treatment professional or interventionist about how best to approach them. Oftentimes, it’s the encouragement of a loved one that motivates someone to get help.

Addiction isn’t a matter of willpower; it requires professional help. For tramadol addiction treatment, rehab will normally involve a combination of medications and therapy, known as medication-assisted treatment (MAT). With MAT, medications like methadone and buprenorphine (Suboxone) are used to manage opioid withdrawal symptoms and cravings, while therapy focuses on identifying and managing problematic thought patterns and behaviors.

Risks of Tramadol Withdrawal

While tramadol withdrawal isn’t usually life-threatening, it can be in some cases. This is why it shouldn’t be attempted without medical supervision and support.

Common tramadol withdrawal symptoms include the following:[14]

  • Anxiety
  • Sweating
  • Insomnia
  • Stiff muscles
  • Pain
  • Nausea
  • Tremors
  • Diarrhea
  • Cold-like symptoms
  • Goosebumps
  • Hallucinations

Tramadol withdrawal is common when long-time users quit the drug abruptly. The symptoms can last for days, and the person’s risk of relapse is heightened the entire time. If someone you love is trying to quit abruptly, they could be at risk for serious health problems. Encourage them to enter a treatment program and get the help they need to get sober safely.

If an individual seems to be experiencing especially severe withdrawal symptoms, especially if they have trouble remaining conscious or seem to be very confused or acting illogically, call 911. It’s always best to err on the side of caution.

Tramadol Treatment Options at Boca Recovery Center

Recovery from tramadol addiction is possible. The best way to regain control of your life and stop abusing tramadol is with professional help. 

At Boca Recovery Center, we can design a recovery plan tailored to the severity of your addiction and your specific needs, maximizing your chances of long-term recovery. We’ll ensure you are safe and comfortable throughout the withdrawal process, and we’ll equip you with the skills you need to manage long-term recovery.

If you struggle with tramadol or other types of opioids, reach out to us. We offer medical detox, inpatient treatment, outpatient care, MAT, and evidence-based therapy. Our team of empathetic and professional addiction treatment experts is ready to help. 

Check out the locations of our addiction treatment facilities in Florida, New Jersey, and Indiana. Whether you live locally or are traveling for treatment, we can get you set up today. Call now.

Updated May 10, 2024
  1. Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. World Health Organization. Published 2009. Accessed March 9, 2024.
  2. Opioid use disorder. Dydyk AM, Jain NK, Gupta M. StatPearls. Published January 17, 2024. Accessed March 9, 2024.
  3. Medications to treat opioid use disorder research report. National Institute on Drug Abuse. Published January 21, 2022. Accessed March 9, 2024.
  4. Tramadol. U.S. National Library of Medicine. Published May 2023. Accessed March 8, 2024.
  5. Assessment of anxiety and depression among substance use disorder patients: a case-control study. Mohamed II, Ahmad HEK, Hassaan SH, Hassan SM. Middle East Current Psychiatry. 2020;27(1).
  6. Low-dose tramadol as an off-label antidepressant: A data mining analysis from the patients’ perspective. Bumpus JA. ACS Pharmacology & Translational Science. 2020;3(6):1293-1303.
  7. Mood and anxiety symptoms in persons taking prescription opioids: a systematic review with meta-analyses of longitudinal studies. Leung J, Santo T, Colledge S, et al. Pain Medicine. 2022;23(8).
  8. Prescription Opioids DrugFacts. National Institute on Drug Abuse. Published June 1, 2021 Accessed March 8, 2024.
  9. Is tramadol an opioid or a nonopioid analgesic? Yes! Washington Medical Commission. Published Summer 2020. Accessed March 8, 2024.
  10. Opioid overdose. Schiller EY, Mechanic OJ. StatPearls. Published 2019.
  11. The impact of opioids on the endocrine system. Katz N, Mazer NA. The Clinical Journal of Pain. 2009;25(2):170-175.
  12. Opioids and the Immune System. Kentucky BMM PharmD, BCCCP Department of Pharmacy Lexington, Kentucky J. Chris Donaldson, PharmD, BCCCP Department of Pharmacy University of Kentucky Medical Center Lexington. U.S. Pharmacist. Published March 19, 2020. Accessed March 8, 2023.
  13. Opioid-induced hyperalgesia: Clinically relevant or extraneous research phenomenon? Tompkins DA, Campbell CM. Current Pain and Headache Reports. 2011;15(2):129-136.
  14. Tramadol prescribing information. U.S. Food and Drug Administration. Published May 2010. Accessed April 15, 2024.
  15. What to do if you witness an overdose. SAFE Project. Published August 2022. Accessed April 15, 2024.
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