Tramadol – Drastic Effects of Abusing this Opioid Painkiller

Last Updated: February 5, 2020

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

Tramadol is an opioid painkiller, similar to other drugs like Oxycodone and Hydrocodone. It is taken for moderate pain, and is prescribed in 50 mg tablets.
Like all Opioids, Tramadol can be abused and addiction is possible. In some cases, even those who use the drug as prescribed by their doctor will develop a tolerance to the drug. When that occurs, more and more of the drug is needed to achieve the same results.
Addicts may also suffer from withdrawal symptoms if the drug is discontinued. These symptoms may include depression, flu-like symptoms, or irritability and mood imbalances.

Tramadol and Its Effects

TramadolTramadol may go by the street names “chill pills,” “Ultra,” or “trammies.” It is prescribed for moderate pain caused by surgery or ongoing conditions, such as fibromyalgia. Although it decreases pain by binding to opioid receptors in the brain similar to other pain medications, it is milder than Oxycodone, Hydrocodone, and Morphine.
It can be very effective in the treatment of mild pain, but it is one of the mildest prescription pain medicines available. It can still be addictive, however, especially for those who abuse it, or those who are on it for long periods of time.

Is the drug tramadol addictive?

Yes, tramadol is addictive, particularly if taken at higher doses, or for a longer period, than prescribed. Tramadol is used for moderate pain, ranging from surgery to conditions like fibromyalgia. Tramadol is classified as a Schedule IV substance, and consuming it for recreational purposes is not only dangerous, but also a criminal offense.
Despite being milder than many other opioids, it is still classified as a Schedule IV substance. Taking Tramadol for recreational purposes is a criminal offense.
People may abuse Tramadol because it causes a sense of extreme relaxation or euphoria. Those who have severe pain may take more than recommended in an attempt to treat their conditions. Although it is often prescribed verses other pain medications with higher addiction risk, Tramadol is still dangerous when abused and should never be used in a way contrary to a doctor’s recommendations.
Tramadol is a depressant, which means it slows down the function of the central nervous system. It slows the rate of lung and heart function, and overdose can lead to lowering of these functions to dangerous levels.
Those who are suffering from a Tramadol overdose may experience:

  • Dizziness
  • Low heart rate
  • Low blood pressure
  • Shallow breathing
  • Sleepiness
  • Seizures
  • Unconsciousness
  • Weak muscles
  • Clammy or cold skin
  • Small pupils

If someone is taking Tramadol, and is experiencing these or other troubling symptoms, immediate medical attention is required.

Signs of Tramadol Abuse

anxietyThe signs of tramadol abuse include:

  • Craving for tramadol when not under its influence
  • Tolerance to the drug
  • Taking tramadol for recreational use
  • Inability to stop using the drug
  • Continued intake, despite negative effects
  • Failing performance at school or work
  • Reclusive behavior

Tramadol abuse may not be plain to see. Many times a person who is abusing drugs try to conceal the fact, and inadvertently, leads others to the suspicion of drug use. For those that are abusing or are addicted to Tramadol, there are signs to be watchful of. Signs of abuse or addiction include:

  • The craving of Tramadol when not under its influence.
  • The forming of a tolerance, leading to increased doses of Tramadol.
  • Using Tramadol for recreational use.
  • Being unable to stop using Tramadol, despite the best efforts.
  • Using Tramadol regardless of mental or physical harm.
  • Demonstrating drug use behavior such as being reclusive, always “misplacing” prescription medications, needing money for prescriptions, etc.
  • Suddenly failing in school or work with no logical or rational explanation.

Displaying a sudden lack of interest towards family, friends, once loved activities, etc.

Drugs Commonly Taken with Tramadol

Users often combine Tramadol with other substances in order to heighten, or dampen, its effects. These substances often make Tramadol far more dangerous than either of the drugs alone. Common drugs used in combination with Tramadol include:
Alcohol – Since both substances are depressants, alcohol and Tramadol combos are especially dangerous. Taking too much of either, or both, can lead to dangerously low respiration, blood pressure, or heart rate. Unconsciousness may occur and can lead to death.
Sedatives or Hypnotics – Like alcohol, these are also depressants and can lead to the same negative effects as combining Tramadol with alcohol.
Other Painkillers – This may be done to heighten the pain killing effects, but it also increases the risk of overdose, especially when combined with other opioids.
Cold Medications – These often contain sedatives and similar ingredients, which may increase the risk of overdose.
Tramadol is also more addictive when combined with other medications and drugs, especially those with similar properties. The risk of serious or life-threatening combinations also increases with every additional drug or substance taken.

Tramadol Risk Groups

While anyone can become addicted to a prescription pain medication, there are certain risk groups who may be more likely to succumb to addiction, or to try abusing a prescription medication they obtained from someone other than physician:

  • Military Personnel/Veterans – Although members of the US armed forces are far less likely to abuse illicit drugs than the general population, they are unfortunately more likely to abuse prescription painkillers like Tramadol. Millions of servicemen and women are prescribed pain medications annually, and the numbers continue to climb. Prescription drug use is also more common among combat veterans, especially those who suffer from post-traumatic stress disorder.
  • Teens/College Students – Teenagers and college students are among the largest groups who abuse prescription pain medications. This is due to the fact that they are usually easy to access, they are fairly inexpensive compared to many kinds of street drugs, and they are perceived as safer than illegal drugs because they are often prescribed by a doctor.
  • Chronic Pain Sufferers – People who suffer from painful conditions which pain medications are prescribed for may be more likely to abuse them and become addicted. While this is more common in those who abuse the medications, addiction is a risk even for people who use the prescriptions exactly as directed.

Spotting Tramadol Addiction Problem

Determining whether someone has a Tramadol addiction can be difficult. There are certain signs one may notice if the loved one has a problem. Those with a Tramadol addiction may exhibit:

  • Drowsiness
  • Nausea or vomiting
  • Slurred speech and lack of coordination
  • Pinpoint pupils
  • Headaches
  • Sudden or unexplained seizures

If someone notices any of these symptoms in themselves, or in a loved one, seek medical attention. Because Tramadol is one of the milder opioids, symptoms may not become immediately apparent. By the time they are picked up on, tolerance has often already occurred.

Tramadol Abuse Statistics

In 2005, surveys found that 84% of tramadol abusers had a seizure within 24 hours. In the years 2012 and 2013, more than 50% of abusers took tramadol without a prescription. In the year 2013, around 1.5 million new abusers began using drugs like tramadol.

  • In a study that was performed in 2005, it was concluded that 84% of Tramadol abusers had a seizure within 24 hours.
  • Over 50% of abusers did not have a prescription for Tramadol between the years of 2012-2013.
  • Approximately a million and a half new abusers began using drugs like Tramadol in 2013.

Seeking Treatment for Tramadol Addiction

The first step in treatment for a Tramadol addiction is detoxification. This is the process of allowing the drug to exit the body. Withdrawal symptoms are common during this period, and they can be very uncomfortable, or even deadly. It is highly recommended that withdrawal symptoms be closely monitored by a medical professional to ensure fatal reactions don’t occur, and so symptoms can be safely managed without relapse into drug use.
This is best achieved in an inpatient drug rehabilitation facility with trained addiction experts.
Once detox is complete, ongoing counseling and support is required. Counselors can give direction on dealing with cravings, managing pain symptoms without drug use, and dealing with underlying issues which may have contributed to the drug abuse.
Counseling in an outpatient capacity is often continued for months, or years, after the initial rehabilitation is complete in order to provide encouragement and to keep patients on track.

Page Sources

  1. El-Safty I., Eltamany E., Shouman A., El-Gamel O., Nada A., Ali W. Effect of tramadol addiction alone and its co-abuse with cannabis on urinary excretion of Copper, Zinc, and Calcium among Egyptian addicts. African Health Sciences. 2018; 18(3): 767–775. doi:10.4314/ahs.v18i3.35.
  2. Medline Plus. Tramadol. 2019.
  3. Drug Enforcement Administration. Tramadol(Trade Names: Ultram®, Ultracet®). 2018.

Published on: October 28th, 2015

Updated on: February 5th, 2020

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.


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  • Oitaba Stephen
    Hi writing from Africa Uganda.My kid brother trained clinical officer is addicted to tramadol.He has upgraded from capsule tabs to intravenous. How do I help this young man.He has become an issue to the community.