Side Effects of Tramadol Abuse and the Dangers of Abuse

Last Updated: June 10, 2020

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

Tramadol is a legal synthetic opioid, a medication to treat moderate, severe and chronic pain. People use it for example to treat post-surgical pain or a chronic condition such as arthritis.
Tramadol acts on the nervous pathways that relay pain signals from the body to the brain. That is how people feel their pain dampen: the cause is still there, but they don’t feel it. Furthermore, the analgesic property of Tramadol may induce mood improvement as a side effect. These two aspects make Tramadol a popular choice to use for treating pain.
Another reason why people use Tramadol is because it is less potent than other similar narcotics. Morphine, for example, has much stronger effects but and also a much higher risk of addiction. That makes people believe that Tramadol is relatively safe. Many recreational users share that belief. Tramadol does not provide extreme highs for everyone, and certainly not for people that wish to stay within reasonable safety limits and not overdose.
But those who experience and seek Tramadol-induced euphoria often believe that they are not risking much because the drug is not as potent as morphine or other opiates.

Effects of Tramadol

These are the benefits that people look for by using Tramadol:

  • Pain relief. Tramadol modifies the pain signals that go to the brain, which dampens pain sensations.
  • Mood enhancement. Tramadol increases the levels of the same neurotransmitters in the brain as many antidepressants.
  • Anti-anxiolytic. The drug is relaxing and helps to reduce anxiety.

Can Tramadol be harmful?

Tramadol is an opioid medication. It is a schedule IV substance, which meant that it has a potential for addiction. In fact, many people that follow precisely the doctor’s prescriptions and orders do not have any side effects.
Problems arise if someone consumes the medication without medical approval. Many people become addicted to Tramadol not because they were seeking a high, but because they deviated from the prescribed regimen. Users are at risk of suffering from serious side effects if they:

  • Use it for an extended period. That happens for example by disregarding doctor’s orders to change the medication. Switch to other drugs to avoid becoming dependent.
  • Take overlarge doses, or too frequent doses. It is important to maintain the right dosage for the pain, age, weight and general health of the patient.
  • Take it with other substances. Some people mix Tramadol on purpose with other drugs to enhance the effects, which can lead to harmful effects and can hasten addiction.
  • Take it on purpose for recreational reasons.

Side Effects Of Tramadol Use

Most people that follow their doctor’s guidelines shouldn’t suffer from side effects, or mild effects if any. People who use Tramadol in a risky manner, however, are at risk to experience the following frequent unpleasant consequences:

  • Sweating
  • Dry mouth
  • Headaches and dizziness
  • Difficulty with sleeping
  • Constipation or diarrhea
  • Loss of appetite and nausea
  • Tension and agitation

These are not very dangerous, but can be impeding daily life quality. However, people that are addicted or took a significant amount of the active substance in a short period can suffer from more severe side effects.

Short-Term Effects of Tramadol

But is Tramadol always harmful? Does it always lead to side effects? Can one get addicted?
Usually, if the patien follows the physician’s precise guidelines and stay cautious, they should not be at risk of harm or side effects. However, people that use Tramadol carelessly or for recreational use quickly expose themselves to side effects.
For these individuals, the short-term effects appear immediately after the consequences of the last dose fade.

Effects Of Tramadol Overdose

People suffering from a Tramadol overdose may experience:

  • Difficulty breathing or swallowing
  • Increased heart rate
  • Agitation
  • Fever
  • Hallucinations
  • Poor or lack of motor coordination
  • Blisters, hives or a rash
  • Unusually cold and clammy skin
  • Slowed breathing
  • Irregular or slow heartbeat
  • Pinpoint pupil
  • Seizures

As a warning, people that suffer from epilepsy or seizures should consult their doctor about an appropriate painkiller. Tramadol might not be the right substance for them, as it can trigger convulsions.
For especially vulnerable people, even small doses can trigger seizures.

Long-Term Consequences of Tramadol Use

Many doctors prefer not to describe Tramadol for an extended period. They recommend switching between various painkillers for irregular time periods, to prevent the body from getting used to any of the drugs. The reason for this is that long-term side effects appear even if people do not use the drug recreationally.
One of the risk factors is the extended use of Tramadol. Even when consumed in a standard, prescribed dosage and frequency and solely for medicinal purposes, it can slowly induce changes in the brain. Depending on the length of use some of the changes may be irreversible.
The most common risks of long-term tramadol use (or abuse) are:

  • Cognitive decline. Many opioid substances gradually impact complex cognition. People’s overall reaction times become slower. Memory is affected, especially short-term memory. Difficulties with attention span and time estimation appear. The person could become a danger to the environment, especially when driving a car. At first, these changes can be a direct result of artificial imbalance. In that case, Tramadol withdrawal could restore the original cognitive skills. But if the Tramadol consumption lasts for several years, it might not be possible to reverse the cognitive impairment.
  • Tolerance. Prolonged use of the same active substance leads to a risk of habituation. That means that the brain can increase its tolerance to the drug: attaining the same pain relief (or recreational) effect requires larger doses.
  • Physical dependence. The growth of tolerance leads to physical dependence. Dependence is reversible and manifests itself very clearly during withdrawal periods. That is when one can observe to what extent the body learned to rely on the drug.
  • Addiction. If physical dependence is relatively easy and quick to treat, it is not so simple when it comes to addiction. Not all physically dependent people are addicts. But those who do show signs of:
  • Being unable to stop or limit their use, even if they know about harmful effects.
  • Compulsively seeking out the drug.
  • Having trouble living functionally without the substance.

Tramadol Withdrawal

The problem with Tramadol is that many people don’t realize that they have an addiction problem. Because Tramadol is a legal medication, there is no stigma of drug abuse or risk of addiction. Sadly, that leads numerous uninformed or negligent people to continue using the substance.
Luckily, there are treatment centers available for addiction to Tramadol and other opioids.
During such a rehab program, the first thing to do is to get clean of the drug. That is, overcoming physical dependence. It usually shouldn’t take more than two weeks and is not particularly dangerous. But unpleasant withdrawal effects will occur. Individuals could expect some of the following common withdrawal symptoms:

Symptoms Of Tramadol Withdrawal

Symptoms of Tramadol withdrawal include:

  • Gastrointestinal pain and diarrhea
  • Vomiting and nausea
  • Numbness and tingling in the extremities
  • Tinnitus (ringing in the ears)
  • Agitation
  • Depressive states
  • Confusion and hallucinations
  • Paranoia

Page Sources

  1. Zabihi E., Hoseinzaadeh A., Emami M., Mardani M., Mahmoud B., Akbar M. A. Potential for tramadol abuse by patients visiting pharmacies in northern iran. Substance Abuse. 2011; 5: 11–15. doi:10.4137/SART.S6174.
  2. Zhang H., Liu Z.. The investigation of tramadol dependence with no history of substance abuse: a cross-sectional survey of spontaneously reported cases in Guangzhou City, China. BioMed Research International. 2013; 2013: 283425. doi:10.1155/2013/283425.

Published on: November 30th, 2016

Updated on: June 10th, 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.


Leave a comment

  • Warren Knight
    I was prescribed this medication so to a foot injury (a contusion). I don’t want to get hooked on it. What should I do?
    • Amber-Claire White
      Talk to your doctor and have it rotated with a different pain relief medication. Also only take as prescribed. For myself, I have ongoing pain, so I rotate with other medications, I only take the “top shelf” meds when my pain levels become unmanageable and I never get complacent about my intake. Good luck!
  • koroma michael
    Thanks for making me to understand the harmful effects of Tramadol