Author: Ruben Bermea, LPC

Tramadol is a synthetic opioid medication that has received international attention due to increased misuse.³ It has many brand names including:³

• Ultram
• Ultracet
• Calmador
• Dolan
• Dolodol
• Lucidol
• Qu Teng
• Tramalgic
• Tramcontin
• Tramoflex
• Yi Bang

First synthesized in Germany in 1962, experts saw Tramadol as a safe alternative to other pain management medications.³ Approved by the FDA in 1995, Tramadol did not receive classification as a Schedule IV substance in the U.S. until 2014.

Several reviews by the World Health Organization conducted over the last 20 years described Tramadol’s low risk compared to other opioid medications. In 2018, WHO reviewed research acknowledging Tramadol’s potential for misuse and severe health risks.³

Information released by the U.S. Drug Enforcement Agency reported that at least 1.6 million people misused Tramadol in 2019.⁴ With Tramadol’s potential for misuse and dependence, researchers have called for greater attention to Tramadol use.⁵

Prescription Uses of Tramadol

Doctors prescribe Tramadol for multiple medical concerns, with the most common being for pain management.³

Tramadol as a prescribed medication can help manage symptoms associated with acute or chronic pain. If you suffer from cancer or had surgery, you may receive a prescription. Other medical reasons why you may take Tramadol include restless leg syndrome and premature ejaculation.⁵

The U.S. Drug Enforcement Administration reports that Tramadol dosages come in 50 to 100 mg tablets. It is usually recommended to take Tramadol every 4 to 6 hours, up to 400 mg a day⁴.

Tramadol has a notably lower potency compared to morphine.³ It also has a similar effect to codeine in pain reduction.³ These qualities of Tramadol may lead you to believe that taking it has little to no risks.

Effects of Tramadol Use

Though prescription Tramadol use aims to manage serious medical concerns, you may still face health risks when you take it.

Seizures have occurred for individuals who took Tramadol dosages as prescribed.⁴ Your risk of seizures may increase with higher dosages and longer time spent using Tramadol.⁶

Before you take it, consider the side effects of Tramadol use:^3,4,5

• Dizziness
• Nausea
• Constipation
• Headache
• Drowsiness
• Insomnia
• Vomiting
• Dry mouth

At higher doses, Tramadol side effects may include:⁴

• Convulsions
• Hyperthermia
• Muscle rigidity

If you have a history of seizures or substance use disorders, discuss Tramadol’s risks with your doctor. Knowing your health risks before choosing to start this medication may save your life. If you experience severe side effects from Tramadol use, seek medical attention immediately.

Along with these side effects, using Tramadol for prolonged periods can raise your risk of becoming dependent on the medication. Some people became angry, hostile, and aggressive after at least five years of Tramadol use.⁷ After engaging in detoxification and quitting the use of Tramadol, these same individuals showed anxiety, depression, and obsessive-compulsive symptoms.

Tramadol Misuse

Many people seek out Tramadol for its pain management properties. Some individuals also seek this medication to feel good or experience its sedative effects. As prescription Tramadol use increased in the U.S. since the ’90s, access to illicit sources of this medication have increased as well.³

Street names for Tramadol include:

• Ultras
• Chill Pills
• Trammies

Though mild compared to morphine, taking Tramadol orally may lead to “opioid-like effects.” ³ While you may see Tramadol as safer to use recreationally than other opioids, misusing this substance can have dangerous effects on your health.

Easy access to Tramadol also raises concerns. Though many countries require a prescription for Tramadol, as of 2014, illicit markets and trafficking of counterfeit Tramadol increased internationally over the last two decades, making it easy to buy online without a prescription.³

WHO reported that medical staff and those with a history of substance misuse face a greater risk of dependence. Your risk of dependence grows even with infrequent use of higher Tramadol dosages.³

Dependence on the drug is dangerous as it can result in using higher Tramadol dosages to get the same effect.⁸

When using Tramadol, if you notice any of the following signs, it may be time to seek treatment for Tramadol abuse or addiction:^3,8

• Taking more Tramadol, or using it longer than originally intended
• Inability to stop or reduce Tramadol use
• Seeking prescriptions from several physicians
• Turning to illicit markets to acquire Tramadol
• A strong desire or urges to use Tramadol
• Use which interferes with life activities
• Self-harming to obtain more Tramadol prescriptions

Beyond these symptoms, Tramadol dependence and misuse can result in other significant life changes.⁸ You may notice more challenges at work, in your relationships, and increased criminal behavior.

The risk for addiction to Tramadol grows after prolonged use or misuse. If a person engages in Tramadol use for several weeks or months, they may experience an increased risk of dependence. This risk increases further if the person has a history of substance misuse or addiction.³

Tramadol Withdrawal and Overdose

If you develop dependence or misuse Tramadol, your risk of experiencing withdrawal or overdose increases.³

Withdrawal from opioid medication, like Tramadol, happens when you begin to reduce or stop using the medication. Withdrawal symptoms can range from mild to severe and even place your life at risk.³

When going through withdrawal from Tramadol, you may experience:³

• Sweating
• Agitation
• Anxiety
• Panic Attacks
• Insomnia
• Diarrhea
• Stomach problems
• Tremors
• Muscle spasms
• Respiratory concerns
• Nausea
• Tingling sensations
• Goosebumps

Severe symptoms of withdrawal include:^3,4

• Numbness
• Seizures
• Hallucinations
• Paranoia

An overdose occurs when you ingest so much of a substance that severe or life-threatening physical and mental symptoms develop.⁹ Tramadol overdose increases the risk of respiratory failure, death, and the potential for completed suicide. Treat an overdose on Tramadol as an emergency.³

Signs you or someone you know may experience overdose on Tramadol or another opioid medication include:³

• Low energy
• Nausea
• High heart rate
• Elevated blood pressure
• Cardiac arrest
• Agitation
• Seizures
• Coma
• Inability to breathe

If you have respiratory problems, you may face a greater risk of respiratory depression.³ Seek immediate medical assistance if you or someone you know shows signs of overdose. Before you risk having a Tramadol overdose, seek treatment for your addiction by calling 800-934-1582(Who Answers?) .

Mixing Tramadol With Other Substances

Using Tramadol with other substances can increase your risk for intoxication and overdose.³ The depressant effects of alcohol and benzodiazepines on the central nervous system can challenge your body’s ability to keep breathing. Combining these substances dramatically increases your risk of serious health concerns.

When taken with monoamine oxidase inhibitors and selective serotonin reuptake inhibitors (SSRIs), serotonin syndrome may occur.³ Symptoms of serotonin syndrome range from uncomfortable to life-threatening.¹⁰ Seek medical support if you experience:

• Irregular heartbeat
• High fever
• Loss of consciousness
• Seizures

The World Health Organization also encourages care and consideration when using Tramadol with the following medications:³

• Carbamazepine
• Digoxin
• Erythromycin
• Ketoconazole
• Lithium
• Mirtazapine
• Bupropion
• Fluoxetine
• Paroxetine
• Phenytoin
• Promethazine
• Rifampicin
• Ritonavir
• Quinidine
• Trazodone
• Coumarins
• Diuretics
• Phenothiazines
• Triptan

If you or a loved one has any questions about Tramadol use, dependence, or addiction recovery, call 800-934-1582(Who Answers?) to find the care you need today.

If you experience symptoms of withdrawal or overdose, seek immediate emergency medical assistance.

Using Tramadol Safely

Before you begin taking prescription Tramadol, discuss the risks with your provider. Your doctor can help you understand how to use medications safely. Professionals can help you monitor your Tramadol use. Prevent dependence and misuse by taking steps to safeguard your health and well-being.

Treatment specialists can help you address the effects of Tramadol misuse and dependence. Inpatient detoxification services can help you safely navigate the side effects of Tramadol use. Get help for withdrawal symptoms today. Comprehensive treatment for tramadol addiction is available. Call 800-934-1582(Who Answers?) to learn more about treatment options available to you.

References

1. Gostin, L. O., Hodge, J. G., & Noe, S. A. (2017). Reframing the Opioid Epidemic as a National Emergency. JAMA, 318(16), 1539.
2. Mann, B. (2020, October 21). Purdue Pharma Reaches $8B Opioid Deal With Justice Department Over OxyContin Sales. National Public Radio. Retrieved March 17, 2021.
3. 4 World Health Organization. (2018). Critical review report: Tramadol.
4. Drug Enforcement Administration Diversion Control Division. (2018). Drug and chemical evaluation section: Tramadol. Retrieved March 17, 2021.
5. Von Dohlen, M., & Jones, J. (2019). Chronic use of Tramadol after acute pain episode: cohort study. Journal of Emergency Medicine, 57(4), 595.
6. Bekjarovski N., Chaparoska D., & Radulovikj-Bekjarovska S. (2012). Seizures After Use and Abuse of Tramadol. Contributions of Macedonian Academy of Sciences & Arts, 33(1), 313–319.
7. El-Hadidy, M. A., & Helaly, A. M. N. (2015). Medical and Psychiatric Effects of Long-Term Dependence on High Dose of Tramadol. Substance Use & Misuse, 50(5), 582–589.
8. American Psychiatric Association. (2013). Substance-related and addictive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
9. United States Department of Health and Human Services Digital Communications Division. (2020, September 25). How to Respond to an Opioid Overdose.
10. Mayo Foundation for Medical Education and Research. (2019, December 10). Serotonin syndrome.