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  • Tramadol Injection | Can You Inject Tramadol?

    Tramadol Injection | Can You Inject Tramadol?

    Tramadol hydrochloride, also known by its brand name Ultram, is an opioid analgesic (painkiller). It is primarily used for chronic or severe pain management but is also used for postoperative pain. 

    Along with pain relief, tramadol can produce feelings of relaxation and euphoria. Sometimes people misuse their prescription by injecting it into their veins to achieve these effects. Injecting tramadol is extremely dangerous and can cause long-term health effects and overdose

    Effects Of Injecting Tramadol 

    As an opioid, tramadol attaches to opioid receptors in the central nervous system and releases dopamine. Dopamine is a brain chemical that can cause the euphoric high associated with opioid medications. 

    Some people may crush the tablets and mix them with a liquid for intravenous (IV) injection. Injecting opioids sends the drug directly into the bloodstream, causing rapid and intense effects. However, injecting increases the risk of negative side effects of the drug as well. 

    The most common side-effects of tramadol include:

    • sedation
    • headache
    • tremors
    • constipation
    • mood changes
    • dry mouth

    Tramadol extended-release tablets are intended to be released over a period of 24 hours. If injected, it sends multiple doses of tramadol into the body at once. This can intensify serious side effects and increase the risk of a life-threatening overdose. 

    Dangers Of Injecting Tramadol

    Your prescribing doctor will likely create a dosing schedule that allows the least amount of tramadol needed for pain relief. However, injecting tramadol can cause you to quickly develop a tolerance. 

    As your tolerance increases, you may need higher doses to achieve the same effects. High doses increase the risk of experiencing an overdose and other adverse effects.


    There is a risk of seizures in people taking the minimal dose of tramadol but the risk is increased with higher doses. 

    The Food and Drug Administration (FDA) warns there is also an increased risk of seizure among people who:

    • take other opioid medications
    • have a history of epilepsy
    • have a head injury
    • alcohol or drug withdrawal
    • take antidepressants 

    Serotonin Syndrome

    Serotonin syndrome is a potentially fatal condition caused by a toxic amount of serotonin in your system. Serotonin is a chemical responsible for nerve and brain function. Serotonin also regulates mood, which is why many antidepressants increase serotonin levels. 

    Selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs) can cause serotonin to accumulate to dangerous levels. When your body has too much serotonin, it can cause mild to severe symptoms. Severe cases can be fatal if left untreated. 

    Viral & Bacterial Infections

    Injecting drugs requires various equipment that can become contaminated with infected blood. Sharing needles and using old or dull needles increases the risk of contracting infections. 

    Infections that can be contracted by injecting tramadol include:

    • hepatitis C
    • human immunodeficiency virus (HIV)
    • abscesses
    • cellulitis

    Along with infections, injecting tramadol can also cause collapsed veins and track marks. Track marks are scars and bruising that appears along the site of injection. These marks are usually a tell-tale sign that someone is injecting drugs. 

    Tramadol Overdose

    Injecting tramadol, especially in high amounts, can produce a life-threatening overdose. In high amounts, tramadol can cause respiratory depression. Respiratory depression is a dangerous side-effect of central nervous system depressants that causes slowed or stopped breathing. 

    Signs of a tramadol overdose may include:

    • trouble breathing
    • unconsciousness
    • bluish skin 
    • severe drowsiness
    • low heart rate
    • low blood pressure

    If you notice the signs of opioid overdose in a loved one, seek medical attention and administer naloxone if available. Naloxone is an opioid antagonist that reverses the effects of an opioid overdose. 

    Serious drug interactions can occur when you inject tramadol while taking other central nervous system depressants. 

    Central nervous system depressants that increase the risk of overdose include:

    • alcohol
    • benzodiazepines (Xanax, Valium)
    • other opioids (Oxycodone, Codeine)
    • barbiturates (Luminal)
    • hypnotics (Ambien)

    These drugs increase the risk of experiencing an overdose because they produce similar effects on the brain and body. 

    Tramadol Dependence & Withdrawal

    Misusing a prescription by injecting it increases the risk of becoming physically dependent. Once dependent, you will likely experience withdrawal symptoms if you stop taking tramadol. 

    Tramadol withdrawal symptoms may include:

    • anxiety
    • sweating
    • insomnia
    • nausea
    • tremors
    • diarrhea

    Although opioid withdrawal is usually not life-threatening, it can be extremely unpleasant. Medical detox can help you manage symptoms in a safe and comfortable environment. 

    Tramadol Addiction

    The longer you inject tramadol, the higher your risk is of becoming addicted. Addiction is characterized by the compulsive use of tramadol despite harmful consequences. If you think you or a loved one may be addicted, residential and outpatient programs offer a variety of services. 

    To learn more about opioid addiction treatment options, please contact Ark Behavioral Health today. 

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Food And Drug Administration (FDA) - Tramadol Hydrochloride Extended-Release Tablets
    Mayo Clinic - Serotonin Syndrome
    National Institute On Drug Abuse (NIDA) - Prescription Opioids DrugFacts
    National Library Of Medicine - Sex Work, Injection Drug Use, And Abscesses: Associations In Women, But Not Men
    National Library of Medicine: MedlinePlus - Tramadol

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 18, 2022
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