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  • Is Tramadol Addictive? | Abuse Potential & Risks Of Misuse

    Is Tramadol Addictive? | Abuse Potential & Risks Of Misuse

    Tramadol, first approved to treat severe pain and chronic pain by the U.S. Food and Drug Administration in 1995, was hailed as a promising alternative to opioid narcotics with a low potential for drug abuse. 

    And, according to researchers, the rates of abuse associated with tramadol in the United States are indeed significantly lower than those associated with other prescription opioid drugs.

    However, even when tramadol is properly prescribed it can prompt misuse and, potentially, harmful effects and addiction.

    Tramadol Abuse Potential

    Tramadol is only about 10% the strength of morphine by dose. But if taken in high doses or with other substances it can trigger euphoria and potentially cause serious or life-threatening adverse effects.

    Notably, high-dose tramadol tablets are a common drug of abuse in Africa and the drug is even used forcibly by certain terrorist and paramilitary organizations to control and motivate fighters, including child soldiers.

    History Of Substance Abuse

    Though it is a weak opioid, tramadol’s narcotic effects are still potent enough to sometimes trigger a relapse, drug cravings, or compulsive use in those with a past history of substance abuse or opioid addiction. 

    The drug may also be used improperly by individuals in an attempt to self-medicate, resulting in the eventual development of dependence and addiction.

    Accordingly, tramadol was converted to a Schedule IV Controlled Substance in 2014 and prescriptions carry warnings regarding the risk of misuse, abuse, or diversion.

    Tramadol’s Effects On The Body

    In the body, tramadol is processed (metabolized) into a new compound known as O-desmethyltramadol (desmetramadol), which attaches to opioid receptors in the central nervous system like other opioid pain relievers.

    But unlike morphine, hydrocodone, or oxycodone, tramadol also acts as a serotonin-norepinephrine reuptake inhibitor (SNRI), increasing the activity of the neurotransmitters serotonin and norepinephrine like certain antidepressant or mood-elevating drugs.  

    These dual effects increase tramadol’s effectiveness in managing pain and also complicate the effects the drug can have as the body becomes accustomed to it. Tolerance and dependence can be accelerated if the drug is taken in higher doses.

    Risks & Side-Effects Of Tramadol Misuse

    If taken in high doses, tramadol can cause side effects that may include:

    • agitation
    • blurred vision
    • coma
    • euphoria
    • dizziness
    • lethargy
    • fast heart rate
    • high blood pressure
    • lethargy
    • nausea
    • seizures

    Tramadol Overdose

    If taken in combination with other opioid painkillers, tramadol may contribute to opioid/tramadol overdose symptoms including:

    • agitation
    • cold, clammy, or blue skin
    • confusion
    • drowsiness
    • nausea and vomiting
    • pinpoint pupils
    • slow, shallow, or stopped breathing (respiratory depression)

    Serotonin Syndrome

    If taken in combination with other serotonergic medications, including SSRIs and SNRIs, tramadol may contribute to dangerous symptoms of serotonin syndrome, including:

    • agitation
    • confusion
    • diarrhea
    • dilated pupils
    • fever
    • goosebumps
    • headache
    • heavy sweating
    • high blood pressure
    • loss of muscle coordination
    • muscle rigidity
    • rapid heart rate
    • seizures
    • Shivering

    Physical & Mental Health Effects

    If taken chronically over an extended period, tramadol can cause physical and mental effects that may include:

    • withdrawal symptoms, when you stop taking tramadol
    • cravings for tramadol
    • tolerance, meaning that you need to take a larger dose to achieve the same effect
    • depression or anxiety
    • impaired ability to concentrate
    • decreased adrenaline production, resulting in muscle weakness, fatigue, and low appetite
    • sexual dysfunction and reduced libido
    • liver and kidney damage

    Tramadol Withdrawal

    Symptoms of Tramadol withdrawal include:

    • aches and pains
    • anxiety
    • chills
    • confusion
    • cramps
    • diarrhea
    • constipation
    • goosebumps
    • hallucinations and psychosis
    • irritability
    • loss of appetite
    • nausea and vomiting
    • restless legs
    • runny nose
    • sleep difficulties
    • sweating

    Using Tramadol Safely

    Healthcare professionals should use caution when prescribing tramadol, as well as any other analgesic (painkiller), and should consider a patient’s past history with substance abuse. 

    You should also never take tramadol that has not been prescribed to you, take more than your recommended dosage, or start taking another drug without consulting your doctor first.

    Tramadol Addiction Treatment

    Research-based detox programs are available to help you or your loved one safely discontinue use of tramadol once dependence has formed, and to help you recover from compulsive misuse or tramadol and other controlled substances.

    Treatment programs are highly personalized and often include services such as:

    To learn more, please contact a treatment center representative today.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.
    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 18, 2022
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