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  • Tramadol can have many serious side effects during long-term use, including increased risk of physical dependence, withdrawal symptoms, and overdose.

    Tramadol is usually prescribed as an opioid analgesic to help with pain management. It is available as the brand names Ultram, Ultram ER, Ultracet, Conzip, and others. Like other opioids, long-term use of tramadol can be harmful to your health.

    What Counts As Tramadol Abuse?

    There are many forms of substance abuse. Though tramadol is a prescription drug, it also sees illicit use. It can be abused in both of these contexts, including:

    Tramadol is a Schedule IV controlled substance. Its potential for drug abuse, addiction, and dependency is well-known, and physicians usually are careful prescribing it.

    According to the U.S. Drug Enforcement Administration (DEA), tramadol is commonly abused by people with addiction, people suffering from chronic pain, and health professionals. Abusing tramadol can happen to all kinds of people, regardless of background or financial status.

    Physical Effects Of Long-Term Opioid Abuse

    Outside of the common side effects of opioids, taking tramadol long-term has been linked to an increased risk of adverse effects such as:

    • bone fractures
    • heart attacks
    • chronic constipation
    • bowel obstructions
    • hyperalgesia (increased sensitivity to pain)

    What counts as short-term or long-term use may vary from patient to patient. If opioids are prescribed for more than 90 days at a time, this usually counts as long-term use. Abusing opioids may only increase your health risks compared to proper use.

    Serotonin Syndrome

    Serotonin syndrome happens when you have too much serotonin in your body. While tramadol works on opioid receptors in the body, it also affects the reuptake of the neurotransmitters norepinephrine and serotonin. 

    Serotonin can build up when taking tramadol over a long period of time, leading to serotonin syndrome. Symptoms of serotonin syndrome range from mild to severe and may include:

    • rapid heart rate (tachycardia)
    • high blood pressure (hypertension)
    • agitation
    • confusion
    • diarrhea
    • goosebumps
    • high fever
    • seizures

    Serotonin syndrome can be more likely if tramadol is taken along with antidepressants or monoamine oxidase inhibitors (MAOIs).

    Tolerance & Reduced Pain Relief

    Taking tramadol for a long time can lead to drug tolerance. You may find that the same dose can be less effective over time. Your chronic pain may even come back while on the drug.

    Tolerance can happen with many opioid drugs, including tramadol. Tolerance can lead to drug abuse if you increase your doses without approval from your doctor. You may also put yourself at risk of the more severe side effects of tramadol this way.

    Tramadol is less likely to affect heart rate when taken as directed, especially compared to other opioids. Taking high doses due to drug tolerance can lead to tramadol affecting your heart rate.

    Risk Of Overdose

    Abusing tramadol can put you at greater risk for an opioid overdose. As opioids affect the central nervous system (the brain and spinal cord), an overdose can affect vital parts of the body.

    Symptoms of a tramadol overdose may include:

    • respiratory depression (slowed breathing)
    • clammy skin
    • constricted pupils
    • severe drowsiness
    • unconsciousness

    Opioid overdose can be life-threatening if not treated immediately.

    Withdrawal Syndrome

    Tramadol comes in both fast-acting and extended-release tablets. Withdrawal from extended-release opioids is usually less intense than withdrawal from fast-acting opioids. 

    However, extended-release withdrawal symptoms may last for longer because the drug takes longer to detox.

    Opioid withdrawal is much more likely if the use of opioids has gone on for a long time, or if opioids have been abused. It is also more likely to last longer. Withdrawal symptoms usually last for about a week and can include:

    • anxiety
    • tremors
    • goosebumps
    • diarrhea
    • cravings
    • hallucinations

    Lingering withdrawal symptoms, such as cravings and dysphoria, can last for months after physical withdrawal has stopped. To manage opioid withdrawal and avoid a relapse, a dedicated treatment program may be needed.

    Treatment Programs For Tramadol Abuse

    Compared to other opioids such as hydrocodone, oxycodone, codeine, and fentanyl, tramadol might be seen as a safer painkiller for forms of acute pain, severe pain, and chronic pain. However, tramadol has its own host of risks, especially when taken improperly.

    If you or a loved one struggles with tramadol abuse, help is available. Dedicated treatment programs tackle opioid abuse from many different angles, which may include mental health treatment. To find the professional treatment for opioid use that you deserve, contact us today.

    Written by Ark Behavioral Health Editorial Team
    ©2022 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    National Centers for Biotechnology Information - Long-Term Opioid Therapy Reconsidered
    National Centers for Biotechnology Information - Opioid Withdrawal
    U.S. Drug Enforcement Administration - Tramadol
    U.S. Food and Drug Administration - ULTRAM (tramadol hydrochloride)

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