How Long Does Tramadol Stay in Your System?

3 min read · 6 sections

What Is Tramadol Used For?

Tramadol is a prescription opioid medication that is sold under the brand names ConZip, Qdolo, and Seglentis. It is prescribed for the treatment of moderate to moderately severe pain. More than 28.7 million prescriptions were written for tramadol in the United States in 2022.1

In a similar manner to other prescription painkillers, tramadol works by binding to and activating opioid receptors in the brain, spinal cord, and other organs in the body. When tramadol attaches to a certain subset of these receptors, several neurochemical events unfold, culminating in decreased perception of pain signaling as well as a subsequent increase in dopamine release, which creates a sense of reward and pleasure that can reinforce drug-taking.2

However, tramadol is also a monoamine reuptake inhibitor, which means that, like certain antidepressant medications, it inhibits the reuptake of norepinephrine and serotonin into nerve terminals. This monoamine reuptake inhibition is believed to contribute to its effectiveness as a painkiller.1

The effects of immediate-release tramadol will be felt for about 4–6 hours, while the extended-release version provides effects for about 12-24 hours.3

Common side effects of tramadol use include:4

  • Headache.
  • Nervousness or anxiety.
  • Dizziness.
  • Drowsiness.
  • Nausea.
  • Vomiting.
  • Constipation.
  • Diarrhea.
  • Sweating.
  • Itching.
  • Flushing of the skin.

How Long Tramadol Stays in Your Body

The elimination of tramadol begins in the liver where, as a result of specific enzymatic processes, at least 23 metabolites are created. The main metabolites are O-desmethyl-tramadol, which is pharmacologically active, and N-desmethyl-tramadol. The metabolites are mainly excreted through the kidneys.5

Tramadol has a half-life of 5-6 hours, and O-desmethyl-tramadol has a slightly longer half-life of 8 hours. A drug’s half-life indicates the amount of time it takes for a person’s system to eliminate half of the serum concentration of the ingested substance.5

Despite tramadol’s half-life, traces of the drug can remain in the system for much longer. This timing varies dramatically by individual based on factors such as amount taken, duration of use, frequency of use, and individual physical and mental health factors.

Is Tramadol Misused?

When used responsibly and as directed by a doctor, tramadol is considered to be a relatively safe pain medication, according to the World Health Organization.3

However, tramadol may be misused or diverted from medical use. The FDA labeling on the drug has been changed to include information about its misuse potential. The label states that use of the drug can result in psychological and physical dependence. Though this may impact both those with and without histories of opioid dependence, there is a higher risk in people with histories of substance misuse. People most likely to misuse tramadol are people with opioid addiction, chronic pain patients, and health professionals.1

In 2017, roughly 1.7 million people age 12 and older had abused tramadol in the past year, which is about 0.6% of that population.6

One of the major risks of misuse is overdose, which can be fatal. Symptoms of a tramadol overdose include:7

  • Seizures.
  • Constricted pupils.
  • Low blood pressure.
  • Slow heart rate.
  • Cardiac arrest.
  • Slowed breathing.
  • Cold and clammy skin.
  • Severe drowsiness.
  • Stupor.
  • Coma.

The risk of a fatal overdose is increased if tramadol is misused with other drugs that depress the central nervous system, such as alcohol, benzodiazepines, or other opioids.7

An overdose requires immediate medical attention. If you notice the signs of an overdose in someone, call 911 without delay.

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How Do You Detox From Tramadol?

Withdrawal symptoms will usually be felt beginning about 12 hours after the last use. In general, withdrawal symptoms will peak in severity within 1­-3 days after last use then subside over the course of another week or so.8

When detoxing from tramadol, a myriad of withdrawal symptoms may be experienced, including:8

  • Insomnia.
  • Yawning.
  • Depression.
  • Pupil dilation.
  • Goose bumps (piloerection).
  • Nausea and vomiting.
  • Pupil dilation.
  • Goose bumps (piloerection).
  • Nausea and vomiting.
  • Watery eyes.
  • Runny nose.
  • Muscle pain.

A supervised medical detox may be helpful for those with significant tramadol dependence. In such a setting, the person going through withdrawal is monitored for any health complications and given medications, if needed.

The FDA has approved various drugs (e.g., methadone and buprenorphine) that can manage opioid withdrawal symptoms. Methadone and buprenorphine act similarly to tramadol on opioid receptors to help ease withdrawal symptoms and suppress cravings.9

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How Is Tramadol Addiction Treated?

Male black men looking over notes with male white medical physicianA person who has been misusing tramadol should seek additional treatment beyond detoxification at an inpatient or outpatient rehab center. The National Institute on Drug Abuse reports that detox does not constitute addiction treatment—it is merely the first step of the process.9

Treatment normally consists of counseling and therapy but may also include medications. Behavioral therapies have found to be among the most effective treatments for drug addiction and include:9

  • Cognitive behavioral therapy—helps people identify, avoid, and deal with situations that may trigger them to use drugs.
  • Family therapy—targets family influences or patterns that may perpetuate drug misuse and aims to improve family functioning.
  • Motivational interviewing—attempts to motivate people who are ambivalent about treatment to stop using drugs and begin rehabilitation.
  • Contingency management—uses incentives to reward healthy behaviors that promote sobriety.

After an initial stabilization period, some people may continue to take methadone or buprenorphine beyond the detox phase to help them maintain a baseline level of craving control and withdrawal prevention so that they are better able to return to their daily lives and continue focusing on their recovery in the long-term. In those who taper off opioid medications altogether, the opioid receptor antagonist naltrexone may be used to block the effects of tramadol and other opioids to discourage relapse and promote long-term abstinence.9

Co-occurring conditions, such as mental health disorders or chronic pain, should also be addressed in treatment to decrease the likelihood of relapse.9

Many different types of drug rehabilitation programs are available across the country. If you or someone you know is ready to start the recovery process, explore your options today.

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