Is Tramadol Addictive?: Risks, Dangers & Addiction Treatment

3 min read · 9 sections
Evidence-Based Care
Expert Staff

Yes, Tramadol can be addictive, and it has the potential for people to develop tolerance, dependence, and subsequent addiction.

Whenever a new prescription analgesic or painkiller comes out, people who struggle with prescription painkiller abuse become interested in the potential of the drug. Tramadol, a relatively new prescription analgesic, is no exception.

Because of its status as a painkiller, tramadol developed a following as a target of abuse. And because of recommendations that tramadol is not highly addictive, it has been prescribed more heavily than some other opioid painkillers. However, some individuals may not know the status, addictive potential, or risks that arise from abusing tramadol. Understanding the action that this drug has in the body can help those who do not know much about tramadol become aware of the risks and challenges of using or abusing this drug.

What Is Tramadol?

Tramadol is a synthetic opioid painkiller, similar to other opiate or opioid drugs such as morphine, oxycodone, and fentanyl. Because of this, it has many of the same effects as other opiate medications. However, tramadol contains other ingredients as well, and this, plus the low level of opioid content, has made many medical professionals consider it to be safer than traditional opioid drugs, according to an article from Live Science. This can result in a dangerous tendency to prescribe the drug to those who may be more likely to be affected by its addictive potential.

Regardless of the level of opioid content, prescription painkillers based on opiates can be highly addictive and result in abuse and addiction in those who take them for euphoric effect outside of their medical applications. While some consider the addiction potential to be low, those who have a tendency toward opioid addiction can easily become dependent on tramadol and have the same symptoms of addiction that develop with stronger opioid medications.

Symptoms of Tramadol Addiction

The following are symptoms of a substance use disorder according to the DSM-5:

  • Taking the substance for long periods of time or in larger amounts than intended.
  • Being unable to cut down or stop substance use.
  • Spending a lot of time obtaining, using, and recovering from the effects of the substance.
  • Experiencing cravings, or intense desires or urges for the substance.
  • Failing to fulfill obligations at home, work, or school due to substance use.
  • Continuing substance use despite having interpersonal or social problems that are caused or worsened by substance use.
  • Giving up social, recreational, or occupational activities due to substance use.
  • Using the substance in risky or dangerous situations.
  • Continuing substance use despite having a physical or mental problem that is probably due to substance use.
  • Tolerance, or needing more of the substance to achieve previous effects.
  • Withdrawal, meaning that unpleasant symptoms occur when you stop using your substance of choice.

Tramadol Abuse

Tramadol abuse has become relatively common, regardless of the fact that the drug was originally intended to be a less addictive type of opioid analgesic. Research from the World Health Organization has shown that, among opioid abusers, tramadol creates a craving response that is similar to that for oxycodone.

As a result, many people who have become addicted to stronger opioid medications have also become addicted to tramadol. Tramadol can indeed induce drug-seeking behavior, and it has the potential for people to develop tolerance, dependence, and subsequent addiction.

Tramadol Addiction Potential

When it was first introduced, tramadol was considered to be a relatively safe alternative for managing pain. Unlike other opioid drugs, it was thought that tramadol’s low level of opioid medication would give it a lower addiction potential than other pain medications.

However, as described in an article from Medpage Today, this assumption has proven false in some cases, particularly for those who have a past history of drug abuse, specifically opioid abuse. In some cases, this has resulted in overdose and death for individuals who have developed tolerance and addiction to tramadol. By taking high doses of the drug, these individuals have ended up with similar reactions to more powerful opioids like oxycodone, leading to the potential for fatal overdose.

Physical Dependence on Tramadol

An article from Drug and Alcohol Dependence demonstrates that tramadol potentially affects the GABA system in the brain, a neurochemical pathway that, when stimulated, decreases neuron activity by decreasing production of dopamine and other neurotransmitters. This system is often implicated in substance abuse and addiction, and it is considered to be one of the potential mechanisms of addiction.

Physical dependence has also been shown through the WHO study, which indicates that, while some studies show only mild effects of dependence on the drug, others have shown a strong tendency toward physical and mental dependence that can lead to addiction to tramadol. Again, prior history of substance abuse often contributes to cases in which tramadol addiction is present.

Physical and Mental Effects of Tramadol

Tramadol’s physical and mental effects are similar to those of other prescription painkillers, including, as reported by Healthline:

  • Nausea, vomiting, and stomach upset
  • Slow breathing and heart rates
  • Confusion and inability to concentrate or focus
  • Depression and anxiety
  • Increased risk-taking behaviors and lowered inhibitions
  • Physical effects from injecting the drug, if applicable

These effects can become extremely uncomfortable, particularly if the individual overdoses on the drug. An overdose can lead to extremely slow breathing that can result in the person passing out, becoming unresponsive, and experiencing coma or death.

Tramadol Withdrawal Symptoms

According to The People’s Pharmacy, withdrawal from tramadol can result in an extremely uncomfortable withdrawal syndrome, sometimes referred to as a discontinuation syndrome. Tramadol withdrawal symptoms may include:

  • Anxiety
  • Tremors
  • Insomnia
  • Depression
  • Hallucinations
  • Shivering
  • Aggression
  • Flulike symptoms
  • Tingling

These symptoms have been reported to be extremely uncomfortable and disturbing. However, because tramadol is considered to be safe, some medical professionals do not offer a sound regimen for tapering off the drug or advice on otherwise completing a safe detox that minimizes symptoms.

Support for Detox

Substance abuse treatment professionals in reputable rehab programs can provide more experienced support for detox from tramadol. These addiction professionals understand the challenges of detox from addictive substances and are able to provide the medical support required to minimize symptoms of withdrawal.

This support can include pharmacological treatments that assist in reducing the sensations described above. The other advantage of these programs is the ability to begin substance abuse treatment and therapies that can help the individual learn to manage cravings and begin to recover from addiction to tramadol.

Treatment for Tramadol Abuse or Addiction

As with many substances that are abused for recreational reasons, research-based treatment programs provide therapies and other support that can help the individual learn to recognize triggers for cravings that lead to abuse. This makes it possible for the individual to substitute other behaviors, reducing the likelihood of relapse to tramadol abuse. Therapies include:

  • Cognitive Behavioral Therapy
  • Motivation Interviewing
  • Family and social therapy
  • Peer support group participation
  • Experiential therapy to manage mental conditions that contribute to addiction
  • Exercise, nutrition, and other supportive treatments

Applying these therapies helps the individual learn to understand and cope with the symptoms of addiction, making it possible to stop using tramadol and remain abstinent in the long-term.

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