Tramadol Addiction: Effects, Withdrawal & Treatment

Tramadol—available in the branded, immediate-release form Ultram and an extended-release formulation known as ConZip—is an opioid pain medication for moderate to moderately severe pain.¹ The extended-release capsule formulation may be used to manage chronic, around-the-clock pain.^1,2 As a Schedule IV controlled substance, Tramadol is available only by prescription.³

This page will cover the adverse side effects of Tramadol, signs and symptoms of Tramadol misuse, and how to find Tramadol addiction treatment in Texas.

Side Effects of Tramadol

Tramadol is a unique painkiller in that its side effects include those that are atypical of other opioid medications. Many of the side effects of tramadol are similar to those of other opioid pain medications, however, and include:^2,3,4

• Drowsiness.
• Dizziness.
• Headache.
• Dry mouth.
• Nausea and vomiting.
• Constipation.
• Sweating.
• Itching.

Tramadol may also produce more serious side effects. These effects are less common and may include:^1,2,4

• Seizures.
• Hypersensitivity reactions—e.g., hives, bronchospasm, angioedema (skin and mucosal tissue swelling).
• Orthostatic hypotension (a drop in blood pressure upon standing).
• Serotonin syndrome (a condition made more likely when individuals are taking two medications that result in excessive serotonergic activity).
• Slowed or shallow breathing.

Why Do Tramadol’s Side Effects Differ from Other Opioids?

Tramadol is a centrally acting opioid agonist thought to relieve pain by targeting mu-opioid receptors. Unlike many other prescription opioids, tramadol is thought to also inhibit the reuptake of two neurotransmitters—norepinephrine and serotonin.^2,3

This somewhat unusual pharmacologic mechanism gives tramadol a side effect profile somewhat different than other prescription drugs in its class.

Tramadol Overdose Risk

Overdose deaths have been reported in connection with the misuse of tramadol. Individuals should not take more tramadol than prescribed by a physician. The risk of overdose increases should tramadol be used at the same time as other opioids or CNS depressant substances such as alcohol.²

Several other medications are contraindicated when using tramadol, including sedatives, tranquilizers, and muscle relaxants, but also a range of other drugs including some antifungal agents, antiviral drugs, and certain psychiatric medications.^2,4 Concurrent use of these medications can increase the risk of life-threatening respiratory issues, over-sedation, coma, and death.⁴

Signs of Tramadol Overdose

Signs and symptoms of acute tramadol overdose may include:^2,4

• Pinpoint pupils.
• Slow or shallow breathing.
• Slowed heart rate.
• Low blood pressure.
• Cold, clammy skin.
• Muscle weakness.
• Extreme drowsiness/over-sedation.
• Loss of consciousness.
• Unresponsiveness.

How Is Tramadol Misused?

When prescribed by a physician, tramadol should be taken exactly as directed. Taking more of the medication than prescribed, taking it more often than prescribed, and taking it for a longer period of time than prescribed are considered forms of misuse. Using tramadol nonmedically, or in a manner other than prescribed, is considered tramadol misuse.

Misuse of a drug like tramadol can increase several health risks and could contribute to the development of compulsive patterns of substance use common to addiction. Particularly with extended-release formulations, intentional misuse may include chewing, crushing, injecting, or snorting tramadol. Bypassing the time-release mechanism in this manner can more easily result in overdose, toxicity, or death.

If tramadol is combined with certain other depressants such as alcohol, other opioids, or anesthetics, its effects may be intensified. This can be dangerous, as it can cause an individual’s breathing to slow or even stop, which could result in fatal overdose.²

Signs of Tramadol Addiction

Signs, symptoms, and behavioral changes characteristic of tramadol addiction—or an opioid use disorder—may include:⁵

• Taking tramadol in larger amounts or for longer than prescribed.
• An inability to cut back on or altogether stop using tramadol, despite one’s intention to do so.
• Development of withdrawal symptoms when use slows or stops.
• Development of tolerance to the effects of tramadol.
• Spending large amounts of time to obtaining, taking, and recovering from tramadol use.
• A decreased ability to manage responsibilities at home, work, and school because of tramadol.
• Strain on personal relationships due to tramadol use.
• No longer participating in work or social events due to tramadol use.
• Continuing tramadol use, even if it has led to worsening physical or mental health issues.

Tramadol Withdrawal Symptoms

Tramadol and other opioid withdrawal symptoms may include:⁴

• Anxiety.
• Insomnia.
• Sweating.
• Runny nose.
• Chills/shivering.
• Nausea.
• Diarrhea.

Because of the risk of an unpleasant withdrawal, abruptly discontinuing tramadol after a period of regular use (and without the supervision of a medical professional) may be discouraged.⁴

Tramadol Detox and Addiction Treatment Options

Medical detox commonly comprises the first part of addiction treatment. In some instances, a stabilizing opioid-agonist treatment drug like methadone or buprenorphine may be used to more comfortably manage withdrawal.

For many, medical detox serves as an entry point for a longer period of rehabilitation for substance use disorders. In these instances, following successful withdrawal management, several behavioral therapeutic interventions may also be utilized.

Cognitive-behavioral therapy (CBT) is one of the most widely prescribed therapies for addiction treatment. Administered in both group and individual therapeutic settings, cognitive-behavioral approaches help individuals identify maladaptive thoughts and behaviors that have to this point contributed to their compulsive substance use issues.

With the help of such therapy, such thoughts and associated behaviors may be changed to promote recovery. Individuals will learn how to recognize which situations put them at a risk for using tramadol, as well as how to best avoid these situations.

Tramadol Addiction Treatment in Texas

Greenhouse Treatment Center offers many options for individuals who are struggling with tramadol misuse or addiction. Our levels of addiction treatment range from medical detox and residential rehab to outpatient treatment.

Our inpatient rehab near Dallas employs several evidence-based therapies, including CBT, to help you learn the skills you’ll need to stay sober long after you’ve left rehab.

To find out more our many treatment options, ways to pay for rehab, or to check your insurance coverage for tramadol addiction treatment, call now. Caring admissions navigators are available 24/7 to help you start treatment.