Tramadol: Addiction, Side Effects & Treatment

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Tramadol is a synthetic opioid painkiller used for the treatment of moderate and severe pain.

Like all drugs in the opioid class, tramadol has the potential for both abuse and addiction. Classified under the Controlled Substances Act as a Schedule IV substance, this means there is only a moderate likelihood of tramadol abuse developing. Physical dependence can occur after prolonged use, and you could become addicted to tramadol.

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If your physician prescribes tramadol, you should only take the medication as directed. You should also inform your doctor about any other medications you are taking as hundreds of drugs interact with tramadol.

What is Tramadol?

Tramadol, like many synthetic opioids, first appeared in the United States in the late 1990s. Initially marketed as a safer alternative to Vicodin (hydrocodone) and OxyContin (oxycodone). 

The medication soothes pain by working on the CNS (central nervous system). 

Tramadol can be prescribed for the treatment of moderate and severe pain in adults. The medication can be used in isolation or as a component of combination therapy. 

This synthetic opioid also comes in an extended-release formulation. Tramadol uses in this formulation include the management of continuous pain. 

Tramadol is an opioid analgesic that alters the way your brain perceives pain by mimicking endorphins in the brain. Endorphins bind to your opioid receptors, sending diluted pain messages to the brain. 

Beyond this, tramadol also works on the monoamine reuptake system and central nervous system, helping you to feel calmer and more relaxed. 

The long-term use of tramadol can lead to changes to the pathways and structures of the brain. 

Tramadol, then, stimulates the opioid receptors in the brain while at the same time reducing the reuptake of norepinephrine and serotonin. As we’ll outline below, this renders you vulnerable to two forms of opioid withdrawal (traditional withdrawal and atypical withdrawal). 

How Long Does Tramadol Last?

The effects of tramadol in its immediate release form last from 4 to 6 hours. 

The effects of tramadol in extended release form last from 12 to 24 hours.

Tramadol dosage is the primary factor that  impacts how long the effects of the medication last. 

Is Tramadol Addictive?

Although tramadol came to market with a claimed low potential for abuse, those claims proved hollow. Although less addictive than many opioids, tramadol addiction can still occur. The risk is highest among those with a track record of substance abuse. 

Boxed warnings, also known as black box warnings, are the most serious of all the warnings issued by the FDA (U.S. Food and Drug Administration) 

One of the boxed warnings issued for tramadol concerns misuse and addiction. The FDA also reports that tramadol use can lead to potentially deadly overdose. 

To minimize the chance of tramadol addiction developing in the form of opioid use disorder, use the medication only as prescribed. Consult your treatment provider if you have any concerns about tolerance or dependence building. 

Abusing tramadol may not always lead to dependence and addiction, but you should not take the risk of this happening. 

Tramadol and Alcohol

To use tramadol safely, you should avoid alcohol completely while taking the medication. There are no safe scenarios for the use of alcohol and tramadol. 

If you combine central nervous system depressants like alcohol and tramadol, this can magnify the effects of both substances. This leads to increased feelings of euphoria, relaxation, and wellbeing, even at very low doses. 

Additionally, you can expect suppression of the following: 

  • Heart rate
  • Blood pressure
  • Breathing 

Tramadol Side Effects

These are the most common tramadol side effects: 

  • Dizziness
  • Drowsiness
  • Nausea
  • Vomiting
  • Sweating
  • Itching
  • Headaches
  • Dry mouth
  • Constipation
  • Lack of energy

Most of these milder side effects of tramadol should subside after just a few days. In some cases, side effects might linger for a few weeks. Consult your healthcare provider if side effects persist for a month. 

You should consult your physician immediately in the event of any of these more serious side effects triggered by tramadol: 

  • Impaired coordination
  • Rapid heart rate
  • Hallucinations
  • Shallow breathing
  • Slowed breathing rate
  • Raised body temperature
  • High blood pressure
  • Agitation
  • Fainting
  • Physical withdrawal symptoms
  • Tramadol dependence or addiction

Tramadol Withdrawal Symptoms

If you take tramadol long-term, your brain gets accustomed to the effects of the drug, adjusting to allow for the continuous presence of opioids in the system.

When you discontinue use, the brain tries to recalibrate and restore homeostasis. Tramadol withdrawal symptoms are a manifestation of the body and brain struggling to regain balance. 

Tramadol withdrawal symptoms last for anywhere up to 14 days.

Many withdrawal side effects can be mitigated if your dosage is tapered down rather than being abruptly discontinued.

You can expect to experience any of all of the following:

  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Muscle pain
  • Tingling sensations
  • Sweating
  • Anxiety
  • Agitation
  • Depression
  • Cravings
  • Confusion
  • Blurred vision
  • Appetite loss
  • Irritability
  • Dizziness
  • Insomnia
  • Headaches
  • Restlessness
  • Nightmares
  • Mood swings
  • Tremors

As mentioned above, you are susceptible to experiencing both traditional opioid withdrawal and atypical opioid withdrawal. 

The symptoms of traditional opioid withdrawal include: 

  • Vomiting
  • Nausea
  • Gastrointestinal pain
  • Diarrhea
  • Body pains
  • Muscle aches

The symptoms of atypical opioid withdrawal include: 

  • Unusual sensory experiences
  • Paranoia
  • Confusion
  • Disorientation
  • Hallucinations
  • Depersonalization
  • Panic attacks
  • Anxiety

The severity of symptoms means a medically supervised detox is generally advisable for tramadol withdrawal. 

Tramadol Addiction Treatment at California Detox

We offer opioid addiction treatment programs at all levels of intensity at our California drug rehab to help you tackle the physical and psychological components of opioid use disorder. 

Most people withdrawing from opioids like Tramadol find that a supervised medical detox offers the smoothest route to recovery. Medications can streamline the detoxification process and you will have access to around-the-clock emotional and clinical care. 

Once you are detoxed from Tramadol – this should take roughly one week – you will be ready to engage with one of the following treatment programs: 

  • Inpatient rehab (residential rehab)
  • PHP (partial hospitalization program)
  • IOP (intensive outpatient program)
  • Virtual IOP (remote rehab)
  • OP (outpatient program)
  • Dual diagnosis (addiction and co-occurring mental health condition)

All California Detox opioid addiction treatment programs draw from an array of the following interventions: 

  • MAT (medication-assisted treatment)
  • Counseling (individual and group)
  • Psychotherapy (CBT and DBT)

When you are ready to move beyond opioid addiction, call admissions at (949) 694-8305.


No. Hydrocodone is stronger than Tramadol.

Yes, Tramadol is a Schedule IV controlled substance.


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