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Understanding tramadol addiction

Mina Draskovic, B.Psy., reviewed this content for accuracy on May 15, 2024

Tramadol is an opioid painkiller used to treat moderate to severe pain. Even when taken as prescribed, people can develop a physical and psychological dependence to this prescription medication. According to Reines, et. al., for the years 2015–2017, 4% of tramadol prescriptions resulted in addiction. 

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Tramadol addiction can be dangerous, causes major health issues, and is tough to overcome. We help those struggling with opioid use disorders to break free from their dependence and reclaim their lives. If you or a loved one is struggling with tramadol addiction, our specialized drug rehab program can help you build a foundation for a healthier, drug-free future.

What is tramadol?

Tramadol is a synthetic opioid analgesic medication used to treat moderate to moderately severe pain. The drug is typically prescribed for the management of:

  • Post-surgical pain
  • Chronic pain conditions (e.g., arthritis, fibromyalgia, neuropathic pain)
  • Cancer-related pain
  • Acute pain (e.g., injury, dental pain)

Tramadol is considered a Schedule IV controlled substance in the United States because of its potential for abuse and addiction. It is classified as an atypical opioid because, in addition to its opioid effects, it also has serotonin and norepinephrine reuptake inhibiting properties, which are similar to the function of some antidepressants.

It is available in several forms, including:

  • Immediate-release tablets and capsules
  • Extended-release tablets and capsules
  • Oral solutions (medicine in liquid form for drinking)
  • Injectable solutions

If you have a history of substance abuse, respiratory disorders, or seizure disorders, use tramadol with caution. This drug may interact with other medications, such as antidepressants, anticonvulsants, and other opioids, increasing the risk of adverse effects.

What are the signs of tramadol addiction?

Tramadol addiction manifests in both physical symptoms and behavioral changes that can have negative consequences on the user’s health and daily life. If you suspect that someone close to you might be struggling with tramadol addiction, there are certain red flags to look out for. 

The physical signs of tramadol addiction often include:

  1. Drowsiness or excessive sleepiness
  2. Constricted pupils
  3. Slurred speech
  4. Impaired coordination or balance
  5. Nausea and vomiting
  6. Constipation
  7. Sweating
  8. Itching
  9. Respiratory depression (slow, shallow breathing)
  10. Seizures (in rare cases)
  11. Withdrawal symptoms when attempting to reduce or stop tramadol use (e.g., muscle aches, runny nose, and panic attacks)

Behavioral and psychological signs of tramadol addiction may include:

  1. Taking tramadol in larger amounts or more frequently than prescribed
  2. Preoccupation with obtaining and using tramadol
  3. Neglecting responsibilities at work, school, or home
  4. Isolating oneself from friends and family
  5. Mood swings and irritability
  6. Engaging in risky behaviors to obtain tramadol
  7. Doctor shopping (visiting multiple doctors to get multiple prescriptions)
  8. Continuing to use tramadol despite negative consequences
  9. Inability to control or reduce tramadol use despite the desire to do so
  10. Tolerance, requiring higher doses of tramadol to achieve the desired euphoric effects
  11. Co-occurring mental health conditions, such as depression, anxiety, or bipolar disorder

If you or someone you know exhibits any of these signs, they may have a problem. Seek professional medical advice and find an addiction treatment program that can address the root of tramadol use disorder. Ardu Recovery Center will guide you through your rehab journey to overcome Tramadol addiction. 

How addictive is tramadol?

Tramadol can be highly addictive when misused or taken for longer than needed. Addiction is a complex brain disorder that is influenced by the physical effects of the drug and psychological and environmental factors. 

Here’s what makes tramadol so addictive:

  1. Tramadol works by binding to the mu-opioid receptors in the brain and spinal cord. These receptors are responsible for regulating pain, emotion, and reward. When tramadol attaches to them, it reduces pain perception and induces feelings of pleasure and euphoria. People don’t want to give up that pain-free, euphoric experience, so they continue to use.
  2. Tramadol increases serotonin and norepinephrine levels in the brain. These neurotransmitters play a crucial role in regulating mood. The mood-altering effects caused by increased serotonin and norepinephrine can be highly reinforcing, prompting people to continue using tramadol to maintain these desirable emotional states.
  3. With continued use, the brain adapts to the presence of tramadol, requiring increasingly larger doses to achieve the desired effects. The longer you take it, the more likely you are to develop tolerance and physical dependence.
  4. Once physical dependence develops, attempting to reduce or stop tramadol use can result in uncomfortable withdrawal symptoms, making it difficult to quit and perpetuating the cycle of addiction.
  5. The euphoric effects of tramadol create strong psychological cravings for the drug, which further drive compulsive use and addictive behavior.
  6. Tramadol can cross the blood-brain barrier quickly. This results in a swift onset of effects, which can increase the likelihood of abuse and addiction.
  7. As a prescription medication, tramadol may be more readily accessible than illicit drugs, making it easier for individuals to obtain and abuse.
  8. Some people may have a genetic predisposition to addiction or may be influenced by environmental factors, such as stress, trauma, or social pressures.
  9. People with underlying mental health disorders, such as depression, anxiety, or bipolar disorder, may be more vulnerable to developing an addiction to tramadol as a means of self-medicating their symptoms.
  10. Many people may not be fully aware of the addictive potential of tramadol, which paves the way for unintentional misuse or abuse.

Ardu’s addiction treatment center provides a compassionate and evidence-based approach to treatment that helps people overcome their dependency and build a foundation for lasting recovery. With the right support, it is possible to break free from the grip of addiction and lead a healthy, fulfilling life.

What organs does tramadol damage?

Tramadol addiction takes a heavy toll on your organs. Some of these effects may be reversible with proper treatment and abstinence, but others can lead to long-lasting or even permanent damage. 

Tramadol substance use disorder affects the following organs and systems:

  1. The brain. Long-term abuse can cause a plethora of negative changes in the brain, affecting memory and concentration, while increasing the risk of mental health disorders. With continued use, the brain starts to require higher doses to achieve the desired effects, developing tolerance and dependence over time. Ghoneim, et. al. revealed that tramadol alters brain chemistry, causing oxidative stress, neuronal apoptosis, and changes in mood, behavior, and cognitive function. Tramadol’s rapid onset of effects and the psychological cravings it induces reinforce addictive behaviors.
  2. The liver. Tramadol is metabolized in the liver. Chronic abuse can lead to liver damage, including inflammation, fatty liver disease, and in severe cases, liver failure.
  3. The kidneys. Long-term tramadol use can cause kidney damage, as the drug and its metabolites are excreted through these organs. Over time, this decreases kidney function while increasing the risk of kidney disease.
  4. The respiratory system. Opioids depress respiratory function, especially when taken in high doses or combined with other central nervous system depressants. Alcohol is one of the most potent central nervous system depressants, and many people combine it with tramadol. Tramadol abuse can cause shallow breathing, hypoxia (low blood oxygen), and respiratory failure.
  5. Cardiovascular system. Tramadol abuse can cause irregular heartbeat, increased blood pressure, and in some cases, heart attack or stroke.
  6. Gastrointestinal tract. Tramadol addiction ravages your digestive system, causing nausea, vomiting, constipation, and abdominal pain. Chronic use may also result in gastrointestinal bleeding and ulcers.

Apart from the organ-specific effects, tramadol addiction can also lead to a weakened immune system, compromising the body’s natural defenses and increasing the risk of infections and diseases. 

Can you overdose on tramadol?

The risk of tramadol overdose is lower than other opioids such as morphine or heroin, overdose is still a very real concern that should never be taken lightly, especially when you combine it with other central nervous system depressants (e.g. alcohol or benzodiazepines). Those with a history of substance abuse, mental health disorders, or those who have built up a tolerance to tramadol are at a higher risk of overdose.

Some of the common symptoms of tramadol overdose include:

  • Pinpoint pupils
  • Difficulty breathing or shallow breathing
  • Extreme drowsiness or loss of consciousness
  • Cold, clammy skin
  • Weak pulse
  • Seizures
  • Nausea and vomiting
  • Confusion or disorientation
  • Blue lips or fingernails (indicating lack of oxygen)
  • Comatose state

If you suspect someone has overdosed on tramadol, call emergency services immediately. Prompt medical intervention can be life-saving. 

How to treat tramadol addiction

I’ve been to many other treatment centers but none of them feel like Ardu. Ardu is such a loving, compassionate, and spiritual place! The staff truly cared about me and taught me so much about myself. They’ve made such a positive impact on my life. Ardu will always be my family and I’m eternally grateful For the safe place they create in order for me and others to heal.

Laskah Clarke


At Ardu Recovery Center, we understand the complexities of tramadol addiction, and we are committed to supporting you every step of the way. Our comprehensive treatment approach is tailored to your specific needs, so you will get personalized care that addresses the root of your addiction.

Some of the therapies and programs we offer include:

  • Medical detox: our medically supervised detox program helps you safely and comfortably manage withdrawal symptoms.
  • Dual diagnosis treatment: if you are struggling with a co-occurring mental health disorder alongside your tramadol addiction, our dual diagnosis program addresses both issues simultaneously.
  • Cognitive-behavioral therapy (CBT): this proven therapy helps you identify and change negative thought patterns and behaviors associated with addiction, developing coping strategies to maintain long-term sobriety.
  • Medication-assisted treatment: in some cases, medication is used to manage cravings and ease withdrawal symptoms.
  • Residential treatment programs: they provide a structured, supportive environment where you can focus on your recovery without the distractions and triggers of everyday life.

The first step in your journey to a tramadol-free life is detox. 

Tramadol detox at Ardu

During our tramadol detox program, our medical team will closely monitor your progress, ensuring your safety and comfort as your body rids itself of tramadol. Our experienced medical staff will develop an individualized treatment plan tailored to your unique needs.

We provide 24/7 care and effective medications to alleviate the often excruciatingly difficult withdrawal symptoms. We use medications as needed to make the detox process as comfortable as possible.

We often combine the traditional medical approach to treating addiction with holistic methods. At our holistic detox, we offer nutritional therapy, yoga therapy, IV amino acid therapy, and massage to help relax the nervous system and restore balance as your body adjusts to life without tramadol. With personalized medical oversight and holistic therapies tailored to your needs, our drug detox center helps you transition into an effective treatment program with the best chance of success. 

After detox, you will transition into our comprehensive addiction treatment program, where you will engage in evidence-based therapies to build a strong foundation for recovery.

Tramadol rehab at Ardu

At our tramadol rehab center, we provide compassionate care to help you reclaim your health and purpose. Our team will work with you to create a treatment plan that may include:

  1. Individual sessions with a licensed therapist to explore the roots of your addiction, develop coping strategies and address any co-occurring mental health issues.
  2. Group therapy, peer support, and guidance from others who are also in recovery foster a sense of community and shared understanding.
  3. Family therapy and involving loved ones in the healing process can rebuild relationships, improve communication, and create a supportive home environment.
  4. Cognitive-behavioral therapy identifies and changes negative thought patterns and behaviors related to tramadol use.
  5. Trauma-focused therapies address underlying trauma that may have contributed to your addiction, such as eye movement desensitization and reprocessing (EMDR) or somatic experiences.
  6. Complementary holistic practices such as yoga therapy, meditation, and art therapy promote overall well-being and support your recovery journey.

Our inpatient and outpatient treatment programs are tailored to your unique needs.

The inpatient treatment program provides round-the-clock structured support and intensive therapy daily. You have constant access to medical care and counseling and a structured daily schedule centered on healing. 

Outpatient treatment allows you to maintain your personal life while getting help every week, on a bi-weekly basis, and even daily if needed. This modality is cost-effective, offers more flexibility to continue working or fulfill caregiving responsibilities, and allows you to apply the skills learned in treatment to your daily life.

Start your recovery with Ardu

We will help you identify and overcome the underlying issues that contribute to your tramadol addiction, while equipping you with the tools and strategies necessary to maintain your sobriety long after you leave our facility.

With the right support and guidance, you can break free from the grip of addiction and start living the healthy, fulfilling life you deserve. Contact Ardu today and schedule a tour to learn more about our tramadol addiction treatment program and take the first step towards a brighter future.

If you want to verify your health insurance coverage, gather more payment information, and pursue the Medicaid redetermination process in Utah, visit our insurance verification page.

Every detail matters to the people who built and run Ardu Recovery Center. Their goal is to provide a healing environment where clients can find peace, hope, medical help, therapeutic guidance, personal strength, and lasting recovery from addiction. The facility is a state-of-the-art wonder. I’m honored to be part of a staff that cares about lifetime recovery. If you or a loved one needs a facility where healing is actually possible because caring is the priority, please consider Ardu. You’ll be grateful you did.

Toni Sorenson


Tramadol addiction FAQ

What happens if you take tramadol every day?

If you take tramadol every day, it will increase your risk of developing an addiction, especially if you take it for an extended period or in higher doses than prescribed. Tramadol has a moderately high potential for misuse and abuse. Daily use can cause your body to develop a tolerance, requiring higher doses to achieve the same pain-relieving effects. Prolonged tramadol use may also result in withdrawal symptoms when attempting to stop or reduce the dosage. Long-term tramadol use can cause adverse reactions, such as gastrointestinal issues and an increased risk of seizures.

How addictive is 50mg of tramadol?

50mg of tramadol is a commonly prescribed dose, and it can be addictive if you take it for longer than your doctor prescribed. The addiction potential of tramadol is lower than other opioid drugs, such as oxycodone or morphine, but people with a history of drug abuse or substance abuse may be at a higher risk of developing dependence. Factors such as genetics, mental illness, and duration of tramadol use can also influence the likelihood of addiction. 

What are the most common side effects of tramadol?

The most common side effects of tramadol include nausea, dizziness, drowsiness, constipation, headache, and dry mouth. Some people may also experience itching, sweating, or mood changes. 

More severe side effects, although less common, can include difficulty breathing, seizures, and serotonin syndrome (a potentially life-threatening condition caused by excessive serotonin levels). If you experience any severe or persistent side effects while taking tramadol, contact a medical professional immediately.

Is it OK to take tramadol every night?

It’s not recommended to take tramadol every night for longer than two weeks, unless specifically directed by your healthcare professional. Long-term, daily use of tramadol can lead to physical dependence and increase the risk of addiction. 

Even a moderately low dose of tramadol every night may cause sleep disturbances and affect your overall sleep quality. If you are experiencing chronic pain that requires nightly pain management, consult your doctor to discuss alternative treatment options or adjustments to your current tramadol prescription.

Is tramadol stronger than codeine?

Tramadol and codeine are both opioid medications used to treat moderate to severe pain. In general, tramadol is considered to be slightly less potent than codeine. The strength and effectiveness of each drug may differ from person to person based on factors such as pain severity, tolerance, and metabolism. 

Is tramadol stronger than ibuprofen?

Tramadol and ibuprofen are different types of pain medications. Tramadol is an opioid that works by binding to opioid receptors in the brain and spinal cord to reduce pain perception. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation by blocking the production of prostaglandins. 

In terms of pain relief, tramadol is generally considered to be stronger than ibuprofen. The choice between them depends on the type and severity of pain, as well as individual factors such as medical history and potential side effects. 

Why is tramadol not recommended?

Tramadol is not recommended for everyone because of its potential for misuse, abuse, and addiction. As an opioid medication, tramadol carries the risk of physical dependence, especially when used for an extended period or in higher doses than prescribed. Tramadol may interact with other medications, such as antidepressants, leading to adverse reactions like serotonin syndrome. 

Tramadol can also cause side effects such as drowsiness, dizziness, and nausea, which may impair daily functioning. In some cases, alternative pain management options may be more suitable, particularly for those with a history of drug abuse or mental health disorders. Your healthcare professional can help determine if tramadol is an appropriate choice for your specific situation.

Why does tramadol give me energy?

Tramadol can give some people a sense of increased energy or euphoria due to its effects on the brain’s reward system. In addition to its pain-relieving properties, tramadol increases the levels of neurotransmitters such as serotonin and norepinephrine, which can lead to feelings of well-being and enhanced mood. 

Not everyone will experience these euphoric and energetic effects of tramadol, which are partly responsible for the development of an addiction. The subjective effects of tramadol, such as increased energy, can contribute to its potential for misuse and addiction. If you experience significant changes in energy levels or mood while taking tramadol, consult your healthcare professional.

Is it safe to take tramadol for life?

Taking tramadol for life is not generally considered safe. Prolonged tramadol use can lead to physical dependence, tolerance, and an increased risk of addiction. Over time, higher doses may be needed to achieve the same level of pain relief, which can further increase the risk of adverse reactions and overdose. 

Long-term opioid use may also cause hormonal imbalances, immune system suppression, and an increased risk of chronic conditions such as depression and sleep disorders. If you require long-term pain management, your healthcare professional may recommend alternative therapies or a combination of treatments to minimize the risks associated with prolonged tramadol use. 


Reines, S. A., Goldmann, B., Harnett, M., & Lu, L. (2020). Misuse of Tramadol in the United States: An Analysis of the National

Survey of Drug Use and Health 2002-2017. Substance Abuse: Research and Treatment, 14. https://doi.org/10.1177/1178221820930006

Ghoneim, F. M., Khalaf, H. A., Elsamanoudy, A. Z., & Helaly, A. N. (2014). Effect of chronic usage of tramadol on motor cerebral cortex and testicular tissues of adult male albino rats and the effect of its withdrawal: Histological, immunohistochemical and biochemical study. International Journal of Clinical and Experimental Pathology, 7(11), 7323-7341. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270590/

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