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Tramadol Addiction: Signs, Symptoms, Effects and Treatment

Are You Addicted to Tramadol?

Tramadol is an opioid medication that is used to treat moderate to severe pain and, with an extended-release formulation, is also used to manage some chronic pain conditions. It is sold under a number of brand names, including Ultram, Ryzolt and ConZip. While tramadol does not have the same potential for addiction as other drugs in its class, recent reports have shown a rise in tramadol abuse.


Is Tramadol Addictive?

Tramadol has a potential for abuse and physical dependence, 7 so it can be safely stated that the drug can be potentially addictive and can lead to a substance use disorder.

The risk of addiction is increased if the user takes a larger dose than prescribed takes it more often than prescribed or takes it for a longer period than prescribed. Over time, tramadol users also develop tolerance and withdrawal symptoms.

In 2014, the U.S. Drug Enforcement Administration listed tramadol as a Schedule IV drug, 1 indicating that it had a low potential for abuse and physical dependence. Prior to this change, tramadol was an unscheduled drug and thought to have little if any abuse potential.

This new classification was determined to be necessary because reports showed that tramadol was being abused by a small portion of the population. In fact, data collected since the release of the drug on the market shows an increasing trend of abuse in the United States. 2

How to Tell If You or a Loved One Is Addicted

A substance use disorder (the clinical term for addiction) is defined by a set of behaviors that indicate a compulsive, non-medical use of a drug that results in a number of negative consequences. A person can be diagnosed with an addiction to tramadol if he or she exhibits at least 2 of the following symptoms within a 12-month period: 3

  • Using more tramadol than prescribed or using it more often than prescribed.
  • Obtaining tramadol illegally (without a prescription).
  • Asking for more frequent refills of tramadol medication or “doctor shopping” for other physicians to prescribe more tramadol.
  • Using tramadol in situations where it may be hazardous, such as operating machinery.
  • Spending increasing amounts of time using tramadol or recovering from tramadol use.
  • Lacking control over tramadol use.
  • Using more and more tramadol to get the same effect (tolerance).
  • Neglecting important personal responsibilities in favor of using tramadol or as a result of tramadol use.
  • Continuing to use tramadol despite negative consequences to relationships, work, school or other areas of life.
  • Engaging in secretive or dishonest behaviors.
  • Using tramadol with other drugs or alcohol.

Physical signs that may indicate a tramadol addiction include: 3

  • Mood swings.
  • Dilated or constricted pupils.
  • Bloodshot eyes.
  • Slurred speech.
  • Lack of attention to personal hygiene.
  • Sudden weight loss or weight gain.
  • Changes in appetite or sleep patterns.
  • Increase in accidents or injuries.

Paying for Treatment

The cost of treatment will vary depending on a number of factors, such as whether you choose inpatient or outpatient treatment, the length of your stay, how high-end the facility is and the facility’s location. Several options exist for paying for tramadol addiction treatment:

  • Insurance: If you have insurance, call our helpline to find out which treatment services are covered under your plan. Typically, outpatient substance abuse treatment is covered, though you may have a co-pay. Inpatient treatment, including detox services, may or may not be covered.
  • Government insurance: Government insurance programs such as Medicaid cover the cost of many substance abuse treatments for low-income individuals or people with disabilities. You can check the Medicaid website to see if you qualify for services. 4 Many treatment facilities, especially community mental health care facilities, will begin treatment while the person is signing up for public assistance or Medicaid.
  • Low-cost treatment: The federal government provides money to state agencies to offset the cost of treatment for substance abuse. Low-cost addiction treatment centers covered under the Substance Abuse and Mental Health Services Administration may be available. You can contact SAMHSA at 1-800-662-HELP (4357) for more information.
  • Finance treatment: Many treatment programs allow a person to finance substance abuse treatment using a credit card. You can call around and talk with treatment program managers to find out if that option is available. Other options for financing your treatment include obtaining a loan, borrowing money from family or friends and crowdfunding.
  • 12-step programs: Many community support groups such as Narcotics Anonymous are free to attend. These groups are funded by donations, but donations are not required for attendance.

Getting Treatment and Starting Recovery

Types of treatment for tramadol addiction and abuse include: 5

  • Inpatient treatment requires you to remain at the treatment center for the duration of treatment. You attend individual and group therapy sessions during the day and are provided access to medical care, including medically supervised detox, if necessary.
  • Outpatient treatment involves going to a treatment center for group and individual therapy and medical care, and then returning home after the day’s treatment sessions are finished.
  • Dual diagnosis treatment is designed to help a person who is diagnosed both with a substance use disorder and with a co-occurring mental health disorder such as depression. In these cases, both disorders should be treated simultaneously.
  • 12-step programs are social support groups that are often focused on maintaining sobriety as well as short-term and long-term recovery strategies. These groups are not run by professional mental health care workers but rather by people who have had abuse or addiction issues themselves.

Treatment Process

People with severe addictions to tramadol may benefit from some form of detoxification program to help them negotiate the withdrawal effects that often occur when tramadol use stops. Detox can be initiated using medication-assisted treatment or a tapering strategy. The physician will be able to prescribe medications to help manage the unpleasant symptoms of withdrawal, if necessary. Medical detox can be provided on an inpatient or outpatient basis.

After detox, the person will be encouraged to participate in a recovery program that includes therapy and aftercare. 5, 6

  • Therapy is designed to address the personal issues that fueled substance abuse. Recovering addicts develop coping skills and relapse prevention skills. Therapists also provide education on other personal issues and on substance abuse/addiction in general. Cognitive behavioral therapy is generally considered the most effective form of therapy for addiction treatment.
  • An aftercare strategy following treatment can provide skills to address future issues and also offer long-term support during recovery. Many aftercare plans include 12-step meetings, sober living, outpatient care or individual and group therapy.
  • Social support from family, friends and even other people with substance use disorders can help the person recover from addiction and maintain sobriety.

What to Look for in a Program

There are several things to look for when considering a specific treatment program:
  • A multidisciplinary team that includes a psychiatrist and/or other physician who specializes in addiction medicine.
  • Professional therapists or counselors trained in evidence-based addiction and recovery therapies such as cognitive behavioral therapy.
  • Case managers who can assist you with potential issues outside of therapy.
  • The option to get family and friends involved in the treatment process.

Short- and Long-Term Side Effects of Tramadol Dependency

Tramadol abuse, whether it occurs for a short time or more chronically, can impact a user’s health, relationships and even employment.

The short-term effects of tramadol abuse include: 5, 8

  • Mild euphoria and elevated mood.
  • Reduction of anxiety.
  • Lightheadedness and headaches.
  • Dry mouth.
  • Excessive sweating.
  • Diarrhea or constipation.
  • Nausea and loss of appetite.
  • Sleep difficulties.
  • Tremors.

Long-term effects of a dependence on tramadol can include: 5, 3

  • Problems with the cardiovascular system, gastrointestinal system, central nervous system and liver.
  • Financial issues related to drug addiction.
  • Problems with personal relationships, employment and achieving life goals.
  • Psychological problems such as depression, anxiety and suicidal thoughts.
  • The development of tolerance, withdrawal symptoms and a severe substance use disorder.

Find a Treatment Program for Tramadol Addiction

If you are concerned that you or a loved one may have an addiction to tramadol, please call our helpline toll-free at . A recovery support advisor can answer your questions, provide information on treatment options and assist you with finding a way to pay for treatment.

[1]. United States Drug Enforcement Administration. Drug scheduling.

[2]. Substance Abuse and Mental Health Services Administration. (2015). SAMSHA reports highlight in rise of tramadol-related hospital emergency department visits.

[3]. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[4]. The Center for Medicaid and CHIP Services. (n.d.) How do I apply for coverage?

[5]. Ries, R. K., Miller, S. C., Fiellin, D. A., & Seitz, R. (2009). Principles of addiction medicine (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

[6]. Volkow, N. D. (2011). Principles of drug addiction treatment: A research-based guide (3rd ed.). Washington, DC: National Institute of Mental Health.

[7]. U.S. National Library of Medicine, PubMed Health. Tramadol (by mouth).

[8]. U.S. National Library of Medicine. Medline Plus: Tramadol.