Tramadol (sometimes branded as Ultram) is one of the less potent opioids, but that does not mean you can avoid developing an addiction to it. Even using the drug within the limits prescribed by your doctor can lead to dependency, and there is growing evidence of its abuse around the world. According to the Substance Abuse and Mental Health Services Administration, “tramadol-related ED visits involving misuse or abuse increased about 250 percent from 6,255 visits in 2005 to 21,649 in 2011.”

While tramadol is less addictive than morphine or other opioids, people susceptible to substance abuse can often find themselves addicted to the drug. If you believe that you or a loved one may be addicted to tramadol, you can find a nearby medical center to help you today.

Tramadol is sold under various brand names, some of which include:

  • Ultram
  • Ultram ER
  • ConZip
  • Ryzolt

Tramadol comes in 50mg, 100mg, 150mg, 200mg, and 300mg tablets. The higher the dose of tramadol, the greater risk there is of dependency, abuse, and addiction.

How Does Tramadol Work?

Tramadol belongs to a group of drugs known as “opioid agonists.” Other well-known agonists include morphine, codeine, and oxycodone. These drugs interact with receptors in the brain to partially block pain pathways. As they act similar to our natural endorphins, they can also give a feeling of euphoria.

If these receptors are continually “activated” by drugs like tramadol, they become less sensitive. This means your brain develops a tolerance. Continued tolerance can lead to addiction.

Reasons to Be Prescribed Tramadol

Tramadol is often chosen for pain relief because it is considered less “powerful” or “addictive” than other opioids. This often leads to people underestimating its addictive properties. Tramadol is often prescribed when paracetamol is not effective. There are concerns that tramadol is being overprescribed for long-term relief and that patients and doctors alike rely too much on it.

Common Side Effects of Tramadol Use

Over five percent of patients who take tramadol develop side effects. Their appearance does not mean you are more or less likely to develop an addiction. Common side effects when first taking tramadol includes:

  • Dizziness and Vertigo
  • Nausea and Vomiting
  • Constipation
  • Heartburn
  • Itchiness

While these side effects generally disappear, continued abuse of the drug will often see them return.

Recognizing and Dealing With Tramadol Abuse

Tramadol abuse refers to using tramadol in a way that was not prescribed. This may be taking the drug when it wasn’t prescribed, or taking more than the doctor ordered.

What Are the Symptoms of Tramadol Abuse?

Symptoms of tramadol abuse may include:

  • Sweating and fever
  • Muscle aches
  • Nausea and vomiting
  • Appetite loss and constipation
  • Dizziness, trouble concentrating, and depression
  • Impaired motor skills (like struggling to pick up items)

What Are the Other Signs of Tramadol Abuse?

It is important to be able to recognize the signs of tramadol addiction in yourself or your loved ones, as catching the problem early and immediately seeking treatment will help minimize the potentially dangerous consequences of this affliction.

Signs and indications of addiction include:

  • Visiting multiple, different doctors.
  • Mood swings.
  • Using tramadol that was prescribed for someone else.
  • Impaired coordination, drowsiness, and difficulty concentrating.
  • Withdrawal symptoms when not taking tramadol.
  • Spending large amounts of money on tramadol.
  • Hiding medication or empty bottles.
  • Neglecting friendships, work, or home responsibilities
  • Obsession with the topic of pain relief.

It is important to recognize that addiction is not a failure of personal character, but is caused by changes in the brain due to long-term use. If you are concerned that you or a loved one is addicted to tramadol, remember to not assign blame, but instead seek professional help.

What Is the Likelihood of Becoming Addicted to Tramadol?

While most people can take tramadol without developing an addiction, patients who have been on the drug for over three months have a greater risk. Tramadol addiction is also far more likely among people who already struggle with drug or alcohol abuse. Before taking tramadol, speak to your doctor about any concerns over the possibility of addiction.

What Should I Do if I Become Addicted to Tramadol?

If you are addicted to tramadol and stop taking it immediately, you will develop withdrawal symptoms that can be as dangerous as your addiction. If you believe that you are addicted to tramadol, it is important to seek immediate help from a medical professional. We can recommend a clinic in your area that specializes in these sorts of issues.

If you are concerned for someone who may be addicted, rehabilitation clinics offer services to help you communicate your concerns and get your loved one the help they require.

The Difference Between Dependency and Addiction

While the two terms do not refer to the exact same thing, there is a lot of overlap between them.

Dependency refers to a physical change in the body, where stopping the use of tramadol will cause withdrawal symptoms and even long-term health complications. The brain comes to rely on tramadol to function. Minor dependency can occur even among those not fully addicted.

Fortunately, dependency is almost entirely reversible. While other health problems due to long-term use and/or abuse of tramadol can remain, dependency can leave within weeks of quitting the drug.

Addiction is extremely rare without dependency. Addiction refers to the person’s inability to stop using a drug and the compulsive behavior caused by this problem. While dependency may make a person feel they must have a drug to feel better, addiction is what would make a person choose the drug over their rent.

How Does Rehab Work for Someone With Tramadol Addiction?

Rehab can be a different experience for every patient, even those with the same addictions. Doctors and nurses work with the patient to develop routines, medications, and activities that will best help you recover from withdrawal and prevent further abuse of tramadol.

Principles of drug rehabilitation usually call for a combination of counseling with a trusted professional, close medical review to ensure your body recovers, and developing plans for the future. Helping recover from withdrawal is only the first step.

For more information about the treatment process, please read our accompanying article on tramadol withdrawal.

Myths About Tramadol and Addiction

Unfortunately, there is a lot of misinformation about tramadol addiction that can sometimes get in the way of seeking help. Knowing the truth can help you gain the confidence to do what is right and find a healthy outcome.

Myth: I Cannot Overdose on Tramadol

Fact: You can definitely overdose on tramadol, and it can be fatal. Over half of patients who overdose on tramadol develop seizures, and many lose consciousness. As an opioid, tramadol combined with other drugs or alcohol increases the risk of coma and death.

Myth: I Need to Be Taking Tramadol for Years to Become Addicted

Fact: Patients have become addicted to tramadol after only a few weeks of use. It is easy to feel the need to increase the dose you are taking if you feel it isn’t working, and this can quickly lead to addiction.

Myth: Tramadol Is As Safe As Aspirin or Paracetamol

Fact: While tramadol is not as powerful as oxycodone or morphine, it is still an opioid analgesic. It acts very differently from aspirin or paracetamol and so comes with unique risks.

Myth: I Can’t Become Addicted if I Don’t Use Other Drugs

Fact: While you are more likely to become addicted to tramadol if you have a history of drug or alcohol abuse, there have been cases of people with no other history developing a dependency on the opioid.

Myth: I Am Physically Well, so I Am Not Addicted

Fact: Physical effects of addiction to tramadol are not always obvious, and we can often be blind to the behavioral changes that come with addiction.

Myth: Withdrawal Is Always Worse Than the Side Effects

Fact: While withdrawal from tramadol is not pleasant, the long-term impact of high doses of tramadol can be irreversible. Working with doctors in a rehab environment can also decrease the debilitating effects of withdrawal.

Myth: Rehabilitation From Addiction Only Works if It Is Voluntary

Fact: Often, the first step of addiction recovery is coming to terms with the problems you are facing. For this reason, rehabilitation centers often find success with patients who at first don’t want to be there.
pile of red and white pills on white background

Contraindications for Tramadol

Certain people should never take tramadol. If you are pregnant or lactating, it is important to avoid any opioids as they may be passed to the child. Tramadol should also be avoided if there has been a gastrointestinal obstruction.

If you are on antidepressants or anti-anxiety medication, it is important to disclose this to your doctor before taking tramadol. Some medications can interact with the drug to cause a dangerous condition known as “Serotonin Syndrome.”

Serotonin Syndrome

Tramadol, as an opioid agonist, can interact with a range of antidepressants by increasing their ability to interact with serotonin receptors or blocking the ability of the brain to decrease serotonin

Serotonin syndrome is a sometimes-fatal condition that arises from excessive serotonin or serotonin receptor excitement. Early symptoms include muscle twitching, rapid or unusual heartbeats, hallucinations, and fever. If left untreated, it can lead to seizures, coma, and even death.

Because serotonin syndrome is such a dangerous situation, doctors recommend avoiding tramadol for pain relief when taking many types of antidepressant or antianxiety medications.

Diabetes and Tramadol

New research from the University of McGill looked into over three hundred thousand patients who had taken codeine or tramadol for non-cancer pain. It was discovered that patients taking tramadol were twice as likely to have a hospitalization for hypoglycemia. This can be quite concerning for anyone who has diabetes, especially Diabetes Mellitus Type I.

Tramadol Addiction Resources

At, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on

About the Author

Michael Couchman, PhD

Michael Couchman holds a Ph.D. in History from Queen’s University, where his research was focused on the origins of international drug control and legislative responses to problematic substance use. His award-winning doctoral thesis comparatively analyzed different official approaches to addictions treatment and their resultant public health implications. He has also written extensively about cannabis legalization in Canada, as well as the opioid crisis in the United States. In his current role at, he researches, writes, and edits helpful and informative content concerning the best available, evidence-based treatment options for those in recovery from drug and alcohol addiction.

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