15 Minutes

Edited & clinically reviewed by THE BALANCE Team
Fact checked

Tramadol is a strong painkiller used to treat moderate to severe pain. It is also a drug of choice (DOC) for prolonged pain when regular painkillers do not work. So, is Tramadol an Opioid painkiller? Yes, it is an opioid painkiller prescribed worldwide to patients with acute or chronic pain suffering from rheumatoid arthritis, fibromyalgia, etc. Rheumatoid arthritis (RA) is an autoimmune disease affecting the joints causing immense joint pain and lethargy. Besides that, fibromyalgia is a musculoskeletal disorder causing fatigue, sleep disturbance, memory loss, etc.  

Ultram is available in the market in five different doses, 50mg, 100mg, 150mg, 200mg, or 300mg. However, a dose depends upon a patient’s weight, well-being, and many other several factors. Shortly, a health care professional can prescribe the best and ideal dose depending upon the history given by the patient. It is available in the market with different brand names like:  

  • Ultram 
  • ConZip 
  • Ultram ER 
  • Ryzolt 

Ultram creates the same craving effect as oxycodone. It is a highly addictive painkiller used to treat severe pain. Now, you must be wondering if it is safe to use Ultram? Is Tramadol (Ultram) abuse very common in the world? How dangerous is Tramadol? What can be withdrawal symptoms of Tramadol use disorder? Let us answer all the questions which are roaming around in your head.  

Note: Tramadol is famous on the streets with few cool names like trammies, ultras, and chill pills.

A spilled pill bottle next to a cup and a hand.

There is a thin line between legal and illegal use. Mostly, you might even realize that you are addicted to it. We will discuss the signs and symptoms shortly. So, few questions might hit your head regarding how does Tramadol (Ultram) works? How to stop taking Tramadol? How to abuse Tramadol? Etc. Let’s explore every aspect of the topic, shall we? 

Is Tramadol an Addictive Drug?

Recent research by World Health Organization (WHO) resulted that Tramadol is one of the commonest abused opioid drugs. The dependence and addiction rates are even higher than heroin in many parts of the world. 

However, it does not mean if a person is ingesting the drug as the prescription. He will become an addict. Simply, a few doses do not take you onto the addiction road leading to death amongst other severe symptoms. 

Although, those who use Tramadol for a long time are prone to get addicted. It is significantly less likely that a person starts popping Ultram. He most likely used to take it once as a prescribed pill to treat moderate pain. 

Tramadol alters the pain receptor in the brain. The drug acts as a similar substance produced by your brain called endorphins. 

Our body naturally produces certain hormones to tackle pain and stress by lowering them. So, Tramadol has an endorphin-like effect, helping our body to relieve stress and pain. 

Just like other opioids, Tramadol use disorder creates a sense of euphoria, which makes you feel better and always relaxed. This makes opioid an amazing choice of drug for the post-operative patient. 

Additionally, the inflammation is enhancing the pain effect in rheumatoid arthritis and fibromyalgia. Tramadol lowers the inflammatory mediators, reducing the pain in our body. High doses produce a generalized result. 

Conclusively, Tramadol (Ultram) reduces pain in two ways. Firstly, it acts like endorphins, and secondly, by affecting the inflammatory pathways. By taking it, a patient feels relaxed, sedated, and most importantly, does not feel any pain. 

Does Tramadol Get You High? 

Tramadol is an opiate painkiller. Hence, it has a high tendency to be addictive. However, compared to other opioid and opiate pain meds, it does not get you high, but there is a risk.

Otherwise, if taken in extremely high doses, it can get you high for hours leading to coma, seizures, and severe respiratory distress.

A doctor may never prescribe 400mg doses for a single unless it is essential. High doses have a severe tendency to get Ultram addiction. So, if you are wondering how many mg of Tramadol to get high? Here is the answer. 

Ultram overdose can occur in two ways. Firstly, if you are under prolong use of Tramadol due to any chronic condition. There is a high risk that you have already developed an addiction.

Secondly, when it is given with other CNS depressants. Tramadol dependency increases. The signs of early Tramadol abuse can be: 

  • Dizziness
  • Seizure
  • Impaired coordination
  • Confusion
  • Bradycardia
  • Decreased breathing

A Tramadol addict can also go into a coma and have seizures if the blood pressure is too low. If you are wondering what happens after a coma? 

The answer is death. Yes! Coma and seizures can lead to death within hours. As mentioned earlier, almost 84% of Tramadol abusers have seizures within 24 hours of Ultram abuse. 

Usually, Tramadol is prescribed for few weeks, as it is a drug of choice (DOG) to treat moderate pain. Mostly, post-operative patients are given these kinds of opioid medications. 

If a patient starts getting more doses for a similar effect and asks their doctor to increase the amount, they are most likely addicted. Also, these show irregular, irrational behavior when they cannot get their hands on Tramadol. 

As mentioned earlier, a doctor prescribes the doses by thoroughly checking out the patient’s history along with several other factors. Most of the doses depend upon the weight.

Related: Codeine Addiction and Abuse Symptoms

So, health care professionals know how many doses would be effective for a particular patient. You cannot argue about it in any case. So, if you see anyone arguing for the dose, they are addicted. 

Therefore, if you are taking your loved ones to a doctor, always mention their previous medication history, including opioid usage and other analgesics. 

Almost all kinds of analgesics are addictive; they affect the pain pathways and relieve stress. You start feeling happy and relieved after the shot. After few doses, your body realizes that it is due to the shots, and it craves with time. 

When a scheduled shot is missed, you start craving it. That is the point where you are addicted, and most of the patients do not know that yet! 

For obvious reasons, now you must be thinking, “what causes Tramadol addiction”? How does it start? 

Primarily, we cannot simply call out an abuser just because he is showing certain signs. As one can be in pain and might not feel well, he asks for more sedatives. 

However, an alarming sign is that when a patient cannot sleep well without an Ultram dose. For starters, they may start making unusual scenarios to get more doses. 

Multiple pain pills can get you high, but the most addictive and sedative one is Tramadol. In this era, where multiple drug abuse is very common. Let us focus on the previous question, “how to abuse Tramadol?” There can be many ways, Although the top three are:

  • Crushing the tablets and snorting them
  • Crushing the tablets and injecting them via intravenous (IV) syringes
  • Ingesting the tablets along with other opioids. 

It all starts with increasing doses to get the same response. Then a patient cannot stay normal after missing a shot. Tramadol misuse makes them dependent on the drug to do everyday routine tasks. 

An Ultram addictive person does not start snorting pills as soon as he gets addicted. So, when this peeks, and the body craves more. The Tramadol abusers choose different means of Ultram abuse which are listed above. 

Ultram addiction can also co-exist with other opioids or alcohol. Getting high by abusing different drugs produces much stronger effects. The other central nervous depressants (CNS) which are mostly abused with Ultram are: 

  • Alcohol
  • Opioids
  • Analgesic
  • Benzodiazepines
  • Sleeping pills
  • Cold medicine
  • Anti-depressants

The most dangerous and severe combination while abusing Tramadol is alcohol. You can go into severe bradycardia (very low heartbeat), loss of sensation, respiratory distress, and coma, leading to death. 

The risk of getting an addiction is higher when a patient is getting Tramadol (Ultram) with CNS depressants. 

Regardless of the combinations, the symptoms and signs of Tramadol abuse can be. 

Note: you know you are addicted when you cannot stop thinking about the next shot while lying on a hospital bed. 

The earliest signs and symptoms of Tramadol overdose should be noticed before it gets too late. Mostly, it starts with a generalized feeling of happiness, a sense of euphoria, and excitement. 

Within weeks, the signs are clear, but not many people notice it. Even the Tramadol addict does not know yet! 

Some patients skip the obvious signs, or they try to look at the other way. Also, they try to act normal and casual so their doctor or any family member cannot observe it. 

Tramadol dependence can show the following signs and symptoms: 

  1. Visiting multiple doctors: When a Tramadol addict is not able to get his hands on more doses. He tends to divert to other means of obtaining it. Primarily, they call it “asking for a second opinion.” These patients have Tramadol addictive potential. However, they are simply visiting another doctor to get another prescription. Ultram addicts need higher doses to get the same effect. So, after a while, they “doctor shop” very often. 
  2. Compulsive use of Ultram: When you cannot even dare to miss a single dose of Ultram. Indeed, it is a red flag. You may not realize it now, but the addiction is there whether you accept it or not. 
  3. Lack of social, work, or family life: A classical addict behavior is when you cannot socialize with people, focus on work, or interact with the family. This negligent behavior can lead to depression, anxiety, which makes them Tramadol addictive potential. 
  4. Isolation: An Ultram addict likes to isolate himself in a dark environment. So, no one can interact with him.
  5. Getting Tramadol from the streets: When all other means of getting Tramadol fails. A Tramadol addict goes Tramadol shopping on the streets. He may try to make fake prescriptions, make excuses like losing the prescription, order Tramadol online, burrowing medicine from a relative, buying other people’s subscriptions, etc. 
  6. Cannot concentrate on any task: An Ultram abuser cannot perform a simple routine task properly due to lack of concentration. You may see them not taking any interest to perform a task, show laziness, drowsiness in the daytime. 
  7. Irrational behavior when addiction signs are pointed out: If you see a Tramadol addict who has started abusing the drug recently and point out the signs. They always get angry, irrational, and anxious about why this topic is even in the discussion. 
  8. Using painkillers for a long time: At first, you were prescribed by a doctor to use Tramadol for a certain condition. However, the pain is resolved, but you are still on Ultram meds is a sign that this is an addiction. 
  9. Spending money on Tramadol: Ultram dependence leads an addict to pay an immense amount of money to meet their cravings. 
  10. Loss of time & energy: Thinking about getting more Tramadol with investing all the time and energy to satisfy their Tramadol dependence behavior. 

Opioid overdose kills millions of people. So, it is important to familiarize yourself with signs and symptoms that can help you take care of a loved one. Tramadol opiate detox prescribed by a doctor can also relieve the symptoms.  

Note: lack of concentration and memory loss is a classic Tramadol addiction symptom. Never miss it! 

All the medications come with different side effects. Addiction to Tramadol painkillers means severe side effects. When we talk about Tramadol and addiction, a combination of drugs is also an indispensable part. 

Ultram addict when using it with alcohol or CNS depressants, there can be following side effects: 

  • Headache
  • Delirium
  • Daytime drowsiness
  • Memory loss
  • Hallucinations

Headache, delirium can be the earliest sign of Tramadol disuse. Another side effect of Ultram use disorder, along with alcohol, is a parasomnia. It is a condition when a person performs an everyday routine task while being high. 

Parasomnia is commonly seen in heroin addicts. These Ultram addicts can eat. Sleep, drive, go to a shop and talk to people while under the effect of high doses of Tramadol. 

Memory impairment is also associated with this side effect as many Tramadol addicts do not remember their actions after Tramadol overdose. 

Read Also: Ambien Addiction Inpatient Treatment

This implies that even a slight sign and symptom should not be left unnoticed. So, the earliest and short-term Ultram addictive person shows these side effects: 

  • Headache
  • Drowsiness
  • Itching
  • Loss of sensation
  • Lack of concentration
  • Fatigued muscles
  • Generalized weakness
  • Lack of energy
  • Sweating
  • Dry mouth
  • Mood swings
  • Constipation
  • Memory loss

The above-listed symptoms of Tramadol overdose might resolve without any medical attention by stopping Tramadol abuse. If not, you may seek medical attention ASAP. Now, let us talk about Tramadol’s long-term side effects. 

Call an emergency service when you see a Tramadol addict overdosed and lying unconscious. You may be able to save a life by doing so. Some of the long-term side effects of Tramadol are:

Breathing issue: Ultram (Tramadol) drug abuse may lead to severe respiratory distress. It includes slowed breathing, fainting, confusion, dizziness, and rapid shallow breathing.

Androgen deficiency: Tramadol abuse side effects also cause androgen deficiency. The symptoms are:

  • Tiredness.
  • Disturbed sleep.
  • Lack of energy. 

Cardiac arrest: one of the most fearful side effects is that Tramadol dangers the normal rhythmic contraction of heart muscles. 

There is a regulated heartbeat in cardiac muscles controlled by the sinoatrial (SA) node. The SA node conveys the electric impulse to heart muscles, resulting in the contraction, and the heart pumps the blood out (to the whole body).

However, Tramadol overdose fatigues heart muscles leading to arrhythmia and sudden cardiac death (SCD). 

Serotonin syndrome: Ultram addiction side effects can also lead to serotonin syndrome. It is a long-term side effect of Tramadol on the brain. Before we get into the details of serotonin syndrome, find out what is a serotonin and what are its functions? 

Serotonin is a naturally occurring neurotransmitter that manages various activities in your CNS. Many drugs interact with the receptors of serotonin, including Tramadol (Ultram).

Serotonin syndrome is when your body produces too much of this hormone. A potential cause of this can be Ultram abuse, as it binds to serotonin-producing receptors, which results in signaling your brain to produce more serotonin.

Symptoms of serotonin syndrome in Ultram addicts are: 

  • Agitation
  • Rigid muscles
  • Confusion
  • Jerky muscles
  • Lack of balance
  • Seizures
  • Tremors
  • Coma 

A study on Tramadol overdose states that almost 84% of Ultram addicts had seizures within 24 hours of ingesting Tramadol painkillers. Fortunately, the short-term side effects of Tramadol addiction can be reversed without the need to visit a health care professional. However, Tramadol’s long-term side effects do resolve themselves. So, it is better to keep an eye on your loved ones using Tramadol painkillers for any condition. 

Ultram addiction side effects may recover soon as the Tramadol abuse stops. It depends upon the severity of the overdose. 

The most considerable Tramadol addiction risk involves the three main organs of our body, the heart, lung, and liver. 

In such cases, a prolonged hospital stay is important even if the immediate side effects of Ultram abuse have been resolved. Medically assisted Tramadol detox is the safest way to overcome the Ultram use disorder. 

A doctor might prescribe a Tramadol opiate detox for Tramadol overdose. It can counter multiple acute symptoms. 

Can Tramadol Cause Depression? 

Generally, when a Tramadol addict starts abusing the painkiller. It may feel good initially, but as soon as time passes, the person goes into depression.

It is due to lack of socializing, sedentary lifestyle, and lack of interest in daily-routine activities that lead to more severe depression. 

The best part of the treatment is that if an addict is brought to an ER within hours, gastric lavage can save the life. However, if it is too late, prolong hospitalized treatment may be necessary. 

Although, gastric lavage is only helpful if the addict has ingested Ultram pills. 

Alright, Tramadol is an addictive painkiller. If you feel yourself abusing the Ultram pain meds, you can recover. All you need is to accept the addiction and involve your family or friends, as it can be very depressing due to withdrawal symptoms. 

Xanax Addiction Treatment Programme

You can recover from addiction to Tramadol, although there might be the following withdrawal Tramadol addiction symptoms:

  • Insomnia
  • Nausea
  • Pain
  • Diarrhea
  • Anxiety 
  • Panic attacks
  • Tremors
  • Respiratory distress
  • Hallucination
  • Dizziness
  • Pupil dilation
  • Stomach pain
  • Agitation
  • Hypertension
  • Depression
  • Pupil dilation
  • Drug craving

Note: Remember, Tramadol use abuse is not a one-way road where you cannot come back. It is never too late. All it needs is a little will to fight off the craving. 

Usually, the dose depends on the patient’s age, weight, medical condition, past medical and surgical history, and disease severity. 

To resolve the immediate symptoms, 50 to 100mg doses are given. On the other hand, 200 to 300 mg are given for extended treatment. 

The number of doses can also change if the patient has kidney or liver disease as it is metabolized through the liver and excreted via urine. 

Always know that addiction is common. When you are under the effect of Tramadol for a long time, and suddenly you are not prescribed it. Your body starts craving it. Although, you can counter this craving easily.

Even if you have developed long-term Tramadol dependence, it is never too late to quit. Also, there are multiple ways to Tramadol addiction. So, addiction does not mean you are crushing Ultram pills and snorting them.

If you cannot have a good night’s sleep without ingesting few pills, you are abusing them. Remember, prolong abuse can lead to Ultram addiction. 

Once you are on top of the staircase, you are showing all the signs of Tramadol addiction. There are ways to come back, which may include withdrawal symptoms, along with medication and psychological treatment. 

If any of your friend, relative, or loved one is under the effect of Tramadol overdose. You can always help them. 

Look out for the signs and symptoms and consult a doctor ASAP.