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Edited & medically reviewed by THE BALANCE Team
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As an opiate analgesic painkiller, tramadol has given rise to an underclass of opiate users who continue to abuse it for recreation. It has been released into the market more recently as a less addictive and safer alternative to Percocet, oxycodone, and other more potent synthetic opiates. As a result, millions of people have come under the false impression that tramadol is not addictive.

While it’s true that tramadol certainly does not carry as high addiction potential as other opiates mentioned above, its regular use and abuse do carry serious health risks. While many may fail to recognize it, tramadol addiction is real and has the ability to destroy lives as any other type of addiction.

Tramadol addiction 2023

Tramadol is an opioid painkiller commonly used to manage pain. It is available in different generic formulations under several brand names. Despite sharing a common family of drugs as hydrocodone, tramadol tends to work in a relatively unusual way compared to other standard opioids. The drug tends to change how the body responds to pain signals by interacting with opioid receptors in the brain. This interaction also increases dopamine activity which further reinforces the repeated use of tramadol and contributes to addiction.

In the initial years of its approval by the FDA, tramadol was not a controlled substance. However, after several reports of its illicit misuse surfaced in 2014, years after its formal introduction to the drug market, FDA classified it as a Schedule IV drug with recognized potential for dependence and abuse.

Mentioned below are some common tramadol addiction symptoms.

  • Personality changes such as mood swings, depression, or anxiety
  • Behavioral changes such as paranoia, secrecy, frequent aggressive outbursts
  • Changes in appearance, such as unexplained weight changes (weight loss or weight gain), poor hygiene, and pinpricked pupils
  • Ongoing health issues such as poor nutrition, exhaustion, or sleep-related disorders
  • Social withdrawal, which leads to strained relationships with family and friends or the formation of new relationships with other substance abusers
  • Poor performance in academics or work mainly because of frequent absences or a general disinterest
  • Money or legal hardships, frequent requests for money from family or friends, or getting in trouble with the law because of doing something illegal under the influence

The time it requires tramadol to cause dependency and addiction in a person depends on various factors. These factors also play a role in determining the severity and length of withdrawal symptoms and typically include the following:

Overall Health

A person with a healthy heart, lungs, and other organs, along with good overall health, usually has an easier time resisting and fighting tramadol addiction and withdrawal.

Body Weight and Size

A person’s weight and height can significantly affect their tramadol addiction and withdrawal timelines. A larger person likely requires higher quantities of this drug for a longer time to achieve the same level of dependency that a smaller person would achieve in much lesser time.

Co-occurring Disorders

An individual with underlying health disorders is likely to fall into tramadol addiction much faster as these drugs can help mask their underlying psychological or physical issue. This temporary salve may tempt them to keep abusing tramadol, bringing addiction much quicker than usual.

Family History

Someone with a genetic risk of drug or substance abuse will face a greater pull from opiates like tramadol. Such individuals are more vulnerable to using and abusing tramadol recreationally, hence, falling into addiction. As a result, people whose parents were drug addicts also experience harsher withdrawal symptoms and find it difficult to kick their habit even with professional help.

Frequency of Intake

Someone who takes tramadol more regularly is likely to fall into addiction more quickly than one who takes it occasionally. The more the brain-body interacts with this painkiller, the more they start relying on it.

Method of Intake

An individual who uses tramadol in another way besides its recommended oral administration will grow addicted to it much faster. This is because when they snort, smoke, or inject tramadol, it is much less diluted and robust than when they consume it orally.

Size of Tramadol Dosage

Someone who takes more tramadol than a doctor has prescribed not only puts them in immediate danger of experiencing an overdose but also increases the risk of developing addiction sooner.


Multiple studies correlating drug use and gender reveal that men are more likely to start using drugs at an earlier age. This also puts them at a higher risk of addiction, including tramadol addiction, than women.

Other Drug Usage

Someone who combines tramadol with other drugs, especially alcohol, may develop addiction much faster. Not to forget that mixing these drugs can also lead to possibly fatal consequences.

In general, someone who consistently consumes 200 to 300 mg of tramadol daily can develop some level of dependence on it within ten days. If they keep taking four to six pills per day for ten days or so, it would not be surprising to experience withdrawal symptoms as soon as they stop.

Getting treatment for drug addiction may feel scary and daunting, but it is a courageous step towards making a positive change in life and beginning the life-long process of recovery. There are many types of tramadol addiction treatment programs that can be tailored according to your personal goals and needs. These individualized programs are critical if you suffer from a co-existing issue in addition to your tramadol addiction.

Following are the typical steps of treatment for tramadol dependency and addiction:

Medical Detox

Medical detox has become the standard of care in most addiction treatment centers for promoting early recovery from opioid use disorders. Its popularity is due to the discomfort and pain accompanying non-pharmacological withdrawal management. Medical detox is usually the first step of treatment for tramadol addiction which involves gradual tapering instead of suddenly quitting it. It takes place under the medical supervision of a professional team who ensures that patients comfortably go through this process with minimal withdrawal effects. Withdrawal from opioids, including tramadol, is not usually life-threatening but can be extremely uncomfortable and hard to cope with on your own. Some of these common withdrawal symptoms due to discontinuation of tramadol after developing a dependency may include:

  • Insomnia
  • Tingling
  • Flu-like symptoms
  • Hallucinations
  • Tremors
  • Anxiety
  • Depression
  • Shivering
  • Aggression

These symptoms are incredibly uncomfortable and can significantly increase the risk of relapse. However, with an effective detox plan in place, individuals can expect to move through it daily with appropriate management. Mentioned below is the expected timeline of medically-supervised detox at a tramadol addiction rehab:

  • One to three days after the last dose, you will start beginning the primary symptoms of tramadol withdrawal, including nausea, sweating, and intense cravings for the drug.
  • Four to seven days after the last dose, the withdrawal symptoms may increase in intensity and may include additional issues like confusion, disorientation, and insomnia.
  • Eight to fourteen days after the last dose, the feelings of depression and anxiety will continue to linger; however, most withdrawal symptoms will dissipate within this timeframe.

In rare cases, withdrawal from opioids such as tramadol may lead to medical complications, such as electrolyte imbalance and dehydration due to gastrointestinal symptoms. Additionally, people with pre-existing heart disease can also experience worsening of their health issues due to high blood pressure or irregular heartbeats secondary to tramadol withdrawal.

Some rehabs offer medication-assisted treatment to manage the uncomfortable symptoms of tramadol withdrawal. These medications include the following:

  • Methadone is a long-acting opioid agonist which helps with the management of withdrawal symptoms while controlling cravings
  • Buprenorphine is a partial opioid agonist that minimizes cravings while making withdrawal less comfortable.

Behavioral Therapy

Several behavioral approaches can successfully help individuals come off tramadol use disorder. Every comprehensive and effective treatment program combines these therapies with medication to achieve optimal success. Some commonly used behavioral therapy approaches in this regard include:

  • Cognitive behavioral therapy (CBT) helps patients identify their problematic behavior patterns and change them by learning and applying new coping skills and avoiding relapse triggers.
  • Motivational enhancement is a common therapeutic approach that uses motivational interviewing techniques to help people overcome any hesitance that keeps them from better engaging with treatment.
  • Family behavioral therapy (FBT)is the most appropriate for adolescents fighting tramadol addiction. It invites the patient’s loved ones and family members to attend combined therapy sessions where they work on their family conflicts and other behavioral problems. FBT also helps individuals develop or restore a strong support system at home, which, in turn, helps them seek recovery early on.



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