Tramadol Addiction: Definition, Symptom, Causes, Effect, Treatment and Prevention

Tramadol addiction is a compulsive dependence on tramadol, characterized by the inability to control its use despite negative consequences on physical health, mental well-being, and social responsibilities.

According to Herrnsdorf, E. A.’s 2022 study, ‘Tramadol misuse in treatment-seeking adolescents and young adults with problematic substance use – Prediction of treatment retention.’, tramadol misuse is a growing concern among young people seeking addiction treatment. The study found 26% of patients reported tramadol use, and these users were significantly more likely to drop out of treatment (35% vs 15%). Tramadol’s complex effects on both opioid and monoamine systems create unique treatment challenges, suggesting specialized approaches be needed for patients with tramadol addiction.

The symptoms of tramadol addiction are categorized into physical, psychological, and behavioral signs. Physical signs include tolerance, withdrawal symptoms, and increased usage. Psychological symptoms consist of tramadol cravings, obsession with the drug, and mood swings, while behavioral symptoms include neglecting responsibilities, isolation, and engaging in risky behaviors.

The causes of tramadol addiction are biological, psychological, and social factors. Genetic predisposition, brain chemistry alterations, and chronic pain conditions increase vulnerability to dependency. Pre-existing mental health disorders, stress, and trauma contribute to problematic use, while environmental influences, peer relationships, and medication accessibility play significant roles in addiction development.

The effects of tramadol addiction are extensive and include respiratory complications, gastrointestinal distress, neurological damage, and cardiovascular issues. Users experience significant cognitive impairments, mood disorders, and severe withdrawal symptoms. Behavioral changes manifest as drug-seeking tendencies, neglect of responsibilities, social isolation, and financial problems.

Treatment options for tramadol addiction include medical and psychological interventions. Detoxification reduces tramadol dosage under medical supervision to manage withdrawal symptoms. Medication-assisted treatment (MAT) uses medications like buprenorphine and naltrexone to reduce cravings. Cognitive Behavioral Therapy (CBT) changes negative thought patterns and develops coping strategies, while Motivational Interviewing (MI) and Contingency Management (CM) enhance motivation and reinforce positive behaviors.

What Is Tramadol Addiction?

Tramadol addiction is a substance use disorder characterized by compulsive use of this synthetic opioid medication despite harmful consequences. Initially prescribed for moderate to moderately severe pain, tramadol affects both opioid receptors and serotonin/norepinephrine systems, creating a complex addiction profile. The disorder manifests through tolerance development, withdrawal symptoms upon cessation, loss of control over usage patterns, continued use despite negative consequences, persistent cravings, and disruption to social or occupational functioning. Despite its once-perceived lower abuse potential compared to traditional opioids, tramadol leads to significant physical and psychological dependence with regular use, requiring professional treatment approaches similar to other opioid addictions.

According to a 2022 study by Almér Herrnsdorf, E., “Tramadol Misuse In Treatment-Seeking Adolescents And Young Adults With Problematic Substance Use – Prediction Of Treatment Retention,” published in Addictive Behaviors Reports, non-medical prescription use of opioids (NMPUO) is increasing, and becoming a major public health concern among adolescents and young adults.

Tramadol addiction develops through prolonged use or misuse of the drug. Individuals usually begin taking tramadol as prescribed but gradually increase their dosage without medical supervision to achieve the desired effects, leading to dependence. Over time, this results in addiction, where the person feels unable to function normally without the drug.

What Are the Signs And Symptoms Of Tramadol  Addiction?

The signs and symptoms of tramadol addiction are categorized into physical, psychological, and behavioral signs. Physical signs include tolerance, withdrawal symptoms, and increased usage. Psychological symptoms consist of tramadol cravings, obsession with the drug, and mood swings while behavioral symptoms include neglecting responsibilities, isolation, and engaging in risky behaviors.

According to Ojha, R.’s 2010 study, “Tramadol Dependence in a Patient With No Previous Substance History,” published in the Primary Care Companion to The Journal of Clinical Psychiatry, a patient with no previous history of using illicit drugs presented to the emergency department seeking assistance with Tramadol addiction. The 39-year-old, college-educated active duty military officer struggled to stop taking Tramadol in increasing doses, which he had been prescribed two years earlier for pelvic pain.

Physical Symptoms

• Tolerance: Needing higher doses of tramadol to achieve the same pain relief or euphoric effects. According to Khodayari, S.’s 2019 study, ‘Acute Tramadol-Induced Cellular Tolerance and Dependence of Ventral Tegmental Area Dopaminergic Neurons: An In Vivo Electrophysiological Study.’, tramadol quickly triggers addiction at the cellular level. A single dose of tramadol (20 mg/kg) first inhibits brain neurons for about 50 minutes, with 31% of neurons completely stopping activity within 24 minutes. This represents the tolerance phase. Following this, neurons enter a dependence phase where they become overactive for approximately 56 minutes, firing at rates 176-244% higher than normal. These dramatic neuronal changes occur even with just one dose, suggesting tramadol’s potential for addiction begins immediately upon administration, well before behavioral signs become apparent.
• Withdrawal Symptoms: Experiencing symptoms such as anxiety, sweating, nausea, vomiting, diarrhea, muscle pain, and insomnia when not taking tramadol.
• Increased Usage: Consuming more tramadol than prescribed or using it more frequently.

Psychological Symptoms

• Cravings: Cravings refer to intense urges to use tramadol that dominate an individual’s thoughts and actions. These cravings arise from the drug’s impact on the brain’s reward system, which reinforces the desire to seek out and consume tramadol to experience its effects. According to Asari, Y.’s 2018 study, ‘Acute tramadol enhances brain activity associated with reward anticipation in the nucleus accumbens.’, acute tramadol administration enhances brain activity in the nucleus accumbens during reward anticipation. In a randomized, double-blind, placebo-controlled trial with 19 healthy adults, tramadol significantly reduced anxiety, enhanced vigor, and increased feelings of contentment, relaxation, and amiability. Most importantly, brain scans revealed that tramadol significantly increased activity in the nucleus accumbens during monetary reward anticipation compared to placebo, suggesting that tramadol directly enhances the brain’s reward system, which explains its potential for abuse or dependence.
• Obsessive Thoughts: Obsessive thoughts involve constantly thinking about obtaining and using tramadol, interfering with daily life. These thoughts result from alterations in brain chemistry caused by tramadol, which creates a compulsive focus on the drug and its effects.
• Mood Swings: Mood swings manifest as significant changes in mood, such as irritability, depression, or anxiety when not using tramadol. These fluctuations occur due to tramadol’s influence on neurotransmitter levels in the brain, leading to emotional instability during periods of withdrawal or absence from the drug.

Behavioral Symptoms

• Neglecting Responsibilities: Failing to fulfill work, school, or home obligations due to tramadol use. According to Alhassan, J. A. K.’s 2-22 study, ‘“Here in Ghana hard work don’t deserve money”: The uncertainty and precarity of youth who use tramadol’, Youth who regularly consume tramadol experience significant disruption in their ability to fulfill daily obligations, with many prioritizing drug acquisition and use over work, education, and family commitments. Research in Ghana reveals that tramadol’s effects, which include sedation at higher doses and stimulation at lower doses, contribute to this pattern of responsibility avoidance among users. This neglect of duties represents one of the broader social and economic impacts of tramadol abuse, placing additional strain on already vulnerable communities and health systems as highlighted in the 2018 World Drug Report, which noted that “the impact on vulnerable populations is cause for serious concern, putting pressure on already strained health-care systems.”

• Isolation:  Isolation involves withdrawing from social activities and relationships to use tramadol, resulting in increased feelings of loneliness. This behavior stems from the drug’s effects on brain chemistry, leading to a preference for drug use over social interactions, ultimately diminishing social connections and support.
• Risky Behaviors: Engaging in risky behaviors to obtain tramadol, such as doctor shopping or buying the drug illegally.
• Continuing Use Despite Harm: Persisting in using tramadol despite experiencing negative consequences, such as health problems or legal issues. According to Groenewald, C. B.’s 2019 study, ‘. ‘Associations Between Opioid Prescribing Patterns and Overdose Among Privately Insured Adolescents’, Tramadol was associated with a significantly higher risk of overdose compared to other opioids prescribed to adolescents. The research, which analyzed data from over 1.1 million privately insured adolescents, found that tramadol exposure was associated with a 2.67-fold increased risk for opioid overdose compared to receiving oxycodone. The study also revealed that approximately 0.06% of previously opioid-naive adolescents who received an opioid prescription experienced an overdose that required medical attention. Additionally, adolescents with preexisting mental health conditions demonstrated an increased risk for overdose, with higher risks observed in those with anxiety and substance use disorders.

What Are the Common Withdrawal Symptoms of Tramadol?

Common withdrawal symptoms of tramadol include both physical manifestations like muscle aches, sweating, gastrointestinal distress, and fatigue, as well as psychological effects such as anxiety, depression, mood swings, and intense cravings.

According to Sidana, A.’s 2019 study, ‘Tramadol withdrawal psychosis.’, Tramadol withdrawal manifests as both typical opioid withdrawal symptoms and atypical presentations. These atypical symptoms include anxiety, paranoia, depersonalization, derealization, and auditory hallucinations. Physical symptoms include severe leg pain, while behavioral changes involve aggressive behavior, sleep disturbances, and self-muttering. The article attributes these unique withdrawal features to Tramadol’s dual mechanism as both an opioid receptor agonist and a serotonin-norepinephrine reuptake inhibitor.

Here are the common withdrawal symptoms of tramadol addiction in detail:

Physical Symptoms

• Muscle Pain and Spasms: Users experience significant muscle aches and spasms, which are particularly intense in the back and legs. This is due to the body’s adjustment to the absence of the drug.
• Sweating and Chills: Excessive sweating and chills are frequent symptoms, reflecting the body’s struggle to maintain homeostasis.
• Gastrointestinal Distress: Symptoms such as nausea, vomiting, diarrhea, and abdominal cramps are common, and are caused by the opioid withdrawal’s impact on the gastrointestinal system.
• Fatigue and Weakness: Patients feel extreme fatigue and weakness as the body attempts to regain normal function without the presence of tramadol.

Psychological Symptoms

• Anxiety and Agitation: Withdrawal causes heightened anxiety and agitation, as the central nervous system becomes hyperactive without the sedative effects of the drug.
• Depression: The sudden removal of Tramadol leads to significant depressive symptoms due to the decrease in serotonin and norepinephrine levels.
• Irritability and Mood Swings: Users experience irritability and severe mood swings, a reflection of the body’s attempt to stabilize its neurotransmitter levels.
• Cravings: Strong urges to use Tramadol again are common as the brain’s reward system seeks the drug to regain the sense of normalcy.

What Are the Causes Of Tramadol Addiction?

The causes of tramadol addiction include biological, psychological, and social factors. Biological influences such as genetic predisposition, alterations in brain chemistry, and chronic pain conditions increase vulnerability to dependency. Psychological elements including pre-existing mental health disorders, stress exposure, and trauma history contribute to developing problematic tramadol use. Social determinants like environmental influences, peer relationships, and medication accessibility play significant roles in addiction development.

Here are the key causes of tramadol addiction:

Biological Factors

Common biological factors for tramadol addiction include:

• Genetics: A family history of addiction increases the risk of developing tramadol addiction. According to Dean, L.’s 2015 study, ‘Tramadol Therapy and CYP2D6 Genotype’, CYP2D6 genetic variations directly impact tramadol metabolism and addiction potential. The enzyme converts tramadol to O-desmethyltramadol (M1), which binds to mu-opioid receptors with 200 times greater affinity than tramadol and produces 6 times more potent analgesia. CYP2D6 ultrarapid metabolizers (1-10% of Caucasians, 3-4% of African Americans, 1-2% of East Asians) experience faster conversion to M1, increasing toxicity and addiction risks.
• Brain Chemistry: Tramadol affects the brain’s reward system, which results in changes in brain chemistry and function, making addiction more likely.
• Chronic Pain: People with chronic pain conditions are at higher risk due to prolonged use of tramadol for pain management. According to Ojha, R.’s 2010 study, ‘Tramadol dependence in a patient with no previous substance history.’, a 39-year-old man without a previous substance abuse history developed tramadol dependence after receiving the medication for pelvic pain. The patient initially received hydrocodone for two months before switching to tramadol. Despite his pain resolving, he increased his usage to 600 mg daily and experienced withdrawal symptoms including dysphoria, muscle cramps, anxiousness, restlessness, and sensations of insects crawling on his skin when attempting to stop.

Psychological Factors

Key psychological factors for tramadol addiction include:

• Mental Health Disorders: Conditions such as depression, anxiety, and PTSD increase the risk of substance abuse, including tramadol addiction. According to Leung, J.’s 2022 study, ‘Mood and Anxiety Symptoms in Persons Taking Prescription Opioids: A Systematic Review with Meta-Analyses of Longitudinal Studies.’, People using prescription opioids were 80% more likely to develop mood disorders and 40% more likely to develop anxiety disorders compared to non-users. The review found that approximately 51% of all prescription opioids in the United States are prescribed to just 16% of the adult population who have depression and anxiety. Additionally, individuals with preexisting mental health conditions were found to be less responsive to non-pharmacological pain treatments, making them more likely to receive opioid prescriptions.
• Stress and Trauma: High levels of stress or a history of trauma contribute to the development of addiction as individuals use tramadol to cope with emotional pain.

Social Factors

Key social factors for tramadol addiction include:

• Environment: Living in an environment where drug use is common increases the likelihood of tramadol addiction.
• Peer Pressure: Social pressure to use drugs plays a significant role, especially among younger individuals. According to Fuseini, A. G.’s 2019 study, ‘Facilitators to the continuous abuse of tramadol among the youth: A qualitative study in Northern Ghana.’, peer pressure constitutes a primary initiating factor for tramadol abuse among youth in Northern Ghana. Most participants in the qualitative study explicitly identified friends as their introduction point to tramadol consumption. These peers recommended the drug either as pain relief or as a mood enhancement substance. A 21-year-old male participant reported seeking advice for neck and waist pain from a friend who suggested tramadol, while a 19-year-old male initially resisted but eventually succumbed to a friend’s persistent claims about the drug making him feel “normal.” The data reveals a pattern where social connections facilitate first-time tramadol use, establishing dependency pathways through seemingly helpful recommendations.
• Accessibility: Easy access to tramadol, either through prescriptions or illegal sources, contributes to addiction.

What Are the Effects Of Tramadol  Addiction?

The effects of tramadol addiction include respiratory complications, gastrointestinal distress, neurological damage, and cardiovascular issues, along with significant cognitive impairments, mood disorders, and severe withdrawal symptoms. Behaviorally, users develop drug-seeking tendencies, neglect responsibilities, experience social isolation, and face mounting financial problems

According to the 41st report of the World Health Organization (WHO) Expert Committee

on Drug Dependence, Tramadol has opioid and non-opioid mechanisms of action with effects such as nausea, dizziness, headache, and constipation.

Physical Effects Of Tramadol Addiction

Here are the main physical effects of Tramadol addiction in detail below:

• Respiratory Issues: Tramadol depresses breathing, leading to respiratory problems, especially in high doses. According to Park, S.’s 2024 study, ‘Risk Factors for Respiratory Depression Associated with Tramadol Based on the Global Pharmacovigilance Database (VigiBase).’, tramadol poses measurable respiratory risks, with 1,126 cases (0.8%) of acute central respiratory depression reported among 140,721 tramadol users. The majority of these cases (81.3%) were classified as serious, presenting as respiratory arrest, respiratory depression, bradypnoea, hypoventilation, and decreased respiratory rate. Notably, children, adolescents, and patients taking concomitant medications including CYP2D6 inhibitors, opioids, benzodiazepines, and antidepressants demonstrated significantly higher vulnerability to these potentially fatal respiratory complications.
• Gastrointestinal Problems: Gastrointestinal problems include chronic nausea, vomiting, constipation, and other digestive issues resulting from tramadol use. These issues arise because tramadol affects the gastrointestinal system by altering gut motility and disrupting normal digestive processes.
• Neurological Damage: Prolonged tramadol use results in seizures, especially when taken in large amounts. According to Raj, K.’s 2019 study, ‘Neurobehavioral Consequences Associated with Long Term Tramadol Utilization and Pathological Mechanisms.’, long-term use of this synthetic opioid analgesic links to several serious neurological disorders. Extensive tramadol intake causes seizures through inhibition of nitric oxide, serotonin reuptake, and inhibitory effects on GABA receptors. It also disrupts redox balance by increasing lipid peroxidation and free radical production, leading to neurotoxicity and neurobehavioral deficits. Additionally, tramadol’s interference with dopamine synthesis and release produces motor symptoms like bradykinesia and tremors, while its SSRI-like effects contribute to serotonin syndrome. These mechanisms explain tramadol’s associations with conditions such as Alzheimer’s disease and Parkinson’s disease.
• Cardiovascular Issues: Increased risk of heart problems, including irregular heartbeats and heart attacks. According to Wei, J.’s 2020 study, ‘Association of tramadol with risk of myocardial infarction among patients with osteoarthritis.’, tramadol initiators showed a significantly higher risk of myocardial infarction compared to naproxen users, with tramadol users being about 68% more likely to experience a heart attack. When compared with diclofenac and codeine, tramadol demonstrated a slightly elevated but not statistically significant cardiovascular risk (about 24% and 23% higher respectively), suggesting that while tramadol presents lower cardiovascular risk than some medications, it carries greater risk than naproxen, which has the lowest cardiovascular impact among commonly used NSAIDs.

Mental And Cognitive Effects of Tramadol Addiction

Here are the key mental and cognitive effects of tramadol addiction:

• Cognitive Impairments: Tramadol affects the neurotransmitter systems in the brain, especially serotonin and norepinephrine, which leads to significant alterations in mental functioning. According to a 2021 study by Hassaan, S. H, et al, “Effects Of Extended Abstinence On Cognitive Functions In Tramadol-Dependent Patients: A Cohort Study”, published in the Neuropsychopharmacology Reports journal, tramadol users experience cognitive impairments, including difficulty concentrating, memory problems, and reduced ability to perform complex tasks. These cognitive deficits affect daily functioning and overall quality of life.
• Mood disorders: Chronic tramadol abuse is associated with mood disorders. Many users report feelings of euphoria initially, which contributes to its addictive potential. However, prolonged use results in mood swings, anxiety, depression, and even psychosis in severe cases. These mental health issues exacerbate the cycle of addiction, as individuals continue to use tramadol to self-medicate for the very symptoms it causes.
• Withdrawal Symptoms: Tramadol cessation produces severe mental symptoms, including agitation, irritability, and intense cravings. In some instances, users experience hallucinations and paranoia during withdrawal, which complicate the detoxification process and make it more difficult to achieve and maintain sobriety. According to a 2019 study by Sidana, A., et al, “Tramadol Withdrawal Psychosis”, published in the Indian Journal of Psychiatry, Tramadol cessation causes psychotic symptoms including hallucinations.

Behavioral and Social Consequences of Tramadol Use

Here are the common behavioral and social consequences of tramadol use:

• Drug-seeking behavior: Individuals struggling with addiction exhibit significant changes in their daily activities and social interactions. One of the most noticeable behavioral signs is drug-seeking behavior. Addicts go to great lengths to obtain tramadol, including doctor shopping (visiting multiple doctors to get prescriptions), forging prescriptions, or purchasing the drug illegally.
• Neglecting responsibilities and social isolation: As addiction progresses, users neglect personal and professional responsibilities. They miss work or school, exhibit poor performance, and generally lack interest in activities they once enjoyed. Social isolation is common, as relationships with family and friends deteriorate due to the addict’s preoccupation with obtaining and using tramadol.
• Financial problems: Tramadol abusers usually get into financial difficulties due to the cost of maintaining the addiction. Individuals usually deplete their savings, sell personal belongings, or engage in illegal activities to fund their drug use. This leads to legal issues, including arrests and convictions, further complicating their lives and hindering their ability to recover.

What Are the Treatment Options For Tramadol Addiction?

Treatment for tramadol addiction typically involves a combination of medical and psychological interventions. These include detoxification, medication-assisted treatment, cognitive behavioral therapy, and group therapy. Effective treatment addresses the physical dependence on the drug as well as the underlying psychological and social factors contributing to addiction.

Detoxification

The first step in treatment is detoxification, which involves gradually reducing the dose of tramadol to manage withdrawal symptoms under medical supervision. In some instances, medications are used to alleviate withdrawal symptoms. According to a 2012 study by Sarkar, S., et al, “Tramadol Dependence: A Case Series from India” published in the Indian Journal of Psychological Medicine, non-steroidal anti-inflammatory drugs (NSAIDs) and oral clonidine are used to support the detoxification process.

Medication-Assisted Treatment (MAT)

Medications such as buprenorphine, methadone, or naltrexone are used to reduce cravings and withdrawal symptoms. These medications help stabilize individuals and support their recovery. A 2022 study by Mukau, L., et al, “ Buprenorphine for High-dose Tramadol Dependence: A Case Report of Successful Outpatient Treatment”, published in the Clinical Practice and Cases in Emergency Medicine, showed that Buprenorphine is highly used in treating Tramadol addiction. 

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) helps individuals identify and change negative thought patterns and behaviors related to tramadol use, while also teaching coping strategies to manage triggers and stress. In addition to cognitive behavioral therapy, Motivational Interviewing (MI) serves as a counseling approach that helps individuals resolve ambivalence about quitting tramadol and enhances their motivation to change. Contingency Management (CM) involves providing tangible rewards for positive behaviors, such as staying drug-free, to reinforce healthy choices.

Where to Find Treatment for Tramadol Addiction California?

Treatment for tramadol addiction in California is available through comprehensive services at Quest2Recovery. The facility offers both inpatient and outpatient programs that include detoxification, counseling, and support groups. Addiction specialists and psychiatrists provide personalized treatment plans featuring behavioral therapies and medication-assisted treatment.

How Do You Treat Tramadol Overdose?

Treating a tramadol overdose requires immediate medical intervention due to the drug’s potential for severe respiratory depression, seizures, and other life-threatening effects. According to a 2023 study by Manouchehri, A., et al, “Tramadol Poisoning And Its Management And Complications: A Scoping Review”, published in the Annals of Medicine and Surgery, Tramadol poisoning is rarely life-threatening unless it is used alongside other drugs. However, Manouchehri demonstrates that Tramadol overdose causes seizures, low heart rate, drowsiness, respiratory depression, coma, and in extreme cases, death.

Initial assessment involves ensuring an open airway and adequate ventilation, along with continuous monitoring of vital signs. 

According to Lagard, C.’s 2018 study, ‘Is naloxone the best antidote to reverse tramadol-induced neuro-respiratory toxicity in overdose? An experimental investigation in the rat.’, Naloxone, an opioid reversal agent, should be administered intravenously or intramuscularly to counteract tramadol’s effects. For seizures, benzodiazepines like diazepam or lorazepam are used, while intravenous fluids maintain blood pressure and hydration. 

If the overdose occurred within 1-2 hours, activated charcoal limits further absorption. Patients with severe symptoms require admission to an intensive care unit for continuous monitoring and advanced care.

What Are the Different Forms of Tramadol?

The different forms of Tramadol include rapid-release tablets for quick pain relief, sustained-release formulations for 24-hour management, liquid options for swallowing difficulties, injectable solutions for hospital use, and combination medications with other analgesics.

Here are the common forms of tramadol:

• Immediate-Release Tablets: These are designed to provide rapid pain relief. They are typically taken every 4 to 6 hours as needed. Common brand names include Ultram.
• Extended-Release Tablets and Capsules: These formulations are designed for chronic pain management, providing a steady release of the medication over 24 hours. Examples include Ultram ER and ConZip.
• Oral Drops and Solutions: These liquid forms are usually prescribed for patients who have difficulty swallowing pills.
• Injectable Forms: Tramadol is administered intravenously or intramuscularly in a hospital setting for quick pain relief.
• Combination Products: Tramadol is sometimes combined with acetaminophen to enhance its analgesic effects. An example of this combination is Ultracet.

What Are the Different Slang Names For Tramadol?

Different slang names for tramadol include “trains,” “tram,” “Tammie,” “chemics,” “Tammie trip,” “Trammies,” “Ultras,” “Chill Pills,” “Trammie Bombs,” and “Friday Pills.”

What Are the Facts And Statistics On The Prevalence of  Tramadol Addiction?

Here are the facts and statistics on the prevalence of tramadol addiction:

• Prescription Rates: Tramadol prescriptions have surged in recent years, reflecting its increasing use for pain management. According to a 2024 survey by Statista,” Number of tramadol prescriptions in the U.S. from 2004 to 2021 over 25 million prescriptions for Tramadol were dispensed in the US in 2014, and 24 million were prescribed in 2018 indicating widespread usage.
• Abuse Rates: A 2020 Report on Key Substance Use and Mental Health Indicators in the United States Results from the 2020 National Survey on Drug Use and Health National Survey on Drug Use and Health (NSDUH) showed that 3.2 million people aged 12 or older had used tramadol for non-medical reasons in their lifetime. 
• Emergency Department Visits: According to a 2015 report by Bush D.M., “Emergency Department Visits For Drug Misuse Or Abuse Involving The Pain Medication Tramadol”, from the Drug Abuse Warning Network (DAWN), there were 21,649 emergency department visits in 2011 related to tramadol misuse or abuse. This number represents a significant increase from previous years, highlighting growing concerns about tramadol’s safety.
• Global Perspective: Tramadol abuse is not limited to the United States. In countries like Egypt, Nigeria, and Ghana, tramadol addiction has reached epidemic proportions, with significant public health implications. A 2021 study in Ghana, “ The Insurgence of Tramadol Abuse among the Most Active Population in Jirapa Municipality: A Study to Assess the Magnitude of the Abuse and Its Contributory Factors,” by Sapphire, F, et al., published in the Psychiatry Journal, showed that 77.6% of respondents abuse tramadol..

How Are the Effects of Tramadol Addiction And Codeine Addiction Different or Similar?

The effects of tramadol addiction and codeine addiction share similarities but also have distinct differences. As opioids, both affect the brain’s reward system by binding to mu-opioid receptors, producing pain relief and euphoria that contribute to their addictive potential. Both substances cause similar psychological effects (cravings, compulsive use, mood swings) and physical dependence with comparable withdrawal symptoms like nausea, vomiting, and muscle aches. They also create similar life impacts, including deteriorating relationships and financial problems. 

However, tramadol has a unique dual mechanism that also inhibits serotonin and norepinephrine reuptake, creating different side effects than codeine. Their usage contexts differ too – codeine is prescribed with other medications for pain and cough suppression, while tramadol is typically used alone for moderate to severe pain. Perhaps most significantly, tramadol withdrawal includes unusual symptoms like seizures due to its serotonergic effects, making it potentially more complicated to manage medically than codeine withdrawal.

What Should I Do If I Suspect Someone Is Addicted to Tramadol?

If you suspect someone is addicted to tramadol, it is important to approach the situation with compassion and support. Encourage the individual to seek professional help from a healthcare provider or addiction specialist. Offer to assist them in finding treatment options by contacting the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline at 1-800-662-HELP (4357). Avoid judgment and focus on providing a supportive and non-confrontational environment.

Why Is Tramadol Addictive?

Tramadol is addictive because it acts on the brain’s opioid receptors, releasing endorphins that create feelings of pleasure and pain relief. Over time, the brain becomes dependent on these effects, leading to physical and psychological dependence. As users increase their dosage to achieve the same level of pain relief or euphoria, tolerance develops, further contributing to addiction. Additionally, tramadol’s dual action as both an opioid agonist and a serotonin-norepinephrine reuptake inhibitor enhances its addictive potential by affecting mood regulation and emotional well-being.

Are There Alternatives to Tramadol for Pain Management?

Yes, there are several alternatives to tramadol for pain management. According to the American Society of Anesthesiologists, “ Non-Opioid Treatment”, there are many non-opioid medications such as acetaminophen, ibuprofen, and naproxen, which are effective for mild to moderate pain. Other options include physical therapy, acupuncture, chiropractic care, and lifestyle changes such as exercise and stress management techniques. It is important to discuss pain management options with a healthcare provider to determine the best approach for individual needs.