Understanding Tramadol Dependency

Tramadol dependence is a growing problem in the UK. A potent prescription drug, many people may not realise that they have a tramadol addiction if it has been prescribed by a doctor.

What Is Tramadol?

Tramadol is an opiate medication that is used to relieve pain. It is known to be less potent than many opiate pain medications and because of this, some people may believe that they cannot be addicted to tramadol.

Tramadol is prescribed to treat moderate to severe pain, for example after surgery or if you have persistent chronic pain. When it is prescribed, doctors may take into consideration how long it will be taken for and will include details of how to stop taking tramadol.

Tramadol is prescribed under many names, including:

  • Larapam
  • Zeridame
  • Oldaram
  • Mabron
  • Maneo

Tramadol is often taken in pill or capsule form, although it is available in suppositories and drops. It can also be injected intravenously. The dosage ranges from 50 to 300 milligrams.

Tramadol is highly controlled in the UK. Prescriptions for this medication are only valid for 28 days, and people can be given a maximum of a 30 day supply. Although it is legal when prescribed, tramadol is also a Class C drug in the UK, and can carry a sentence of up to two years in prison if sold or consumed illegally.

How Does Tramadol Work?

Tramadol is classed as an opioid agonist, as it activates specific receptors in the brain. It works by changing how your brain senses pain. It acts in a similar way to the endorphins that your brain naturally produces, and decreases the amount of pain that your body thinks it is experiencing.

Tramadol is not just an opioid painkiller. It is also classed as a serotonin-norepinephrine reuptake inhibitor (SNRI), with properties that are associated with antidepressants.

Even when it is being used correctly, tramadol has many dangers. People can experience nausea and dizziness, along with the intentional effects of euphoria, relaxation, and pain relief. More severe symptoms of tramadol use, even if you are not addicted, include:

  • Serious breathing problems
  • Adrenal insufficiency
  • Seizures
  • Androgen deficiency

Tramadol is a unique medication in that almost 100% of the drug makes it to the site of action, which makes it highly potent and effective pain relief.

Signs Of Tramadol Addiction

Signs of tramadol abuse vary from person to person, but include:

  • Pinpoint pupils
  • Nausea
  • Drowsiness
  • Slurred speech
  • Headaches

Symptoms of tramadol addiction can also be behavioural, such as:

  • Failing to meet professional or personal obligations because of substance abuse
  • Using tramadol despite the problems it causes
  • Spending a lot of time finding, using, and recovering from the effects of tramadol
  • Spending money needed for necessities on tramadol
  • Mood swings

Many people experiencing addiction have personality changes, appearing more withdrawn or anxious because of their drug abuse. They can become incredibly secretive in an attempt to hide their problems, and withdraw from their family and friends.

People with a tramadol addiction can often obtain tramadol in highly unsafe ways. They may buy it illegally or try and obtain prescriptions from multiple doctors to increase their supply. Many people often have to take more tramadol than recommended to feel the same effects as when they started to abuse it.

Understanding Tramadol Dependency

Causes of Tramadol Addiction

There is no one cause of tramadol addiction. Even when people take tramadol as directed, they still have a chance of becoming addicted. However, the risk factors for substance abuse may be raised for several reasons:

  • A prior history of substance abuse – Those who have struggled with substance abuse in the past have a higher chance of developing a tramadol addiction.
  • A co-occurring mental health condition – People with a mental health condition such as depression and anxiety can struggle with substance abuse as a way to self-medicate and manage mental conditions.
  • Environmental factors – Environmental causes of addiction include aspects such as peer pressure, an unstable home environment, and a parent or family member with a substance use disorder.

However, anyone can develop a substance use disorder. Even if people are undergoing tramadol treatment for pain relief, they can still find themselves addicted.

Effects of Tramadol Addiction

Tramadol causes a variety of both long- and short term effects. Short-term effects of tramadol include anxiety and tremors, and it may trigger low blood sugar. Severe reactions also include liver failure and hepatitis. These reactions vary depending on how people metabolise tramadol, and some reactions are more severe than others.

Prolonged use of tramadol can cause damage to the liver, as that is where it is metabolised. The risk of developing a tramadol addiction also rises the longer somebody takes the drug.

Continuous tramadol abuse also rewires neuropathways within the brain. Tramadol elevates levels of the neurotransmitters dopamine, serotonin, and norepinephrine, and the brain adapts accordingly. When users stop taking tramadol suddenly, the levels of these neurotransmitters drop suddenly and people can quickly become depressed, anxious, and angry.

Serotonin Syndrome

Serotonin syndrome is a highly dangerous side effect of tramadol abuse in conjunction with selective serotonin reuptake inhibitors (SSRI). Serotonin is produced naturally by the body and helps the brain and nervous system communicate. However, an overload of serotonin can lead to extreme nerve cell activity, causing symptoms such as:

  • Confusion
  • Shivering
  • Vomiting
  • Changes in blood pressure
  • Agitation or restlessness

Serotonin syndrome can be a potentially life-threatening condition and can lead to complications including:

  • High fever
  • Fainting
  • Seizures
  • Coma

Signs of Tramadol Overdose

Taking high doses of tramadol can lead to overdose. Overdose can also occur if tramadol is taken with substances such as alcohol, as it can cause severe central nervous system depression. The symptoms of a tramadol overdose include:

  • Extreme weakness
  • Blue tinged lips and fingernails
  • Slow heartbeat
  • Loss of consciousness

Tramadol overdose can be prevented by taking tramadol only as prescribed. Never mix tramadol with any other substances and do not increase your dose without consulting a medical professional.

Treatment for Tramadol Abuse

For those who have developed a physical dependence on tramadol, addiction treatment may not be needed. Physical dependence is not the same as addiction, although people will still experience tramadol withdrawal when they stop taking it.

However, for those who are abusing tramadol, addiction treatment is a necessity. Addiction comes with many psychological symptoms as well as physical symptoms, which make it nearly impossible for people to stop alone.

There are multiple treatment options for people struggling with tramadol dependence.:

  • Inpatient treatment – This form of addiction treatment takes place in a specialised facility, with twenty-four-seven medical care. Inpatient treatment often takes several weeks to complete, with the client cut off from the outside world.
  • Outpatient treatment – Outpatient substance abuse treatment allows people to continue with their daily routines while receiving help. People are able to integrate lessons learned into everyday life and cope with triggers as they arise, and family and friends can be involved in treatment.

It is important to discuss treatment with your loved ones before making a decision. There is no universal treatment that works for everyone – what works for one person may not work for another.

Tramadol Withdrawal Symptoms

The first step in any treatment programme will be a medical detox to treat tramadol dependence physically. Even if people do not think they are addicted to tramadol, they may find that they experience withdrawal symptoms when they try to stop using it, including:

  • High blood pressure
  • Muscle pain
  • Insomnia
  • Restlessness
  • Stomach cramps
  • Vomiting
  • Sweating
  • Chills

Tramadol is a central nervous system depressant, and so when people stop taking it, they find that their nervous system begins to speed up again. This causes withdrawal symptoms such as high heart rate and rapid breathing.

If you stop taking tramadol and experience any of these withdrawal symptoms, it is vital that you seek help from a medical professional. Withdrawal symptoms can be life threatening in extreme cases, and seeking detox in a medical setting can reduce the risk of serious complications arising.

In treatment centres, they may use benzodiazepines to reduce withdrawal symptoms. Benzodiazepines are particularly effective for withdrawal symptoms such as anxiety, agitation, and restlessness.

Counselling and Therapy

Addiction treatment does not stop with detox. Drug use can come with a host of negative consequences, both physically and mentally, and therapy can help to treat the mental side. Many people who struggle with an opioid addiction can also have co-occurring mental disorders which are one of the causes of their drug abuse. Many programmes incorporate mental health services into their treatment plans, including:

  • Cognitive-behavioural therapy (CBT) – CBT helps people to interrupt their negative thought patterns and behaviours that may lead to drug abuse. Therapists help clients to develop new, healthy coping strategies to avoid drug use.
  • Group therapy – Group therapy provides a forum for other people in treatment to learn from each others experiences and learn interpersonal skills.
  • Support groups – Support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are available to

Aftercare is also a vital part of addiction treatment. It provides clients with additional skills and coping methods when support tapers down and they begin to phase out of the programme.


Tramadol is an opioid painkiller which many people consider not to be addictive. However, this is not true – although it is a milder opioid, it can still be highly addictive, and many people can also struggle with physical dependence.

The symptoms of tramadol withdrawal can be severe, and stopping tramadol use should never be attempted alone. Outpatient and inpatient treatment is available to help people through their addiction, targeting both withdrawal symptoms and the root causes of addiction.

The Revoke Programme provides intensive outpatient treatment for tramadol addiction and dependence. Drug addiction is a serious issue that nobody should go through alone.

Understanding Tramadol Dependency

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