Tramadol is a synthetic drug with an opioid component that is used to treat moderate to severe pain, such as following an accident or operation. It can also be prescribed to treat long-term or chronic pain if weaker painkillers are no longer working.

It is known by several brand names, including Invodol, Larapam, Mabron, Maneo, Oldaram, Tilodol, Tradorec, and Zeridame. The opioid part of the drug works like other opioids, by acting on pain receptors in the central nervous system and the brain to block pain signals. It also has other ingredients though, which inhibit chemicals in the brain associated with mood and responsiveness to pain.

Because it has lower opioid content than other strong painkillers such as morphine and oxycodone many people, including doctors, view it as safer. The opioid content can still be addictive though and the drug is often abused and used recreationally. As with other opioids, it can also cause overdose if used in larger amounts.

What Are the Risks of Tramadol?

As with any medication, there is a danger of side effects when you take tramadol. Feeling sick and feeling dizzy are very common side effects that affect more than one in ten people who take it.

Less common side effects (affecting more than 1% of people) include:

  • Headaches
  • Feeling sleepy, tired, dizzy, or ‘spaced out’
  • Feeling or being sick (nausea or vomiting)
  • Constipation
  • Dry mouth
  • Sweating
  • Low energy

And rare but potentially serious side effects affecting less than 1% of users include:

  • Feeling dizzy and tired with low energy – which can be signs of low blood pressure
  • Hallucinating
  • Feeling confused
  • Feeling very sleepy
  • Having trouble peeing or being unable to pee at all

These side effects can happen to anyone who uses tramadol, even the first time they use it. The risks can become greater for long-term or heavy users, especially if you are using the drug recreationally or taking more than the prescribed amounts.

The opioid part of the drug can lead to overdose. As with other opioids, this can affect parts of the brain responsible for breathing and an overdose can cause respiratory depression – meaning your breathing can no longer support you. This can lead to unconsciousness, coma, or even death.

Tramadol overdose can also cause seizures and other symptoms including extreme tiredness, slowed heartbeat, and weak muscles. The risks of using tramadol can also be increased when it is used with other drugs. Alcohol can also affect breathing, for example, meaning the effect can be worse and potentially dangerous if the two substances are combined.

Taking tramadol with some antidepressants can also lead to a condition known as serotonin syndrome. This is caused by too much of the chemical serotonin in the brain and can be very serious if left untreated. As well as relatively minor side effects such as confusion, shivering, and diarrhoea, severe serotonin syndrome can cause unconsciousness, irregular heartbeat, and seizures.

Long-term use of tramadol can lead to increased tolerance and addiction. As well as increasing all the risk factors outlined above, this can give rise to withdrawal symptoms when you try to stop and increase the risk of mental health issues like depression and anxiety.

Any addiction can have a knock-on effect on other aspects of your life, damaging families and relationships as the drug becomes a central focus.

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Why Are Prescription Drugs Addictive

Long-term use of tramadol can result in the user building up a tolerance to the drug, meaning they need more and more of it for the same effect.

At the same time, the brain comes to rely on the chemicals that the drug supplies and your brain chemistry changes to accommodate them. This can influence parts of the brain to do with pleasure and reward, as well as impulse control.

Using tramadol can also result in pleasurable sensations, including a feeling of euphoria, relaxation, and drowsiness. This can create a psychological addiction as users seek out these sensations. As tolerance builds, this can lead them to seek more and more of the drug or move on to stronger opiates to chase the effect.

Dr Lewis Nelson, a professor of emergency medicine at New York University’s Langone Medical Centre, told Live Science: “It would be great if you could dissociate the pain-relieving part of [opioids] from the euphoria-inducing part of [opioids], but you can’t. They’re inextricably linked.”

Signs of Tramadol Abuse

If you believe a loved one may have an issue with tramadol abuse, these are some of the signs to look out for:

  • Pinpoint (very small) pupils
  • Changes in appetite
  • Nausea or vomiting
  • Drowsiness
  • Slurred speech
  • Headaches
  • Impaired coordination

The list is not exhaustive though and the signs above could also have many different causes.

Symptoms of Tramadol Addiction

If you feel you cannot function without prescription drugs such as tramadol or feel anxious at the thought of coming off it, you may have a substance misuse problem up to and including addiction.

Typical signs are taking more regularly or in bigger doses, being dishonest with doctors to obtain more, and obtaining the drug through unofficial channels such as a friend’s prescription or buying it on the street. You may find you need to use more of the drug for the same effect and experience a range of withdrawal symptoms if you stop using tramadol.

Drug Detox and Therapy at Ocean Recovery

If you think you might have an addiction to tramadol or any other substance, drug rehab could be your way forward. This is the most effective way to treat addiction as you can undergo a medically supervised detoxification followed by an intensive package of therapies aimed at treating the psychological aspects of the addiction. You will also learn to develop coping strategies to deal with cravings and avoid relapse moving forward.

If you want to know more, contact us today for free and confidential advice on how to take the next steps towards a healthier, drug-free life.

Alternatively, you can email a member of our team at

John Gillen - Author - Last updated: December 22, 2023

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.

Dr Robert Lutaaya - Clinical Reviewer - Last reviewed: September 20, 2022

MBChB, MSc Psych

Dr Robert Lutaaya qualified in 1995 from Worclaw Medical University as MBChB, and obtained a MSc Psych from the University of Manchester in 2014. Dr Lutaaya has previously worked for the CGL Substance Misuse Service and as an on-call doctor substance misuse Doctor for 17 years before joining Ocean Recovery. Dr Robert Lutaaya is committed to helping those struggling with alcohol and drug addictions.