What Is Tramadol Used For?

Tramadol is an opiate medication that alters the way people feel pain, providing relief for moderate to severe pain. Tramadol is the generic name of the pain reliever that’s included in brand name drugs like:

  • Ultram
  • Conzip
  • Rybix ODT
  • Ultram ER

Tramadol is a prescription-only pain medication that can be given as a tablet, extended-release tablet or capsule, and can be used as an around-the-clock way to treat pain. Tramadol is effective because it interacts with opioid receptors in the brain, suppressing neurological signals that create the sensation of pain. Some brand-name drugs with tramadol, such as Ultracet, also contain acetaminophen, which increases the effect of tramadol by simultaneously reducing other pain signals in the body.

Tramadol is an opioid medication, creating the potential for addiction and abuse. However, it is considered somewhat safer regarding its habit-forming properties and side effects when compared to stronger opioid medications, such as hydrocodone and morphine.

When the U.S. Food and Drug Administration (FDA) first approved tramadol in 1995, it wasn’t a controlled substance. There has since been increasing evidence of the potential for abuse and withdrawal side effects when someone stops using the medication. In 2014 it was classified by the Drug Enforcement Administration as a Schedule IV drug. This means that it’s federally controlled.

Tramadol Warnings

The FDA has a black box warning on tramadol, indicating that tramadol may be habit-forming, and carries a risk of addiction, abuse, misuse, overdose, coma and death.

People shouldn’t take tramadol if they’re suicidal or potentially at risk for addiction. Tramadol also isn’t meant to be prescribed to individuals who have problems with drug or alcohol abuse or severe breathing problems.

The consequences for misusing or abusing tramadol are dire: in 2011, an estimated 21,000 emergency room visits in the U.S. were related to tramadol.

What Are the Effects of Tramadol?

As with most opioids, there is a range of effects that can occur when someone uses this drug, both intended and unintended. Determining how to know if someone is on tramadol or if someone is using tramadol can come down to understanding these potential signs.

Tramadol may affect how someone acts or talks. It may cause difficulty holding a normal conversation and may cause drowsiness that seems out of place. Someone using tramadol may have impaired coordination and small pupils.

As with other opiates, there are also negative signs someone is on tramadol. Some of the potential adverse effects of this drug include:

  • Dizziness
  • Weakness
  • Drowsiness
  • Headache
  • Anxiety
  • Nausea and vomiting
  • Constipation
  • Itching
  • Sweating
  • Dry mouth
  • Diarrhea

These signs that someone is on tramadol aren’t the most severe potential side effects of this opioid. Taking too much tramadol can result in respiratory depression, in which the body has problems breathing. Using tramadol can also create a condition called serotonin syndrome; this most often happens when people combine antidepressants and tramadol simultaneously. Serotonin syndrome and respiratory depression are medical emergencies, potentially causing seizures, brain damage, coma and death.

Signs Someone Is Dependent on Tramadol

When someone is on tramadol and misuses it for an extended period of time, they may develop a psychological and physical dependence, making them unable to stop using tramadol without experiencing mental and physical distress.

If someone is psychologically addicted to tramadol, obtaining the drug has become a top priority for them, and their behavior reflects that. They will often start to lose interest in other areas of their life. They may start doing things like creating symptoms or doctor shopping to get more of the drug. Some users of tramadol may even do illegal things, such as forging prescriptions for tramadol. Psychological dependence on tramadol also often means that the person will continue to use tramadol even if they are experiencing adverse effects.

Physical dependence on tramadol involves changes in how the body functions. As someone continues to use tramadol, they build up a tolerance to it. They may increase the amount they take to feel the same effects or take it more frequently. This enhances the likelihood of an overdose occurring and makes it more difficult to stop using tramadol. Signs of a tramadol overdose can include:

  • Pinpoint pupils
  • Slow or labored breathing
  • Marked drowsiness
  • Skin that feels cold or clammy to the touch
  • Seizures
  • Loss of consciousness

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone, contact Web Poison Control Services for online assistance.

Physical dependence also generally means the person can experience withdrawal symptoms. When someone either stops taking the drug suddenly or takes a smaller amount, signs of withdrawal may be present. These withdrawal symptoms may be some of the first indicators a person is on tramadol and is abusing the drug.

Withdrawal symptoms of tramadol can include:

  • Abdominal and gastrointestinal pain and problems
  • Depression
  • Agitation
  • Ringing in the ears
  • Paranoia
  • Confusion
  • Hallucinations
  • General feeling of illness
  • Runny nose

When someone is misusing tramadol or is addicted to it, they need addiction treatment as anyone with opioid dependence would require. This often includes a medically supervised detox period followed by intensive therapeutic programs.

If you notice any of the signs someone is on tramadol and is struggling with the drug, it is important to contact a medical professional or an addiction treatment facility to determine possible options and next steps that can be taken.

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Benjamin Caleb Williams, RN
Benjamin Caleb Williams is a board-certified Emergency Nurse with several years of clinical experience, including supervisory roles within the ICU and ER settings. Read more

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Durbin, Kaci. “Tramadol.” Drugs.com, July 12, 2021. Accessed August 13, 2021.

Fauber, John. “Killing Pain: Tramadol the ‘Safe’ Drug of Abuse.” December 22, 2013. Accessed August 13, 2021.

O’Malley, Gerald F. & O’Malley, Rika. “Opioid Use Disorder and Rehabilitation.” Merck Manuals. May 2020. Accessed August 13, 2021.

O’Malley, Gerald F. & O’Malley, Rika. “Opioid Toxicity and Withdrawal.” Merck Manuals. May 2020. Accessed August 13, 2021.

Tanen, David. “Serotonin Syndrome.” Merck Manuals. May 2020. Accessed August 13, 2021.

U.S. National Library of Medicine. “Opiate and opioid withdrawal.” MedlinePlus, May 10, 2020. Accessed August 13, 2021.

U.S. Drug Enforcement Administration. “Rules – 2014 – Final Rule: Placement of Tramadol Into Schedule IV.” DEA Diversion Control Division, July 2, 2014. Accessed August 13, 2021.

Bush, Donna M. “Emergency Department Visits for Drug Mis[…]Medication Tramadol.” Substance Abuse and Mental Health Services Administration, May 14, 2015. Accessed August 13, 2021.

Centers for Medicare & Medicaid Services (CMS). “Opioid Oral Morphine Milligram Equivalen[…] Conversion Factors.” U.S. Dept. of Health & Human Services, January 1, 2020. Accessed August 13, 2021.

U.S. Food and Drug Administration. “Warning Letter: TramadolHub.” June 5, 2018. Accessed August 13, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.