Is Tramadol Addictive? Top 3 Signs to Watch Out For

Tramadol is an addictive drug. Between 2015 and 2017, 4% of all tramadol prescriptions were misused.[1] You may have heard that the drug is less addictive than substances like OxyContin. However, it’s still far from safe.

Full opioids like OxyContin work by latching to mu receptors in the brain. Pain signals lessen, and euphoria builds. Tramadol latches to mu receptors too, and it can trigger addiction issues that are just as intense as those associated with other painkillers.[2]

The U.S. Food and Drug Administration (FDA) approved tramadol for moderate-to-severe pain.[3] Someone using the drug per a doctor’s orders may not need your help. Spotting tell-tale signs of misuse can help you understand when to step in. Here’s what you need to know. 

3 Signs of Tramadol Addiction to Be Aware Of 

Is someone you love misusing tramadol? Looking for common addiction signs and symptoms may be helpful. While every person is different, strong drugs tend to cause a similar set of problems when they’re misused. Here’s what to look for:

1. Inability to Control Tramadol Use 

Tramadol is a prescription painkiller that is FDA-approved to treat moderate to severe pain.[3] Some people develop an opioid use disorder (OUD) while using the drug via a valid prescription. Others buy the substance from dealers and never visit a doctor at all. People in both groups can quickly lose control over how much they use. 

Opioids like tramadol work by latching to receptors within the brain and triggering intense euphoria. Some people keep using these drugs — despite the consequences — as they attempt to recreate the first tramadol high they experienced.[4]

As people keep using tramadol, their brain cells change. Pain signals grow stronger, so the drug seems less effective. Between doses, people feel uncomfortable and anxious. They may keep using the drug just to feel normal, not to get high.[4]

If someone you love has lost control of their substance use, they may spend all of your household money on drugs. They may stop going to work or school to spend more time using drugs or recovering from a binge. They may promise that they’ll quit yet keep taking tramadol. They are no longer able to moderate their use of the drug.

Using more tramadol than a doctor recommends is another sign of lost control. Most people take pills every day at the same time, and they’re told to swallow them whole.[3] Someone with a problematic relationship with tramadol may take pills more frequently or crush them to snort the powder and make them work faster. They may combine the use of tramadol with other substances to intensify its effects.

2. Doctor Shopping 

Doctor shopping is the practice of visiting multiple clinicians for the same purpose.[5] For someone with a tramadol misuse issue, going to many doctors or clinics can seem like a smart way to ensure a consistent drug supply. 

Many street drugs are made in illicit laboratories by people emphasizing profit over safety. They may use stronger substances (like fentanyl) in their pills to stretch out their drug supply. If their substitutions are too strong, they can cause an overdose.

In one study, over half of the people who bought street drugs said they noticed fentanyl within their purchases most of the time.[6] Some people may doctor shop to ensure their pills come from licensed labs and aren’t contaminated with other drugs like this. 

People who doctor shop typically struggle with other issues, such as mental health disorders and alcohol use disorder or dependence.[7] However, anyone with a persistent tramadol problem may lean on multiple providers and pharmacies to ensure they don’t run out of the drug. 

Doctor shopping is dangerous, as it can lead to large stashes of drugs. In some states, the practice is also illegal. In about 20 states, people can face jail time for visiting practitioners without disclosing that they’re seeing someone else for the same issue.[8]

Someone who is doctor shopping may seem unrealistically busy due to the multiple appointments required. That person may also have unusual spending habits at clinics, doctor’s offices and pharmacies. 

3. Experiencing Tramadol Withdrawal Symptoms 

With continued use, the body can develop tramadol dependence. Researchers say this issue can occur in anyone, including people using the drug as directed by a doctor.[9] When it happens, people can develop physical and mental health symptoms if they quit using abruptly. 

Common symptoms of tramadol withdrawal include the following:[10]

• Flu-like symptoms: Muscle aches, chills, headaches, nausea and vomiting are common in all opioid withdrawal symptoms. 
• Drug cravings: People may feel an overwhelming need to get and take more tramadol, even when they know the drug is causing them discomfort. 
• Mental health challenges: About 10% of people withdrawing from tramadol experience hallucinations, paranoia, anxiety, panic attacks and confusion. These symptoms aren’t common with other opioid withdrawal episodes, so they may seem unusual to less experienced doctors and treatment teams. 
• Unusual pain signals: Some people develop numbness and tingling in their fingers and toes. 

If you spot these signs in someone without a valid tramadol prescription, that person may be using drugs that were purchased from street dealers. Withdrawal is a clear sign of a misuse issue in these cases. 

If the person you love has a tramadol prescription, doctors should monitor those drugs to prevent withdrawal. Typically, doses are reduced slowly to help the brain adjust to sobriety slowly.[9] If someone develops withdrawal symptoms, that person could be using more than their doctor recommends or not following the treatment plan in some way. 

What to Do if You Notice These Signs 

Noticing that someone is misusing tramadol is just the first step. You must also take action to ensure the problem doesn’t get worse. 

The following steps can help:[11]

• Learn about the issue. Keep reading about tramadol, opioid misuse and OUD. The more you know, the better you can help the person you love. 
• Approach the person. Your loved one may offer excuses or rationalizations, especially when you open the conversation for the first time. Be prepared with specific examples of the behavior that worries you. 
• Be understanding. Substance misuse requires treatment. Don’t expect the person to quit tramadol without appropriate support from trained professionals. 
• Support your loved one. Tell the person how much you care about them. Offer to research their treatment options and go with them to appointments. 
• Connect during treatment. Stay in touch throughout the treatment process. Offer praise, encouragement, and support as the person works on recovery. 

Know you may need to discuss tramadol misuse several times before the person agrees to enter a treatment program. It’s uncommon for someone to immediately get help after one discussion. Every conversation you have can bring the person closer to that critical decision. It’s hard work, but it’s very worthwhile. 

MAT for Tramadol Addiction Treatment 

Medication for Addiction Treatment (MAT) is an effective way to treat tramadol abuse. Doctors combine medications like buprenorphine (Suboxone) with counseling to address both the physical and mental aspects of opioid misuse. 

Buprenorphine is a partial opioid agonist that can reduce drug cravings without producing intoxication or euphoria. It’s safe and effective when taken as prescribed. Some people use this medication indefinitely to reduce their relapse risks.[12] As long as it continues to support your recovery, you can remain on Suboxone or some other forms of MAT.

While MAT is effective, it’s sometimes difficult for people to access these programs and get started. Bicycle Health and our online MAT program were created to fill this need. 

When you work with us, you’ll meet with a trained doctor in a virtual appointment held on your phone or computer. You can then pick up your prescription for Suboxone at a local pharmacy. You can start treatment right away.

If someone you love is misusing tramadol or any other opioid, talk to them about Bicycle Health. Our program could help them to attain and sustain recovery safely, without sacrificing their privacy. Contact us to find out if this approach is right for the person you love.