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Tapentadol Addiction & Misuse: Signs, Dangers & Treatment

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 14, 2023 • 8 cited sources

Tapentadol is a prescription painkiller sometimes sold under the brand name Nucynta. Doctors choose this medication to help people with acute pain that isn’t responding to traditional opioids like OxyContin.[1] 

Tapentadol is a unique painkiller that works in two ways. It’s an opioid agonist, so it latches to the same brain receptors used by drugs like Vicodin. But it’s also a norepinephrine reuptake inhibitor that works like an antidepressant. As researchers put it, the drug suppresses pain signals in two directions: both moving into the brain and down from the brain to the source of pain.[2]

Many people know that drugs like Vicodin come with hazards. If doctors prescribe these drugs, people may use them carefully. Tapentadol is less well known, and some people may not think it’s dangerous. But many people who start using tapentadol for pain develop misuse issues or addiction in time. 

Is Tapentadol Addictive? Why?

All opioids, including tapentadol, can cause opioid use disorder (OUD). The mechanism is well known.

Tapentadol crosses the blood/brain barrier, moving from the digestive tract to opioid receptors deep within the brain. Once there, it latches and triggers a series of complex chemical reactions, including dopamine release. This chemical makes people feel calm, cared for and relaxed. 

People in pain may feel relief due to some of these chemical changes. But people with no pain — and those with mild versions of pain — may notice the drug’s euphoria. They may seek it out and keep taking tapentadol to make it return. 

As brain cells become accustomed to tapentadol, they malfunction without it. Dopamine is no longer created as easily without drugs, leaving people feeling deprived and sad without it. In time, people may keep taking drugs just to feel normal. 

Researchers say tapentadol is associated with fewer addiction issues than other opioids.[2] But that doesn’t mean the drug is safe to use, misuse or take over the long term. 

Tapentadol Risks & Dangers

Like all prescription medications, tapentadol has several risks. If you get the medication from a doctor or pharmacy, you might be aware of the dangers. If you buy the drug from dealers, you may be misinformed. 

Common side effects associated with tapentadol include the following:[3]

  • Anxiety
  • Headache
  • Heartburn
  • Dry mouth 
  • Insomnia
  • Irritability 
  • Sedation
  • Stomach pain

Tapentadol’s dangers increase when the drug is mixed with other substances. Central nervous system depressants (such as sedatives, anesthetics or other opioids) are particularly dangerous.[4] These substances slow down breathing rates, just like tapentadol. Mixing them can lead to such seriously slowed breathing that your life is at risk. 

Main Risks Long-Term Users Face

While anyone can experience a bad side effect or dangerous drug interaction, people who keep using tapentadol have even more worries. The drug can cause two known problems in people who keep taking it for long periods. 


Using tapentadol for long periods means adjusting your brain chemistry levels. Eventually, cells won’t release important neurotransmitters like dopamine to adequate levels unless tapentadol is available. If you quit taking opioids suddenly, you may experience flu-like symptoms combined with deep drug cravings.

Researchers say tapentadol doesn’t cause severe withdrawal symptoms like other opioids do.[5] But if you’ve mixed tapentadol with other opioids, you could face significant withdrawal symptoms that make quitting difficult. And even mild withdrawal could be uncomfortable enough to push you toward relapse. 


Brain cells accustomed to tapentadol change their reaction to the drug. In time, you’ll need bigger doses to cause reactions once prompted by small amounts of tapentadol. If you take too much, you could experience an overdose.

Tapentadol is a central nervous system depressant that slows breathing. Very large doses can slow your breathing down so much that brain cells die. Without prompt treatment, you could die due to an overdose of this drug.

Signs & Symptoms of Tapentadol Misuse 

Even people who use tapentadol as directed by a doctor can become physically dependent on the drug.[6] Anyone who uses this medication should be on the alert for signs of misuse, as they indicate you’ll need treatment. 

Common signs of drug misuse include the following:

  • Frequent requests for drug refills
  • Taking doses closer together than the doctor recommends
  • Taking more of the drug than the doctor recommends
  • Feeling defensive about drug use
  • Secretive behavior regarding the prescription 
  • Poor performance at work or school due to intoxication
  • Feeling desperate or upset between drug doses
  • Declining performance in other areas of life due to drug use
  • Strained relationships with family and friends because of drug use

Researchers say the majority of people who misuse tapentadol inject the drug with a needle.[7] Someone who uses this method may have track marks on the arms or wear long-sleeved shirts at all times to cover up those marks. 

Researchers also say over 80% of people who misuse tapentadol also misuse other opioids, such as OxyContin or heroin.[8] Someone like this may experience severe sedation and multiple overdose episodes until they enter treatment and recover. 

How Does MAT Help?

Medication for Addiction Treatment (MAT) involves prescriptions like Suboxone (buprenorphine/naloxone) to amend brain chemistry changes caused by opioids like tapentadol. 

MAT can help you to move through withdrawal without feeling sick or experiencing overwhelming cravings. Medications can also help to keep your long-term cravings in check, so you can rebuild your life without distractions.

MAT is considered the gold standard of addiction care for people struggling to quit using drugs like tapentadol. And telemedicine lets you get the help you need in the privacy of your own home. Meet with a doctor via telemedicine appointments conducted through your phone, computer or tablet. Pick up your prescription at your pharmacy. Telemedicine allows you to get the addiction treatment you need discreetly and conveniently. 

Bicycle Health, a leading telemedicine MAT provider, is accepting new patients now. Contact us to see if this model is right for you. We can help you to get started on a life-saving medication like Suboxone.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Nucynta Prescribing Information. U.S. Food and Drug Administration. October 2019. Accessed April 2023.
  2. Tapentadol: A Real-World Look at Misuse, Abuse, and Diversion. Practical Pain Management February 2020. Accessed April 2023.
  3. Tapentadol. U.S. National Library of Medicine. October 2020. Accessed April 2023.
  4. Tapentadol: Can It Kill Two Birds with One Stone Without Breaking Windows? The Korean Journal of Pain July 2016. Accessed April 2023.
  5. Tapentadol Hydrochloride: A Novel Analgesic. Saudi Journal of Anesthesia July 2013. Accessed April 2023.
  6. Tapentadol. Health Direct. January 2021. Accessed April 2023.
  7. Tapentadol Abuse and Dependence in India. Asian Journal of Psychiatry. March 2020. Accessed April 2023.
  8. Tapentadol: The New Kid on the Block in India. Is It Time to Worry? Indian Journal of Psychiatry.,_the_new_kid_on_the_block_in_India__Is.12.aspx. November 2020. Accessed April 2023.

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