While tramadol can be effective when used as directed under medical supervision, misuse of the drug poses significant dangers and side effects.[1] Misusing tramadol to get high can lead to physical dependence, the development of an opioid use disorder (OUD), overdose and health issues, such as liver damage, cognitive issues and serotonin syndrome.[2,3]
Tramadol works by binding to opioid receptors in the brain and throughout the body.[4] It also creates a high, or sense of euphoria, by inhibiting the reuptake of certain neurotransmitters like serotonin and norepinephrine.
This dual mechanism of action helps to alleviate pain and provide relief to people who are experiencing various types of discomfort. Because it also triggers the pleasure pathway in the brain, it can be dangerous as cravings for that feeling develop. Paired with physical dependence, this often prompts the development of OUD.[2]
Tramadol is available in various forms, such as extended-release pills, immediate-release pills and capsules.[5]
Yes, tramadol has the potential to produce a euphoric effect, which can “wake up” the pleasure pathway in the brain and trigger cravings to experience that feeling again and again.[2] The dump of “feel-good” chemicals in the brain can be addictive. With repeated misuse, OUD can form.
Some people argue that tramadol is not as addictive as other opioids since it has a weaker affinity for opioid receptors compared to other opioids like morphine or heroin.[6] This causes a comparatively milder euphoric effect, but that high is still possible.[7] The euphoria from tramadol use can also be more potent for people who are opioid naïve.
Some factors that contribute to tramadol misuse include the following:[1-3]
Some people misuse tramadol because it is more accessible than other opioids. Since it is often viewed as “weaker” than other opioids, such as oxycodone or hydrocodone, it can be easier to get a prescription for tramadol.
Tramadol misuse can lead to a range of risks and dangers, such as these:[1,2,8-13]
Once use of tramadol becomes compulsive, opioid use disorder is present. OUD involves intense cravings for tramadol, making it very difficult to stop using without professional assistance. Generally, Medication for Addiction Treatment (MAT) is recommended to treat OUD resulting from tramadol misuse.
If you’ve been misusing tramadol for a while, physical dependence has likely formed. This dependence also occurs with legitimate use if it is sustained. This means you’ll experience withdrawal symptoms when you stop using tramadol. The discomfort of withdrawal often prompts further misuse, fueling a cycle of drug misuse.
Misuse of tramadol can lead to an overdose, which can be fatal. Symptoms can include respiratory depression, low blood pressure, stroke or seizures. If the drug is combined with alcohol or other substances, such as other opioids or benzodiazepines, the risk of overdose is further increased.
Tramadol overdose is a medical emergency. Opioid overdose can be reversed with prompt administration of naloxone.
Continued misuse of tramadol can cause serious health issues, including liver damage, seizures and serotonin syndrome, which can be life-threatening. Tramadol misuse can also negatively affect mental health, leading to anxiety, depression and cognitive impairments.
Tramadol misuse, such as getting the drug without a prescription or distributing the drug illegally, may have legal consequences. Depending on the nature of the crime, penalties may include fines, rehabilitation and/or prison.
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 of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
