Tramadol and Alcohol: A Potentially Fatal Combination

Tramadol is an opioid analgesic that is prescribed to treat moderate to severe pain. Often prescribed after an individual undergoes a serious surgery. It was first introduced in the US in the mid-1990s and has since become one of the top 25 most prescribed drugs in the country. Like other opioids, this medicine can be addictive and has been classified as a Schedule IV controlled substance by the Drug Enforcement Administration. With that being said, it’s important to take this prescription medication only as directed by your healthcare provider.

More About Tramadol…

Tramadol is a synthetic opioid that works to relieve acute or chronic pain by affecting the central nervous system (CNS) and changing the way that your brain responds to pain signals. It is most commonly prescribed for nerve damage, muscle spasms, or any other chronic condition that causes severe pain. It acts as a depressant to the CNS, often resulting in decreased respiratory rate, heart rate, and blood pressure. 

Generally, it is only prescribed when a weaker pain relieving medicine is not effective. Prescriptions for tramadol have become increasingly common since the start of the opioid epidemic. In fact, there was a 90% increase in just 6 years; from 2008-2013. You may be more familiar with tramadol when called by its brand names; ConZip; FusePaq Synapryn, and Rybix ODT to name a few. 

This substance is known to generally have a low risk of dependence, when compared to other drugs such as morphine. However, addiction can still occur when misused or taken for prolonged periods of time. This medication was not considered a controlled substance by the Food and Drug Administration until 2014 and is classified as a Schedule IV controlled substance by the US Drug Enforcement Administration. The National Survey on Drug Use and Health states that 1.5 million people misused or abused Tramadol in the year 2018. 

The Effects of Alcohol

In the United States, the number one abused drug is alcohol. The Substance Abuse and Mental Health Services Administration states that the majority of all substance use disorders in the United States involve the use of alcohol, whether by itself or in combination with other drugs. Like tramadol, alcohol is a central nervous system depressant, however, it operates on different neurotransmitters. 

Although it acts as a depressant to the central nervous system, alcohol can leave you feeling energized initially upon consumption. This is because it enhances the GABA neurotransmitter in your brain which helps to reduce anxiety and provides you with a calming effect. Additionally, it can affect your memory and cause several other common side effects may include drowsiness, impaired coordination, dizziness, headache, dry mouth, and low blood pressure. 

Drinking alcohol while taking any medicine can have several negative consequences. Although some do not consider alcohol to be a drug, this combination can have significant drug interactions. While some may make this mistake by accident, others may combine opioids and alcohol intentionally to create a stronger high. 

Risks of Abuse

Misusing and abusing either of these substances can be dangerous even when taken by themselves. When combined together their dangerous side effects can be quickened and far more enhanced. This will likely lead to physical and mental impairment, as well as an increased risk of overdose. 

When taken in combination, alcohol intensifies the effect that tramadol has on your central nervous system, putting you in more danger. Causing you to experience more severe side effects and issues such as the inability to concentrate, insomnia, drowsiness, dizziness, relaxation, euphoria, etc. There is no safe way to combine these two substances. Even if combined in very low amounts, the results can be very damaging and harmful, requiring medical attention. The National Institutes of Health warn that this combination can result in life-threatening side effects. Some of the more serious side effects that may occur could include serotonin syndrome, decreased respiratory rate, blackouts/loss of consciousness, and even coma in severe cases. 

In the United States, opioid overdose is responsible for at least 130 deaths per day. In most of these cases, the individual has more than just opioids in their system. Some experts say that the most serious risk of combining tramadol and alcohol is the risk of respiratory depression. This condition is also one of the most common signs of tramadol overdose. When you experience slow or shallow breathing your brain is only receiving a limited amount of oxygen, this is known as hypoxia. If the brain is deprived of oxygen for prolonged periods of time, permanent brain damage may occur. 

Additionally, long-term complications could include damage to the kidney and liver, addiction, mood instability, and mental health disorders. 

Alcohol Addiction & Opioid Dependence

Losing control over several if not all aspects of life due to drug use, although you’re aware of the negative consequences, is one of the signs that addiction has developed. Per the Diagnostic and Statistical Manual of Mental Disorders, an individual must meet 2 or more of the following criteria within a 12-month period in order to receive the diagnosis of an alcohol or opioid use disorder. 

  • Strong cravings or urges to use. 
  • Inability to cut back or quit.
  • Experiencing withdrawal symptoms upon any attempt to quit. 
  • Requiring larger amounts or more frequent doses to achieve the same effects due to a built-up tolerance to the drug. 
  • Taking higher doses of opioids or drinking alcohol more frequently than originally intended. 
  • Spends the majority of their time obtaining, using, and recovering from opioids and alcohol. 

Once an individual reaches physical dependence or becomes addicted to a substance it becomes increasingly difficult to stop using that substance, it will likely even become difficult to cut back at all. This is due to the feelings of withdrawal that one will experience when attempting to stop taking the drug. 

Symptoms of withdrawal from tramadol and alcohol can last for up to a week in most cases, ranging from uncomfortable to severe. Making it very discouraging and difficult to stop using on your own, it can even be considered dangerous. 

Frequently Asked Questions

The safest thing to do would be to wait until you can be sure that the tramadol is completely out of your system before consuming any alcohol. This could take anywhere from 6 to 50 hours, depending on the dosage and half-life.
Anytime that you suspect you have an alcohol or drug addiction, it is important that you seek help from a medical professional immediately. They will likely be able to recommend treatment programs that are most suitable for you. Some of which may include some type of behavioral therapy.
Respiratory depression, also known as hypoventilation, is a breathing dysfunction in which an individual experiences ineffective and slow breathing. Respiratory depression has the ability to cause brain damage due to the decreased amounts of oxygen that the brain is receiving.
Tramadol can induce seizures, even when taken at the recommended dosage. However, this is more likely to occur when taken at high doses or if the individual has a history of epilepsy.

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