Tramadol, a Schedule IV controlled substance, is less potent than most other opioids and is thus often thought to be safe. Unfortunately, this couldn’t be further from the truth, and it’s not uncommon for people to underestimate the dangers of this drug. In reality, it carries the same risks as other opioids, including those of dependence, addiction, and tramadol overdose.
This article will discuss what causes tramadol overdose, how to recognize and prevent it, and other important information you should know if you or someone you love has been prescribed this medication.
What Is Tramadol?
Tramadol is an opioid prescribed for moderate-to-severe pain resistant to non-opioid pain medications. It is available in immediate- and extended-release formulations and comes in various forms, including capsules, tablets, and suspension.
Some brand names tramadol is commonly sold under include:
- Ryzolt®
- Ultram®
- ConZip®
As a synthetic opioid, tramadol differs from most other opioids in that it is created by combining opioids with monoamine reuptake inhibitors (MRI). Due to its dual mechanism of action, it is considered an atypical opioid; it works both as an opioid and a serotonin and norepinephrine reuptake inhibitor (SNRI).
Though relatively weak compared to other opioids, tramadol can still lead to tolerance, dependence, and addiction. Since extended use of the drug increases these risks, it is generally not recommended to take tramadol for chronic pain.
Tramadol Usage in the US
Here are some statistics that will give you more insight into the extent of tramadol usage in the United States:
- Tramadol was the fourth most commonly misused prescription painkiller in the United States in 2022, with 16.6% (around 1.4 million) of pain reliever misusers abusing tramadol products specifically.
- Around 15.4 million tramadol prescriptions were issued to just above 5 million Americans in 2021, making it the 41st most frequently prescribed drug that year.
- In 2021 alone, more than 70,500 Americans lost their lives to an overdose caused by synthetic opioids like tramadol.
- Any lifetime misuse of tramadol increased 3.75 times between 2002 and 2014, from 0.4% to 1.5%.
- With over 3,500 import shipments, the United States is the largest tramadol importer in the world.
Can You Overdose on Tramadol?
You can overdose on tramadol, even though it is among the least potent opioids. If you take more tramadol than your body can tolerate, a tramadol overdose is inevitable; if not treated promptly, it can be fatal. Tramadol misuse, i.e., taking tramadol in any other way than prescribed, significantly increases the risk of tramadol overdose.
The amount leading to a tramadol overdose depends on various individual factors, such as the method of consumption, metabolism, and opioid tolerance. Specifically, opioid-naïve people should be cautious when taking tramadol, as they face a higher risk of opioid overdose than those with a high tolerance to the drug.
You should carefully follow your doctor’s instructions and track your tramadol intake. If you miss a dose, skip it instead of trying to make up for it by taking a double dose, as this could lead to an overdose.
Is Tramadol Safe?
Contrary to popular belief, tramadol isn’t safe. Though it carries a lower risk for abuse, dependence, and addiction than most opioids and is thus classified as a Schedule IV controlled substance, it affects the brain in the same way as other opioids. Therefore, anyone taking it can become dependent. The risk of opioid dependence increases with prolonged tramadol use.
Furthermore, tramadol can cause various side effects, some of which may require immediate medical care.
Some possible tramadol side effects include:
- Nausea
- Vomiting
- Seizures
- Drowsiness
- Constipation
- Stomach ache
- Loss of appetite
- Allergic reactions
- Lightheadedness
- Difficulty breathing
Inform your doctor about any side effects you experience while taking tramadol, including those not mentioned in the list above.
Tramadol Overdose Signs and Symptoms
The signs and symptoms of tramadol overdose often look similar to those associated with other opioids. What makes it somewhat different, however, is that tramadol often induces seizures when taken in large doses.
Besides seizures, the most common signs and symptoms of tramadol overdose include:
- Blurred vision
- Pinpoint pupils
- Muscle weakness
- Cold, clammy skin
- Unresponsiveness
- Severe drowsiness
- Loss of consciousness
- Slow, shallow breathing
- Discolored skin, lips, and nails
Recognizing a tramadol overdose isn’t always easy, as it can look quite similar to medication side effects or a very strong “high.” Nonetheless, you should never ignore the signs of a tramadol overdose.
If you aren’t sure whether you or someone around you is overdosing, take a closer look at the pupils—small, constricted pupils characterize a tramadol overdose, whereas tramadol abuse typically enlarges them.
Seek medical attention as soon as you suspect you or someone around you may have taken too much tramadol, even if you aren’t entirely sure about it. Without timely medical care, a tramadol overdose can lead to coma, brain injury, and death.
How Does Tramadol Affect Your Body?
Tramadol affects the body by interacting with opioid receptors located in the central nervous system (CNS) to alleviate pain. Attaching to these receptors disrupts the transmission of pain signals between the body and the brain, altering the perception of pain.
As an atypical opioid, tramadol also hinders the reuptake of serotonin and norepinephrine. This means you should never mix it with serotonergic medications due to an increased risk of a potentially lethal serotonin syndrome.
Besides pain relief, tramadol also triggers a surge of dopamine, which improves your sense of well-being and induces euphoria. This enhances its potential for dependence and addiction, as people are naturally wired to repeat actions that release dopamine.
Moreover, repeated exposure to tramadol can cause your body to stop producing endorphins and increase the production of opioid receptors. Because of this, prolonged use of tramadol eventually leads to tolerance and dependence, even if you take your medication precisely as prescribed.
How Long Do Tramadol Effects Last?
Tramadol effects last between 4 and 24 hours, depending on the drug’s formulation, dosage, body weight, and other factors.
The effects of immediate-release tramadol begin within an hour, peak within 2–3 hours, and last for roughly 4–6 hours. On the other hand, extended-release tramadol gradually releases the medication into your system over 12–24 hours. Its effects usually peak at 10–12 hours following ingestion.
Risk Factors Leading to Tramadol Overdose
The main risk factors leading to tramadol overdose are low tolerance, tramadol abuse, and mixing tramadol with other substances.
Let’s look into each of these factors in greater detail:
- Low tolerance. The lower your tolerance to tramadol is, the smaller the amount of it you need to reach the tramadol overdose limit. Since not taking the drug reduces your tolerance, those who relapse are at an exceptionally high risk of tramadol overdose; if you relapse, even your typical dose may be potent enough to cause an overdose.
- Tramadol abuse. Taking tramadol for non-medical purposes and in other ways than prescribed by a doctor increases the likelihood of an overdose. You should never take it in higher doses or more frequently than instructed.
- Mixing tramadol with other substances. You should never take tramadol with other substances your doctor hasn’t approved of due to an increased risk of side effects, serotonin syndrome, respiratory depression, and overdose. This includes other opioids, muscle relaxants, antidepressants, alcohol, and even herbal medicines.
Tramadol Addiction vs. Tramadol Dependence
Tramadol addiction and tramadol dependence often occur simultaneously, but they aren’t the same; you can be dependent on tramadol without being addicted to it.
Specifically, tramadol dependence refers to the physical dependence people develop after taking the medication for a prolonged time. It is characterized by tolerance and opioid withdrawal symptoms that follow tramadol discontinuation.
In other words, once you develop tramadol dependence, your regular dose will lose its effectiveness, and you’ll need to rely on the drug to prevent withdrawal and function normally.
Treating tramadol dependence is of utmost importance, as it can turn into an addiction if left untreated. Tramadol addiction differs from tramadol dependence in that it is largely psychological; people addicted to this drug take it despite the toll it takes on their personal and professional lives.
Some common signs and symptoms of tramadol addiction include:
- Isolation from family and friends
- Preoccupation with obtaining and using tramadol
- Failure to meet personal and professional obligations
- Tramadol abuse, such as taking it more often than prescribed
- Inability to control tramadol use (e.g., multiple failed attempts at quitting it)
- Tramadol withdrawal symptoms in the absence of the drug or after cutting back on it
Tramadol Withdrawal Symptoms
Tramadol withdrawal symptoms are a set of physical and psychological symptoms that occur in people who quit this drug after developing tramadol dependence or addiction. The intensity of these symptoms ranges from one person to the next, with abrupt discontinuation of tramadol increasing the risk of severe withdrawal symptoms.
Tramadol withdrawal symptoms typically begin the first 24 hours after taking the last dose and last 5–8 days. However, their duration may vary based on the type of medication you take, how long you’ve taken it, and other factors. Some people continue to struggle with psychological symptoms, such as cravings, for months and even years after quitting tramadol.
Some of the most common tramadol withdrawal symptoms include:
- Chills
- Nausea
- Vomiting
- Diarrhea
- Body aches
- Mood swings
- Restlessness
- Stomach pain
- Tramadol cravings
- Sleep disturbances
- Increased sweating
As a dual-acting opioid, tramadol can sometimes cause atypical withdrawal symptoms, such as hallucinations, panic attacks, and psychosis.
Since tramadol withdrawal symptoms can be incredibly hard to bear and lead to potentially life-threatening complications like dehydration, you should never quit tramadol “cold turkey” or without medical supervision. Seeking professional help is the most effective way to minimize the risk of relapse.
Preventing Tramadol Overdose
The best way to prevent a tramadol overdose is not to take this medication in the first place.
If your doctor cannot suggest any non-opioid treatment alternatives, follow these practical tips to minimize the risk of tramadol overdose:
- Take your medication exactly as prescribed.
- Never take a double dose; if you miss one, simply skip it.
- Never increase your tramadol dosage without your doctor’s permission.
- If your current dose seems no longer effective, consult with your doctor.
- Do not mix tramadol with any other substances your doctor hasn’t approved of.
- If you suspect you’ve become dependent on tramadol, seek professional help.
ANR Treatment for Tramadol Dependence
Accelerated Neuro-Regulation (ANR) is a highly effective tramadol dependence treatment developed by Dr. Andre Waismann. As of today, this revolutionary has helped nearly 25,000 people around the world break free from opioid dependence and leave the fear of relapse in the past.
ANR is unlike any other opioid dependence treatment, as it is the first and only treatment designed to address the root cause of the problem rather than simply treating its symptoms. For this reason, ANR has a very high success rate.
ANR treatment works by re-regulating the endorphin-receptor system to its normal levels while the patient is sedated. By reversing the damage repeated opioid exposure causes to the CNS, it returns the brain to its pre-addiction state, thereby negating the risk of ongoing withdrawal symptoms and relapse.
Moreover, ANR is very safe, even for those with complex health conditions. Not only is it tailored to each patient individually, but it is also performed in an ICU setting of accredited hospitals by highly experienced board-certified medical professionals.
To get started with ANR, contact us for a free consultation today!
Key Takeaways
The bottom line is that tramadol is no safer than any other opioid. To reduce the risk of dependence, addiction, and tramadol overdose, take it strictly as prescribed.
Lastly, let’s go over the key points we covered today:
- Tramadol is a synthetic opioid with a dual mechanism of action prescribed to treat moderate-to-severe pain.
- Even though tramadol is a relatively weak opioid, it isn’t safe and can lead to dependence, addiction, overdose, serotonin syndrome, and other potentially life-threatening conditions.
- A tramadol overdose can manifest in seizures, pinpoint pupils, trouble breathing, loss of consciousness, and severe drowsiness, among other symptoms. If you suspect someone may be overdosing on tramadol, seek medical assistance immediately.
Tramadol Overdose FAQ
The maximum amount of tramadol you can take depends on the type of tramadol you take. You should never take more tramadol than prescribed, as this can lead to an overdose. Talk to your doctor if you aren’t sure how much tramadol you should take.
Tramadol can be life-threatening, especially when taken in large doses or mixed with other substances. As a dual-acting opioid, it can cause respiratory depression, serotonin syndrome, overdose, and even death, among other adverse effects.
The amount of tramadol leading to overdose varies from one person to another, depending on opioid tolerance, the method of consumption, metabolism, body weight, and other factors. Your doctor can help you determine how much tramadol you can safely take.
Tramadol can cause seizures even in low doses. Even though it is generally thought to induce seizures when taken in high doses, one report indicates that tramadol can cause seizures in doses as low as 75 mg/day.
Additional Information:
The Risks, Dangers & Effects of Mixing Tramadol and Alcohol
