The opioid epidemic has plagued the United States for years and overdose death rates have recently spiked, primarily due to the influx of synthetic opioids like fentanyl to the United States. However, opioid use disorders don’t always start with the use of street drugs like heroin or powerful drugs like fentanyl. It often starts with the use and abuse of prescription opioids. In fact, prescription opioid sales have quadrupled between 1999 and 2014. 

Prescription opioids, like tramadol, are used in the treatment of chronic pain, post-surgery pain, and to manage pain from injuries. The U.S. Centers for Disease Control and Prevention (CDC) notes that despite the dramatic increase in opioid prescribing, there has not been a notable decrease in the number of pain Americans report but addiction and overdose rates have skyrocketed. 

Though tramadol is a weak opioid compared to other options on the market, it still has a significant dependence and addiction potential. Even if used as directed, people can still develop a dependence to opioids. If you have a predisposition toward addiction or if you have a personal or family history of addiction, it’s important to monitor for tolerance and dependence closely while on a prescription. However, most opioid abuse disorders develop from misuse of prescriptions like using more than directed or taking larger doses that are appropriate. The spike in prescriptions has also increased the number of opioids that are shared with family and friends. 

Addiction is a serious disease. Learn how tramadol can cause physical dependence and addiction and how it can be treated.

What is Tramadol?

Tramadol is a synthetic opioid pain reliever that’s primarily used to treat mild and severe pain symptoms. It has a moderate onset of action (as little as 30 minutes but typically around an hour depending on the dose) but it can take up to two hours for users to experience peak effects. It’s relatively mild in terms of potency when compared to other opioids and it’s about a tenth as strong as morphine and on par with codeine. It’s as effective as morphine in mitigating moderate pain symptoms but it’s less effective when pain becomes severe.

Though it is a weaker opioid, it still has significant effects on the brain and body. Its primary effect is analgesia (pain relief) but it can also cause physical and cognitive euphoria, itchiness, constipation, nausea, cough suppression, decreased libido and sexual function, sedation, and anxiety. Unlike other opioids, it also causes stimulation due to unique neurochemical actions.

How Opioids Like Tramadol Work

Tramadol works on the brain in ways that are similar to other opioids with some unique additions. Like all psychoactive drugs, tramadol affects the brain’s chemical messaging system. Your nervous system passes messages to control everything in your body from your mood to your consciousness. Drugs interrupt this process by interfering or altering the way the messages are passed. 

Normally, your body produces natural opioids called endorphins that help you regulate and mitigate pain. Pain travels from nerve cell to nerve cell from the site of pain to your brain. Endorphins bind to the receptor in the nerve cell that help stop the cell from sending and receiving powerful pain signals. This helps you prevent seriously damaging injuries and teaches you to avoid painful scenarios.

Opioid drugs like tramadol are great at binding to the same receptors on the nerve cell and agonizing (activating) them. They stop pain messages from reaching the brain and help prevent psychological trauma because of serious pain.

Why Tramadol is Unique

In addition to being an opioid receptor agonist, tramadol is a serotonin-norepinephrine reuptake inhibitor (SNRI). It blocks the reuptake of serotonin and norepinephrine, which means it stops the process of removing and recycling chemicals from the brain, allowing a buildup that causes noticeable effects. 

Serotonin and norepinephrine are both feel-good chemicals that are essential for healthy brain chemistry. The presence or lack of serotonin has been linked to several psychological effects including cognition, mood, anxiety, and even psychosis. A healthy level of serotonin can help fight off depression and an increase of serotonin can lead to mood-lifting effects and psychological euphoria.

Norepinephrine causes you to feel energized and promotes wakefulness and alertness. It can also increase your heart rate and blood pressure. As an SNRI, tramadol can improve mood and has been investigated for the possible treatment of depression and fibromyalgia but has not yet been approved for those purposes.

What is Tramadol Addiction?

Long-term use of tramadol can cause you to build up a tolerance, dependence, and addiction to the drug. When your brain adapts to the regular presence of tramadol, dependence can lead to withdrawal symptoms for both opioid and SNRI effects. In some cases, opioid withdrawal symptoms are treated with antidepressants called SSRIs to combat psychological symptoms. However, in tramadol’s case, SSRIs can actually worsen or prolong SNRI withdrawal symptoms.

Addiction is now understood to be a chronic disease that primarily affects the limbic system of the brain and can have a negative impact on your physical, psychological, and social well-being. It’s difficult to overcome, especially on your own. Preventing and treating addiction is the key to avoiding serious consequences.

What are the Signs of Tramadol Addiction?

Tramadol addiction symptoms will follow some of the same patterns that other opioid addictions do with the added symptoms of SNRIs. Addiction is complicated and its signs and symptoms might be different from person to person, but there are a few common signs that you may be able to notice. 

If you have been using tramadol regularly for some time, pay attention to its relative potency. If you feel that it’s starting to lose its effectiveness or that you need heavier doses to achieve the same effects, you may be developing a tolerance to the drug. As your tolerance grows, your brain will start to adapt and counteract tramadol and your dependency on the foreign substance will grow. Cutting back or quitting can leave you with unbalanced brain chemistry and withdrawal symptoms.

Unlike other opioids, tramadol causes withdrawal symptoms that are associated with opioid receptor binding and the fact that it is an SNRI.  

How Dangerous is Tramadol?

Like most opioids, tramadol is relatively harmless if you take the appropriate dose and there are no added impurities. The biggest danger of the chronic use of the drug is the development of tolerance, dependence, and eventual addiction. If you are prescribed opioids and you use them for short-term relief only when you absolutely need them, you are not likely to have an issue with the drug. However, it is possible to develop an addiction to opioids like tramadol, even with routine use, especially if you have other factors that increase your addiction risk.

If you have a family history of addiction, a personal history with addiction, or a history with mental health issues, you should avoid opioids and ask your doctor about alternative pain-relieving options. Still, the majority of prescription opioid addiction comes from the following opioid abuses:

  • Taking doses more frequently than directed
  • Taking opioids longer than you should
  • Sharing pills with friends and family
  • Taking pills not prescribed to you
  • Doctor shopping to get prescriptions from multiple sources

Non-medical use of opioid prescriptions largely comes from sharing pills with friends and family and it accounts for 26 percent of illegal prescription opioid use. If you are prescribed pills and you don’t need them, don’t give them away, throw them away or flush them down the toilet. 

Tramadol overdose rates have increased in the past few years during the opioid crisis. It’s fairly unique as far as opioid overdoses go, in that they have the potential to cause seizures. In fact, there is even some debate as to the effectiveness of the life-saving, opioid overdose-reversing drug naloxone in stopping these seizures. One study suggested there is not enough evidence to show that naloxone would reliably stop seizures during tramadol overdose. This might have something to do with tramadol effects apart from the opioid receptor. Naloxone may kick tramadol off opioid receptors but it doesn’t stop its serotonin agonism, for instance.

Seizures typically aren’t deadly on their own but they can be in certain circumstances. They come on suddenly and can cause fatal accidents and injuries. They can also lead to medical complications, especially if you are susceptible to heart problems or high blood pressure.

Beyond the use of medically prescribed tramadol, there are additional dangers found in illicitly purchased opioids. Tramadol addiction can be expensive to maintain, which leads some users to turn to cheaper illicit alternatives like heroin. Illicit heroin use, especially involving intravenous injection, is linked to an increased likelihood of contracting an infectious disease like HIV and hepatitis. 

Illicit opioid use also increases your risk of an overdose. Illegally purchased opioids can be unpredictable and often includes fentanyl, which is cheap, easy to make, and way more powerful than other opioids. Even if you buy what appear to be tramadol pills, it can actually be fentanyl pressed into pills intended to look like prescription opioids.

Opioid addiction is a dangerous path and it’s difficult to escape on your own, even when it involves pills obtained from a doctor. If you feel you are becoming addicted or dependent on tramadol, call your doctor immediately.

What is Involved in Tramadol Addiction Treatment?

Opioid addiction is a significant problem in the U.S. and it may be among the most dangerous epidemics we’ve ever faced as a nation. Tramadol addiction and addiction to other opioids is notoriously difficult to overcome. There is no cure for opioid addiction but studies show that there are a variety of treatment options that can help lead you to long-lasting meaningful addiction recovery.

When you enter an addiction treatment program, you will go through an intake and assessment process that is designed to tailor treatment to your individual needs. You will be instrumental in creating your own treatment plan, which will allow your clinicians to address your needs and concerns throughout your treatment. 

You will also be placed in one of several levels of care based on your specific needs. The levels include:

  • Detox. Medical detox involves 24/7 medically managed treatment to help guide you safely through withdrawal symptoms. As you break your chemical dependence, medical professionals will help ease uncomfortable symptoms and avoid dangerous complications. This level is also necessary for anyone with other medical or psychological conditions of complications that require urgent assistance.
  • Residential Treatment. After detox, you may still have some medical concerns that need monitoring and continued care. In residential services, clinicians will monitor your health and well-being to avoid any complications as you work through your treatment plan.
  • Intensive outpatient. In the outpatient level, you will live independently but you will still have access to intensive clinical services. With nine or more hours of service each week, you will be able to get to the roots of your addiction and develop relapse prevention strategies for long-term recovery.
  • Outpatient. This is the lowest level of care in formal addiction treatment with fewer than nine hours of services each week. Though it’s low intensity, it’s an important step in before you complete treatment. You will be able to ease into an independent life while you continue to develop your strategies for relapse prevention. 

Tramadol Abuse Statistics

  • More than 19,000 deaths were associated with synthetic opioid overdose in 2016.
  • Males between 25 and 44 are the largest demographic of people affected by overdose.
  • Synthetic opioid deaths have doubled in 10 states since 2016.
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