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What is Tramadol?

Tramadol (Ultram) is used to relieve moderate to moderately severe pain. Tramadol extended-release tablets and capsules are only used by people who are expected to need medication to relieve pain around the clock [1]. It is in a prescription drug called opioid analgesics. It works by changing the way the brain and nervous system respond to pain.

Take this medicine only as directed by your doctor and do not take it for a longer time than your doctor ordered. It is very important that you understand the rules of the Opioid Analgesic REMS program to prevent addiction, abuse, and misuse of acetaminophen and codeine combination. Alcohol and Tramadol interactions combine the dangers of both and result in intensified consequences for the user.

In 2014, Tramadol went from being viewed as a drug of concern to a Schedule IV controlled substance by the US Food and Drugs Administration (FDA) [2]. Also, FDA recommends against the use of Tramadol in pregnancy. The use of tramadol with serotonergic medicines can increase the risk of serotonin syndrome. Tramadol serotonin syndrome can be a life-threatening emergency and should be managed in an acute care setting. 

Is Tramadol a Narcotic
People abusing Tramadol can experience uncomfortable and dangerous side effects when attempting to detox from the drug.

Is Tramadol an Opioid?

Tramadol is indeed an opioid, though its exact mechanism of action is slightly different than other opioids. In short, it acts on the brain to change how the body feels and responds to pain. In addition to attaching to opioid pain receptors, tramadol also inhibits the uptake of two neurotransmitters, serotonin-norepinephrine, which may add to its pain-relieving effects, although the exact mechanism in which it does this isn’t entirely clear. Tramadol is a controlled substance in all 50 states. 

Tramadol is structurally similar to other opioids, such as codeine and morphine, and can lead to dependence, tolerance, addiction, and withdrawal [3]. People with a history of substance abuse and drug-seeking behavior may be at a heightened risk of addiction, but people without prior substance abuse issues may resort to doctor-shopping or other illicit means to obtain tramadol. Persons who regularly use tramadol should not abruptly stop taking tramadol, as withdrawal symptoms can occur. If you have a prescription, consult with your doctor before discontinuing tramadol treatment, and do not discontinue treatment on your own.

Is Tramadol a Narcotic?

Most tramadol users are not aware of the drug’s specifications. Therefore, there is always confusion as to whether tramadol is a narcotic or not. The truth of the matter is that this medicine works like a narcotic but is not categorized as one. It is only referred to as “narcotic-like”.

Tramadol is not classified as a federal narcotic by the Drug Enforcement Administration (DEA) or the US Food and Drug Administration (FDA). Tramadol is placed in a class of medicines, which are categorized as opiate agonists. Having said this, there are certain states such as Virginia and Kentucky where this drug is classified as a narcotic.

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What Are Narcotics?

Also known as “opioids,” the term “narcotic” comes from the Greek word for “stupor” and originally referred to a variety of substances that dulled the senses and relieved pain. Though some people still refer to all drugs as “narcotics,” today “narcotic” refers to opium, opium derivatives, and their semi-synthetic substitutes. A more current term for these drugs, with less uncertainty regarding its meaning, is “opioid.” Examples include the illicit drugs heroin and pharmaceutical drugs like OxyContin, Vicodin, codeine, morphine, methadone, and fentanyl [4]. 

Tramadol Uses 

Tramadol is commonly prescribed to treat neuropathic pain and various disorders characterized by tender, painful, and stiff muscles. The medication is typically used to alleviate the pain that ranges from moderate to moderately severe, as well as that which is experienced following a surgical procedure.  

Tramadol has proved beneficial for those suffering ongoing (chronic) pain. The medication effectively works with the body’s central nervous system in order to relieve pain. Used for long-term treatment, this medication has been noted as potentially habit-forming, resulting in dependence in both a mental and physical capacity. Physical dependency can lead to a variety of Tramadol side effects, especially when discontinued. 

Is Tramadol a Narcotic
Tramadol is more addictive than many people believe. 

Tramadol Dosage 

Tramadol comes as a tablet, a solution (liquid), an extended-release (long-acting) tablet, and an extended-release (long-acting) capsule to take by mouth. The regular tablet and solution are taken usually with or without food every 4 to 6 hours as needed. The extended-release tablet and extended-release capsule should be taken once a day. Take the extended-release tablet and the extended-release capsule at about the same time of day every day. 

If you are taking the extended-release capsule, you may take it with or without food. If you are taking the extended-release tablet, you should either always take it with food or always take it without food. Take tramadol exactly as directed. Do not take more medication as a single dose or take more doses per day than prescribed by your doctor. Taking more tramadol than prescribed by your doctor or in a way that is not recommended may cause serious Tramadol side effects or death.

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Tramadol Side Effects

Tramadol oral tablet may cause drowsiness. You should not drive, use heavy machinery, or perform any dangerous activities until you know how this drug affects you. Tramadol may also cause other side effects.

More common Tramadol side effects

The more common Tramadol side effects can include:

  • Dizziness
  • Headache
  • Drowsiness
  • Nausea and vomiting
  • Constipation
  • Lack of energy
  • Sweating
  • Dry mouth
  • Itching

If these Tramadol side effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Tramadol side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious Tramadol side effects and their symptoms can include the following:

  • Tramadol Serotonin syndrome. Symptoms can include:
    • fast heart rate
    • high blood pressure
    • body temperature that’s higher than normal
    • reflexes that are stronger than normal
    • lack of coordination (control of your movements)
    • nausea and vomiting
    • diarrhea
    • agitation
    • hallucinations (seeing or hearing things that aren’t real)
    • coma
  • Serious breathing problems. Symptoms can include:
    • slowed breathing rate
    • very shallow breathing (little chest movement with breathing)
    • fainting, dizziness, or confusion
  • Physical dependence and withdrawal when stopping the drug. Symptoms can include:
    • feeling irritable, anxious, or restless
    • trouble sleeping
    • increased blood pressure
    • fast breathing rate
    • fast heart rate
    • dilated (large) pupils
    • teary eyes
    • runny nose
    • yawning
    • nausea, vomiting, and a loss of appetite
    • diarrhea and stomach cramps
    • sweating
    • chills
    • muscle aches, back pain, or joint pain
  • Adrenal insufficiency. Symptoms can include:
    • long-lasting tiredness
    • muscle weakness
    • pain in your abdomen
  • Seizures
  • Addiction or misuse of this drug

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Tramadol Abuse 

Tramadol abuse does occur, though, often by those who have never been prescribed the medication in the first place or those who started taking more of the drug to combat their building tolerances. This type of behavior can lead to several severe effects, especially as the result of tramadol abuse as opposed to the abuse of other opioids. This drug, in particular, can cause a severe withdrawal syndrome in certain individuals, which makes it potentially more dangerous than other drugs in its class.

Signs and Symptoms of Tramadol Abuse

According to the US Department of Health and Human Services, tramadol and other opioids like it “bind to receptors in your brain and body,” causing relaxation, confusion, and a decreased perception of pain. A person on large doses of the drug will often seem intoxicated and euphoric. 

Other signs and symptoms of tramadol abuse include

  • Sleepiness
  • Insomnia
  • Headache
  • Nervousness
  • Anxiety
  • Itching
  • Tightness of the muscles
  • Constipation
  • Heartburn or indigestion
  • Nausea
  • Vomiting
  • Dry mouth
  • Mood swings

A person who gets high on the drug often may swing back and forth between happy or excited moods and depression or anxiety. Because the drug causes such intense symptoms when taken in large doses, it is usually easy to tell if someone you know has been abusing it.

Someone can take a large dose of tramadol once without becoming immediately addicted, but there are other significant dangers associated with the abuse of this particular opioid. One should be very careful not to misuse their tramadol medication––or anyone else’s––under any circumstances.

Withdrawal Symptoms 

Long-term use can lead to withdrawal symptoms if a person suddenly stops taking tramadol. The symptom usually begins 6-12 hours after the last dose and lasts about 5-7 days. Detox centers and rehab programs can treat withdrawal symptoms and manage any medical complications. 

Tramadol withdrawal produces flu-like symptoms, which are typical of opioid withdrawal.

Common effects people may experience include: 

  • Nausea and vomiting
  • Diarrhea
  • Sweating
  • Anxiety, nervousness, and/or panic
  • Sleep problems
  • Cold chills (rigors)
  • Uncontrollable shaking (tremors)
  • Muscle, joint, and/or bone pain
  • Runny nose
  • Sneezing
  • Coughing
  • Hair standing on end

Withdrawal symptoms can pose mental and physical health risks. In some cases, these effects may be life-threatening. Some potential dangers of tramadol withdrawal include:

  • Severe depression and/or anxiety
  • Suicidal thoughts and behavior
  • Psychosis
  • Paranoia

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Tramadol Abuse and Addiction Treatment NJ 

Even if a user is experiencing mild withdrawal symptoms, it can still be beneficial to attend a professional detox center, outpatient treatment program, or inpatient rehabilitation facility. He or she can be monitored for any medical complications and lower the risk of relapse.

Detox Treatment in New Jersey Rehab Center

The first step in treatment is detoxification. It will help you navigate the complicated withdrawal process, but it doesn’t address patterns of thought and behavior that contribute to Tramadol abuse. Various treatment approaches and settings can help provide the ongoing support necessary to maintain long-term sobriety after you complete detox.

Cravings are very common during detox and can be challenging to overcome. This often leads to relapse. Constant medical care provided during inpatient treatment helps prevent relapse. Clinicians can provide necessary medication and medical expertise to lessen cravings and the effects of withdrawals.


Several different modalities of psychotherapy have been used in the treatment of depression, including:

  • Cognitive Behavioral Therapy (CBT) – is an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioral routines which are affecting the daily life of the depressed person for various forms of depression. 
  • Dialectical Behavioral Therapy – is a comprehensive mental health and substance abuse treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. The main goal of DBT is to help a person develop what is referred to as a “clear mind.” 
  • Person-Centered Therapy – is a strategy that allows and encourages clients to understand and resolve their concerns in a safe, supportive environment.

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Medication-Assisted Treatments

Medication-Assisted Treatments (MAT) for substance use disorders and mental health disorders are commonly used in conjunction with one another. This includes the use of medications and other medical procedures. During your rehab, the staff from your treatment facility will help you identify what caused your addiction and teach you skills that will help you change your behavior patterns and challenge the negative thoughts that led to your addiction. Sometimes, the pressures and problems in your life lead you to rely on substances to help you forget about them momentarily.

Now that we’ve answered the question, “is tramadol a narcotic?” It is important to always be reminded that Tramadol has the tendency of becoming a habit-forming drug. If you need help with a Tramadol addiction, seek help from trained professionals. Contact one of our helpful treatment specialists today. We Level Up rehab center in New Jersey can provide information on dual diagnosis and detox programs that may fit your specific needs.

Is Tramadol a Narcotic
Inpatient rehab is the highest level of care for Tramadol abuse treatment

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[1] NIH –

[2] FDA –

[3] WMC –

[4] DEA –