Tramadol is an opioid medication that is prescribed to help patients work through severe, acute, and chronic pain. As an opioid, it is also part of the Opioid Epidemic that has ravaged communities across the United States. Though often considered a milder drug than, say, Fentanyl, it can nonetheless be a gateway to harder drugs, including illicit opioids.

Despite its DEA classification as a Schedule IV drug, Tramadol is still a narcotic drug just like Heroin. It is addictive and patients are known to overdose using it. This page is designed to provide clear, helpful information for patients who have been prescribed this dangerous substance. While it does have benefits for patients in pain, there are also alternatives to try prior to obtaining a prescription for Tramadol. There are also simple safety measures to heed prior to accepting a doctor's prescription, such as insisting on a prescription for Narcan to fill along with the Tramadol pills.

What is Tramadol?

Tramadol is an opioid analgesic that is prescribed as an oral medication to treat mild to severe pain. It is in the same class as other opioid analgesics such as oxycodone, hydrocodone, and even fentanyl. Tramadol is available as either an immediate release or an extended release medication. The immediate release format takes full effect between 30-60 minutes then lasts for up to six hours. The extended release takes between one and two hours for full onset and then lasts for up to 24 hours.

Tramadol might be prescribed to ease the pain and discomfort that follows minor oral surgery or even more severe pain such as a broken bone. It can also be prescribed to treat chronic pain conditions such as lower back pain, myofascial pain, or osteoarthritis. Patients with chronic pain often use the extended release form of the drug for long-term relief.

Tramadol, like other opioid medications, is an addictive drug that has potentially severe side effects and detrimental drug interactions, especially with alcohol.

Common Side Effects of Tramadol

Tramadol is not a benign pain medication. It has many serious side effects that should be considered before taking this powerful drug. Though even prescribed doses will elicit side effects, there is increased danger when the dosage is exceeded or when Tramadol is mixed with other drugs, including alcohol.

Some of the side effects of Tramadol include:

  • Itchiness
  • Irritability and agitation
  • Anxiety
  • Constipation or diarrhea
  • Delusions and hallucinations
  • Tremors
  • Sadness
  • Blocked nasal passages
  • Drowsiness
  • Lack of focus
  • Profuse sweating
  • Addiction
  • Depressed respiration

The addictive properties of all opioids, including Tramadol, cannot be overstated. Users begin to develop a tolerance to these drugs quite quickly, and they may seek more intense effects. While delayed and extended release formulations are intended to address issues related to addiction, it is well known that addicts can find ways to work around these measures.

Further, one should not consider using alcohol on the same day as using Tramadol. Though the drug's literature may indicate that it should be clear of the user's system within a set time frame, there’s no need to take chances. It's also advised that you consult with a healthcare professional to learn about other drug interactions. Be aware that Tramadol can interact with over-the-counter medications and even herbs can cause a negative reaction if used while you are taking Tramadol.

Interactions of Alcohol and Tramadol

Alcohol is a powerful drug that is a part of most lives in the United States and the Western World in general. Thus, it's vital to understand how it interacts with medications. Patients should always be wary of drinking when taking any medication, including herbs or over-the-counter drugs.

Opioid medications, including Tramadol, pose a special risk and users should take great care to avoid drinking while using them.

Interactions between Tramadol and alcohol include:

  • Extreme sedation
  • Euphoria
  • Deep relaxation
  • Sleepiness
  • Vomiting
  • Depressed heart rate
  • Slow, shallow respiration
  • Loss of consciousness
  • Coma
  • Death

Note that the disorienting effects of both Tramadol and alcohol can result in unintended overdoses. Patients may become forgetful of how much of one or the other drug they have used and then take another dose. Elderly patients in particular are at risk for this sort of accident. They might even want to consider having a loved one help manage their pain medications or even liquor cabinet when they are taking opioids or any other drug that could have similar effects. Something as simple as a plastic pill organizer can save a life.

Alcohol Poisoning and Tramadol Overdose

Alcohol overdose, also known as alcohol poisoning, is a dangerous condition that is, unfortunately, normalized in many subcultures, particularly among teens and young adults. This malady is caused by the over-consumption of alcoholic beverages.

Symptoms of alcohol overdose include:

  • Memory loss (blackout)
  • Slurred speech
  • Loss of motor control
  • Loss of consciousness
  • Seizure
  • Possible coma and death

Tramadol overdose arises when users surpass their recommended dosage. This may be a particular danger when using the extended release form of the drug. If the user has developed a tolerance, they might be prone to forget when they initially took a dose, resulting in an accidental doubling-up of the drug.

Tramadol overdose symptoms include:

  • Unaware of surroundings
  • Lightheaded
  • Pinpoint pupils
  • Unusual sleepiness
  • Unresponsive
  • Loss of consciousness
  • Depressed heartbeat

When any of the above symptoms arise, contact 911 or drive the victim to an Emergency Room for immediate care. Another way to address an overdose is to have a prescription of Narcan, also known as Naloxone, handy. In fact, all patients should ask their doctor for a prescription for Narcan if they intend to fill a prescription for Tramadol. If the pain is not severe, patients might also request high doses of ibuprofen rather than an addictive, opioid medication, which have already killed thousands. Cannabidiol (CBD) also shows great promise for pain management and can be tried prior to opioids.


When Tramadol addiction sets in, it's important to address the issue and begin the process of withdrawing from the drug. Doctors may be helpful here. They can prescribe increasingly lower doses of the drug, eventually allowing patients to completely stop taking it with minimal symptoms. However, tapering off is often not an option for some, for whom the allure of a Tramadol high is too tempting. Furthermore, many might graduate from Tramadol to street opioid drugs, or stronger prescription drugs, especially if their prescription is well controlled.

When it's time to undergo detox, the following symptoms are common:

  • High anxiety
  • Deep depression
  • Insomnia
  • Hot/cold flashes
  • Achy muscles
  • Nausea
  • Irritability
  • Cravings
  • Restless leg syndrome


When an addicted patient overdoses on Tramadol, it should be clear that it's time to seek help. The immediate intervention should begin with a dose of Narcan (aka Naloxone) which will put an immediate halt to the overdose. This can be obtained with a prescription. In fact, all patients should request a Narcan prescription when their doctor recommends Tramadol or any other opioid medication. Narcan can be administered via an intranasal spray that anyone can provide, though they may need to provide multiple treatments as they wait for emergency medical services to arrive.

After the initial overdose emergency has been handled, patients can proceed to a medical detoxification clinic. There, they will be monitored by professionals and can receive proper medication, if needed. Detox clinics often are attached to rehabilitation facilities that offer detox patients the opportunity to visit 12 step meetings or otherwise begin long-term recovery.

Once detoxification is complete, patients usually receive recommendations for local rehab facilities. It's recommended that recovering addicts take this opportunity to continue their road to health and sobriety. When in rehab, recovering addicts will receive the counseling and knowledge they need to attain a lasting sobriety. Their families will also have an opportunity to heal, as addiction impacts the victim’s family as well, not to mention the wider society.