What is tramadol?

Tramadol is a synthetic opioid analgesic (or painkiller) generally used to treat moderate pain. Learn more about Tramadol and what it is used for here.

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Tramadol is a synthetic opioid analgesic (or painkiller) generally used to treat moderate pain. This drug was first developed in the 1960s, but it wasn’t approved for human use in the United States until 1995. At low doses, it’s considered as equally effective for pain treatment as codeine. At high doses, it’s comparable to hydrocodone. In general, tramadol is considered less potent than morphine which has led some clinicians to believe it is less addictive than other opioids.

While tramadol was originally believed to be safer than other opioids, that assumption has since been called into question. Tramadol addiction is indeed possible, and it needs to be taken as seriously as other types of opioid misuse. 

Is tramadol a controlled substance?

When it was originally approved by the Food and Drug Administration (FDA), tramadol was not controlled. However, that status changed in 2014 when it was promoted to a Schedule IV drug. This came after years of reports of tramadol addiction caused by use and misuse. Its Schedule IV status means the drug has accepted medical uses and a relatively low potential for addiction compared to more potent Schedule II or III drugs

How is tramadol used?


Tramadol is still used today in both human and veterinary medicine, where it’s prescribed as a painkiller after injuries or surgeries. It’s most commonly found in pill form. When taken orally, its analgesic effects take about an hour to kick in and last approximately 6 hours. There are also slow-release formulations, which are meant to provide relief over a 24-hour period. 


Because tramadol was originally uncontrolled, it could easily be found sold under brand names, like Ultram®, or as the acetaminophen combination Ultracet®; it also came under generic labels. This wide availability made it an easy target for recreational use and led to tramadol addiction being relatively common. 

Recreational use of tramadol tends to match that of other opioids. It is used to relieve pain, induce relaxation, and produce feelings of happiness and contentment. In cases of misuse, the doses taken tend to be substantially higher than what is prescribed and can lead to dangerous side effects and overdose.

Signs + symptoms of tramadol addiction

In many cases, tramadol addiction starts after the drug has been medically prescribed as a painkiller. Patients may develop a reliance on the drug due to its relaxing or euphoric effects and wish to continue using it.

Eventually, patients will develop a physical dependence on the drug, and discontinuing its use will lead to uncomfortable and dangerous withdrawal symptoms. Once a person becomes dependent, it’s common for them to continue using tramadol to avoid withdrawal, even though they know it’s become a problem.

Tramadol addiction follows the familiar pattern of substance use disorder, including prolonged use past the initial prescription, eventual withdrawal from social or work activities, cravings, and spending a significant amount of time seeking the substance. Someone who can’t get tramadol may seek other opioids to satisfy their cravings.

Tramadol behaves much like other opioids in terms of effects and side effects. It can cause depressed heart and lung function, nausea, constipation, lethargy, dry mouth, stomach upset, and many other minor symptoms. In the case of an overdose, it can cause decreased awareness or loss of consciousness, lightheadedness, and a slow heartbeat. Signs of withdrawal to look out for include anxiety, aggression, tremors, hallucinations, depression, insomnia, and flu-like symptoms.

Evidence-based help for opioid use disorders

No matter the type, opioid use is a serious problem that demands a serious solution. At Ophelia, we get to know you first so we can provide personalized treatment recommendations, which may include Suboxone® or another form of buprenorphine-naloxone. All intake and maintenance appointments are held virtually, so you can meet with your care team in the comfort and privacy of your home or (parked!) car.

We work with insurance providers in a growing number of states and accept private pay patients to help people get the care they deserve.


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