Tramadol is an opioid, and it can only be used with a prescription from a doctor.
MedlinePlus states that tramadol can be habit-forming. The risk of dependency and misuse goes up with long-term use. Chronic use can lead to addiction.
Pain is a public health concern that requires additional research and attention.
In September 2018, the U.S. National Institutes of Health published a report stating that up to 20 percent of Americans report feeling chronic pain.
In response to this health epidemic, pharmacists, doctors, and other experts have done whatever they can to soothe patients who truly need help. Though there are many ways to deal with chronic pain, opioids such as tramadol have been a lifeline for many who deal with debilitating chronic pain.
Despite its possible risks, the Substance Abuse and Mental Health Services Administration (SAMHSA) says prescriptions of tramadol rose 88 percent between 2008 to 2013. This was an increase from 23.2 million to 43.8 million prescriptions, respectively.
SAMHSA reports that the U.S. Drug Enforcement Administration (DEA) has been concerned about this increase in prescriptions of tramadol since 2011. More prescriptions make it easier for the public to get their hands on the drug, sometimes unintentionally.
Dependence With Medical Use
According to the Mayo Clinic, using opioids for any time period could lead to addiction. Various factors can make it easier for someone to depend on opioids and increase their odds of misusing them.
Opioids work by releasing endorphins — chemical messengers that produce a sense of well-being. Endorphins change the way the body perceives pain. Their invigorating feelings make it hard for people to deal with pain after their dose of opioids starts wearing off.
It is normal for patients to want to feel better, but the desire for a return of these good feelings is usually the first step toward abuse. Regularly taking opioids also leads to tolerance, and this encourages a person to take doses that are higher than prescribed.
If a person becomes tolerant of a medication, they will need a larger dose to continue experiencing its effects. In this case, they will need a higher dose of tramadol to manage their pain effectively.
As with other opioids, patients should not quit tramadol cold turkey. Instead, they should discuss their concerns with their doctor.
Depending on the level of use, the doctor may recommend a tapering schedule to stop taking the medication slowly.
How Tramadol Works
Tramadol is sold as a capsule, tablet, and extended-release tablet. Regardless of how it is taken, it works by blocking the reabsorption of two key chemical messengers: norepinephrine and serotonin. These neurotransmitters are known to induce relaxation.
A person begins to feel relief about an hour after taking the medication, and the feelings may last at least two hours more.
While tramadol is active, a person’s digestive system works more slowly, and this may cause constipation. There are other side effects.
- Constriction of the blood vessels
- Red eyes
The medication should only be used as directed. People should never crush or chew tablets or capsules. They should also never take more than what their doctor has instructed.
Who Is Addicted to Tramadol?
An exact number of people who are misusing tramadol is hard to come by, but SAMHSA relays the following statistics relating to tramadol and emergency room visits:
- In 2011, about a third of patients admitted to the emergency room for tramadol use were younger than 34. About 31 percent of patients were 55 or older.
- About half of tramadol users used tramadol along with other medication (pharmaceuticals), approximately 14 percent used it along with alcohol, and 12 percent mixed it with other drugs.
- Between 2005 and 2011, emergency room visits linked to tramadol rose about 250 percent, from 6,255 cases to 21,649.
NIDA provides a few illuminating statistics about the opioid crisis in general.
- An estimated 21 to 29 percent of people who have an opioid prescription use their medication recreationally at some point
- About eight to 12 percent of people with a prescription misuse their medication
- About four to six percent of people who misuse opioid medication move on to heroin use eventually
- Between July 2016 and September 2017, opioid overdoses increased roughly 30 percent in 45 states
As stated by NIDA, opioid overdoses are now considered a national crisis, with opioids of all kinds involved in the deaths of 130 Americans per day.
Along with tobacco, alcohol, and certain illicit drugs, prescription opioids are some of the most commonly abused drugs in the United States today.
How Opioids Trigger Addiction
Eventually, opioids cause the body to reduce their production of feel-good hormones such as norepinephrine and serotonin. Patients may be tempted to increase the dose they take on their own. They may ask their doctor to renew their prescription or authorize a refill.
Doctors know the risks of opioid dependency, tolerance, and misuse. A patient’s regular physician might deny their request.
Misuse may cause a patient to exhibit normal signs of addiction, such as doctor shopping, or searching for another physician who will give them an additional tramadol prescription.
As mentioned by NIDA, using opioids on a long-term basis can change the brain, affecting the reward center. Drugs cause a person to decrease their output of feel-good hormones on their own. After a while, the body will rely on the drug to function.
A person then stops being able to feel pleasure from activities they enjoyed in the past. Now, their brain only rewards them when they are using drugs. It is normal for a person to want to feel good, and they may change their habits to support their drug dependency.
Other risk factors for becoming addicted to tramadol are:
- Misusing the pills by chewing them, or crushing them and then snorting the powder, to feel their effects faster
- History of past drug or alcohol abuse
- Being surrounded by people who misuse substances
- Mental health issues that have not been addressed
- Family history of addiction
- Past legal problems or involvement in criminal activity
Women are also at higher risk of becoming addicted to opioids, as they are more likely to deal with chronic pain.
Risks of Buying Tramadol from Illegitimate Sellers
The Mayo Clinic states that some people who become addicted to opioids may decide to buy tablets or pills from online sellers or even dealers on the street. This puts them at risk of using counterfeit drugs or contaminated tramadol.
A fake tramadol pill may be cut with toxic substances or more potent drugs, such as fentanyl. This means the user has no idea what they are taking, and this could rapidly lead to overdose and even death.
Preventing Tramadol Addiction
A few steps can be taken to prevent tramadol misuse.
- Take the medication in the dose prescribed
- Use it only as intended
- Abstain from drinking alcohol while taking the medication
- Communicate with your physician about any other medications or supplements you take
- Avoid the use of illicit drugs along with tramadol
If you notice that you are becoming tolerant of tramadol, discuss this with your doctor.
Quitting tramadol cold turkey is dangerous, but your doctor may put you on a tapering schedule. This allows you to reduce your intake of tramadol without experiencing uncomfortable withdrawal symptoms. Your doctor may also discuss alternative pain management methods with you.
If you have been abusing tramadol, comprehensive addiction treatment is recommended. Otherwise, relapse back to substance abuse is likely.