Tramadol is a centrally acting analgesic with a multimode of action. It acts on serotonergic and noradrenergic nociception, while its metabolite O-desmethyltramadol acts on the µ-opioid receptor. Its analgesic potency is claimed to be about one-tenth that of morphine.
Tramadol is used to treat both acute and chronic pain of moderate to (moderately) severe intensity. Tramadol monotherapy does not usually provide adequate analgesia. In chronic non-cancer pain, there is little evidence for the use of tramadol for more than three months.
Tramadol is considered to be a relatively safe analgesic. The main adverse reactions to tramadol therapy are nausea, dizziness, and vomiting, particularly at the start of the therapy. At therapeutic doses, tramadol does not cause clinically relevant respiratory depression.
Tramadol is contraindicated, however, in patients with diminished respiratory function.
Tramadol is used worldwide and is listed in many medical guidelines for pain treatment. It is mentioned as a step-2 analgesic in the WHO guidelines for cancer pain relief. Tramadol is also listed on several national essential medicines lists. Tramadol is a Schedule IV controlled substance.
Is Tramadol addictive?
Tramadol is generally considered a medicinal drug with a low potential for dependence relative to morphine. Nevertheless, tramadol dependence may occur when used for prolonged periods of time (more than several weeks to months). Dependence on tramadol may occur when used within the recommended dose range of tramadol but especially when used at supra-therapeutic doses. In many individuals with tramadol dependence, a substance abuse history is found.
Can tramadol get you High?
Orally administered tramadol can produce opioid-like effects (both mentally and physically) but these effects are mild and not produced following parenteral administration. Tramadol is generally considered a medicine with a low abuse potential relative to morphine, and this potential is associated with high dose oral tramadol. At supra-therapeutic doses and rarely at therapeutic doses, intoxications may occur.
Reports of people feeling energy and euphoria after taking large amounts of Tramadol are generally correct. The explanation for why Tramadol gives some people a boost in mood and energy level is because it affects the reuptake of serotonin and norepinephrine in the brain. Not all people who take Tramadol feel energized.
Doctors recommend that patients take no more than 50 mg of short-acting tramadol every six hours as needed, or 100 mg of long-acting tramadol per day when starting out. This amount may be increased as tolerances do. However, the max dose of the drug is 300 mg a day for the short-acting formulation and 400 mg a day for the long-acting formulation.
There is no exact milligram amount of tramadol that can cause an overdose. The amount of tramadol it takes to overdose depends on the person and is linked to both tolerance and genetics.
Tolerance means the amount of drug that your body is used to. For example, if you regularly take 50 mg of tramadol and suddenly increase to 400 mg, your risk for an overdose increases.
Symptoms of tramadol intoxication are similar to those of other opioid analgesics but may include serotonergic and noradrenergic components. Symptoms include:
- Central nervous system (CNS) depression
- Coma
- Tachycardia
- Cardiovascular collapse
- Seizures
- Respiratory depression up to a respiratory arrest.
Fatal intoxications are rare and appear to be associated with large overdoses of tramadol and co-ingestion of other drugs (including alcohol).
