Tramadol (e.g., Ultram, Ultracet) is a prescription medication that addresses pain and works on the brain and body, much like a typical opioid. When initially marketed, it was promoted as having a low potential for abuse when compared to many other prescription opioids. Still, in recent years, an increasing amount of clinical evidence has suggested that this may not be wholly correct.
And although tramadol is less powerful than morphine, when abused, it can induce a high, meaning there is also a potential for further misuse, dependence, and addiction.
What Is Tramadol?
Tramadol is a prescription opioid painkiller that can be administered to patients to treat acute moderate-severe pain. Ultram, the brand name for Tramadol, is also available in an extended-release version, so it can also be used by individuals suffering from chronic pain who require 24/7 relief.
It’s administered orally, and health providers will often start patients on a low dose and gradually increase the strength if needed. As an opioid analgesic, tramadol works by decreasing activity in the CNS (central nervous system) and alters how the brain interprets and responds to pain. Tramadol is different than most other opioids because it also increases adrenaline and serotonin levels in the brain.
Common conditions that tramadol treats include migraines, back pain, nerve disorders, spinal stenosis, fibromyalgia, and osteoarthritis.
As noted, when tramadol was introduced initially, it was touted as a safer opioid option with a lower potential for abuse. However, in 2010, the FDA (Food and Drug Administration) and Ultram’s manufacturer modified the warning label for this medication, informing health providers not to prescribe it to persons at risk for addiction, thus implying some potential for abuse.
Physicians are urged not to prescribe tramadol to individuals with a history of substance abuse. It is not recommended for persons who may be suicidal or use certain other medications such as antidepressants or sedatives.
Due to concern about the potential for abuse, tramadol prescribing and usage patterns were monitored for several years after it was marketed initially. After three years, abuse rates were reported as fewer than two patients per 100,000—a tiny percentage, suggesting that tramadol misuse was not a significant concern.
However, despite early evidence that implied tramadol was not addictive, many health experts remained unconvinced because nearly all known substances that activate the brain’s µ-opioid (mu-opioid) receptors had ultimately been shown to be addictive.
In fact, in 2012, the National Survey on Drug Use and Health (NSDUH) reported that 2 million Americans aged 12 or older reported using tramadol for non-medical (recreational) purposes. In 2010, emergency room visits related to tramadol abuse had increased to nearly 26,000—over 2.5 times the number of visits in 2005.
For these reasons, in 2014, the DEA (Drug Enforcement Administration) classified tramadol as a Schedule IV controlled substance.
Can a User Experience a High?
As with any opioid, tramadol abuse can result in a high. There are several ways individuals seek to enhance the sought-after effects of tramadol, such as by chewing pills versus swallowing them, crushing the tablet and snorting, smoking, or injecting the residual powder, and taking tramadol in higher doses or more often than directed.
The effects can also be intensified when used in combination with another substance, such as alcohol or benzodiazepines. When an individual mixes tramadol with alcohol or another drug, it may amplify pleasurable feelings and increase the risk of dangerous and even lethal side effects, including perilously slow respiration and overdose.
When a person abuses tramadol using any of the methods mentioned above, they administer the drug into their system faster and at a higher concentration than directed, thus increasing the effects. One of the most common ways tramadol is abused is by insufflation (snorting), thereby enabling the drug to enter the bloodstream almost immediately. The side effects of snorting tramadol include breathing issues, hallucinations, seizures, cardiac arrest, or coma.
For patients who use tramadol as directed, less than 1% will experience a high, and instead, side effects may only include nausea or dizziness. Moreover, under normal circumstances, a tramadol high will not occur, and if an individual takes the medication exactly as prescribed, the chances of experiencing euphoria are unlikely.
Treatment for Tramadol Addiction
Treatment for tramadol abuse or addiction usually begins with medical detox, which helps individuals stop using tramadol as safely and comfortably as possible.
After detox, patients are urged to undergo long-term addiction treatment programs, which can also help address underlying mental health disorders, such as anxiety or depression. Just Believe Detox and Just Believe Recovery centers employ certified staff who specialize in addiction and deliver clinically-proven services, such as behavioral therapy, individual and family counseling, and mindfulness therapy.
Moreover, comprehensive, integrated treatment is the most effective approach to addiction. It provides individuals with the knowledge and tools they need to achieve sobriety, avoid relapse, and enjoy long-lasting happiness and wellness.