When people hear the word addiction, they usually think of things like marijuana, cocaine, heroine, alcohol, etc. If speaking in lighter terms they may think of chocolate, a certain Netflix series, shopping or scrolling social media. Addiction is defined as the “compulsive need for and use of a habit-forming substance…” A growing problem in the United States, that is bigger than many people realize, is substance abuse and painkiller addition. Some of these additions are responsible for an alarming number of deaths, including Tramadol (Ultram) a pain reliever that is similar to morphine and extremely addictive. (1, 2, 3, 4)
According to the American Society of Addiction Medicine, in 2016 there were over 2 million Americans age 12 and older who had a substance abuse disorder involving painkiller medications. Although not all deaths caused by drugs are tracked carefully, in 2017 the National Institute On Drug Abuse posted the following graphic to emphasize the rising problem of deaths caused by overdose in the past 17 years. (5) According to the U.S. Centers for Disease Control (CDC), Tramadol specifically is grouped with Fentanyl in the “Synthetic Opioids other than Methadone” category.
Image Source: NIH
When it comes to Tramadol specifically (along with Fentanyl) and the case of opioid/painkiller addiction and death, this graphic from the CDC also dictates how those numbers rose in 2013 and have only continued to rise.
What Is Tramadol & Why is It Dangerous?
Tramadol is a powerful synthetic pain reliever that falls under the category of opioids and narcotics. It is used to treat moderate to severe pain. It is often given to adults with severe, around-the-clock chronic pain because it can be administered in extended-release tablets. It works by binding to receptors in the brain that are responsible for alerting the body of pain. (6)
Side Effects of Tramadol
Blood in urine
Increased blood pressure
Increased heart rate
Professor Jack Crane, a former Northern Ireland State Pathologist and leading expert in forensic medicine, believes that Tramadol should be reclassified as a class A drug. This would put it alongside heroin and cocaine in how dangerous it is with potential for addiction and other side effects. “People seem to assume that Tramadol is safe because it is prescribed by doctors, but in my mind it is just as dangerous as heroin and should be reclassified as a class A drug,” he said.(7)
The Professor was prompted to publicly speak on the issue of Tramadol in 2017 after several tragic Tramadol-related deaths occurred in his beloved country of Ireland. It is estimated that in 2017 more people in Northern Ireland were killed by opiate-based drug use than were killed in car crashes.
The problem is not unique to Ireland, however. In the United States, drug overdose deaths caused by synthetic opioids including Tramadol, fentanyl and fentanyl analogs doubled between 2015 and 2016 from 3.1 to 6.2 per 100,000 people. (8)
Why Is Tramadol Addictive?
Besides providing effective pain relief, Tramadol also creates feelings such as:
Detachment from one’s body
These dual-acting benefits of Tramadol are due to its ability to increase availability of two neurotransmitter chemicals in the brain called neropinephrine and serotonin. These chemicals have been found to improve concentration, improve quality of sleep and also help relieve symptoms of depression and other mood disorders. (9,10)
Tramadol & Alcohol
What makes Tramadol particularly dangerous, is the fact that it can cause a lethal comatose state when mixed with alcohol. According to the book Drug Interactions: Analysis and Management, mixing Tramadol with alcohol enhances the effects of the drug and significantly increases the risk of dangerous side effects including breathing problems, decreased blood pressure and heart rate, organ damage and death. (9,10)
Side Effects Of Tramadol Overdose
The following are symptoms one may experience if they take more Tramadol than prescribed:
Reduced muscle tone
How Much Tramadol Is Safe?
Doctors generally recommend taking 50 to 100 mg every 6 hours. One should never increase their dose without first consulting with their physician. Although this dose is considered safe for most adults, for those likely to experience addictive feelings or behavior, it is possible that no dose is safe.
Important note for pregnant women: Tramadol is NEVER recommended for pregnant or nursing women as it can cause life-threatening side effects or withdrawal symptoms in newborns.
When taking any medication or drug it is important you understand the risks. Although in some cases, strong painkillers may be necessary to maintain quality of life. For most others, especially those with addictive tendencies, there are other options for managing pain that may be just as effective and less dangerous. If you are nervous that you may experience feelings of dependency or addiction to Tramadol or other drugs, don’t stay quiet about it. Let your physician know. He can either give you a different, less addictive medication or provide tools and strategies to keep you safe while taking Tramadol.