Dependence on tramadol

Taking tramadol long-term can lead to dependence on tramadol or tramadol addiction. What’s the difference? We explore here, and inform you on how to treat tramadol dependence.

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Are you concerned about developing a dependence on tramadol?

Developing physical dependence on tramadol is a normal part of how tramadol works.  But are you worried you might be addicted to tramadol and wonder, “Can I just stop taking tramadol?” In this article, we’ll explore tramadol dependence vs. addiction to tramadol, and the different strategies used to treat both. Your questions about tramadol are welcomed at the end.

What is dependence on tramadol?

Tramadol dependence is a serious problem that occurs after taking tramadol regularly over time. While immediate release tramadol duration of action is only around 6-8 hours, you can start to need to take tramadol to feel “normal” after weeks of use. In other words, while tramadol is less habit-forming than many other opioids, taking tramadol long term or in high doses will cause you to develop a tolerance – the need to take higher doses for the same effects – and dependence. When you’re dependent on a medication you won’t be able to stop taking it abruptly without withdrawal symptoms. So how and why does dependence occur?

Long-term use of tramadol causes changes in brain chemical systems and circuits. In other words, the brain adapts to constant influx of tramadol by self-adjusting and “slowing down” some processes and “speeding up” some others. When you stop taking tramadol, or significantly lower tramadol dosage, the brain, which has become dependent on tramadol and has adapted to its presence, goes into “over drive”. This is why you go through withdrawal.

Tramadol dependence time: How long to be dependent on tramadol?

If you’re given tramadol for short-term pain relief, such as treatment for a minor injury, illness, or medical procedure, you won’t be taking tramadol long enough to develop a dependence. Typically, it takes about 3-4 weeks of continuous use for someone to become tramadol dependent. The longer you take tramadol and the higher the dose, the more likely you are to develop a dependence.

Dependence on tramadol symptoms

Although dependence on tramadol symptoms symptoms may seem frightening, they don’t necessarily indicate an addiction to the pain medication. Your body is simply used to having tramadol in your system. The main symptoms of a tramadol dependence are:

  1. needing larger doses for effective pain relief (tolerance)
  2. experiencing withdrawals when stopping the medication
  3. the physical need to take tramadol every day

Treating physical dependence on tramadol

How can you treat tramadol dependence? A physical dependence on tramadol can be unpleasant if you no longer need to take tramadol or don’t have a prescription for tramadol and can’t access more of the medication. However, the withdrawal symptoms from tramadol are usually milder than on other opioid medications. Doctors will treat a physical tramadol dependence by gradually lowering your dose over a period of days or weeks, so that your body can slowly adjust to not having the medication in your system. And we recommend that you always seek medical advice when considering treating physical dependence on tramadol.

Tramadol dependence withdrawal

Tramadol withdrawal is pretty unpleasant and can cause:

  • mood changes
  • insomnia
  • panic attacks
  • abdominal pain

The only way to treat tramadol withdrawal is ask for medical supervision from your prescribing doctor or a detox clinic. If you no longer want to continue taking tramadol, most experts recommend gradually decreasing your dosage until you can safely go off the medication. If this is not an option, you will eventually stop having withdrawal symptoms, but it can take days or weeks.

Tramadol dependence vs addiction

Tramadol dependence is clinically different from a tramadol addiction. An addiction to tramadol may present the same physical symptoms as dependence, but also comes along with psychological symptoms. These include drug cravings and compulsive tramadol seeking and use despite negative life consequences. You’re more likely to become addicted to tramadol is you’re taking it in a manner other than it would normally be prescribed – such as taking very large doses, or snorting tramadol rather than taking it orally.

Treating psychological dependence on tramadol

A psychological dependence on tramadol occurs when tramadol dependence crosses the line into addiction. If you’re psychologically dependent on tramadol, you will:

  • be unable to cope with stress or day-to-day life without taking tramadol
  • feel a compulsive need to use tramadol
  • feel strong cravings for tramadol
  • continue taking tramadol even if it has negative consequences

A psychological dependence on tramadol is much more difficult to treat than a physical dependence. You may need to see a therapist specializing in addiction, join a support group, or ask your doctor about medical interventions to help you break the cycle of tramadol addiction.

Tramadol dependence questions

Do you still have questions about tramadol? Are you unclear about the difference between dependence on tramadol and addiction to tramadol? We welcome all questions in the comments below and try to respond with a personal and prompt reply.

Reference Sources: ToxNet: Tramadol
NCBI: Withdrawal syndrome after long-term treatment with tramadol

FDA: Important Drug Warning – Tramadol
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. Been on tramadol 12yrs max per 24hrs was 400mgs 2yrs ago came down to 250mgs No withdraws was using codeine as well but stopped codeine just like snapping your fingers Now take 100mg at 5pm and 100mg at bed time about 11pm fast acting want to get off this evil stuff as Doctor said NON adictive he is wrong
    So what way should i to come off tramadol
    Stopped smoking and drinking bang like that 25yrs ago

  2. I’ve been taking Tramadol 50mgs x 4 a day for diabetic nerve pain in my feet. It’s the only thing that works. Doctor, after 10 years, wants me to get off Tramadol. From what I have been reading 200mg isn’t a lot, so I can probably wean off without issue. My doctor has tried Gabapentin, Lyrica…nothing works for my diabetic nerve pain…I think he’s running scared because he doled it out for 10 years with unlimited refills. The doctors have the biggest hand in this mess yet they want to tell patients, “NO MORE!” after years and tears of prescribing. Again, I feel like I can wean off pretty easily from only taking 200mg per day. I’m going to start next week going from 4 pills a day to 3 and so forth. Good luck to everyone!!

  3. I ve been taking tramadol for over 2 years now.and i ve now stopped taking it for 4 days
    i am experiencing some symptoms
    i ve now got body shaking
    feeling tiredness
    very high body temperature
    please what can i do because i really wants to stop taking it

    1. Hi Asante. I suggest that you consult with a doctor to help you plan an individualized tapering schedule. Also, call the helpline you see on the website to get in touch with a trusted treatment consultant who can help you find a rehab for you.

  4. I have been taking trammys for about 2+ years now I notice when I skip a few doses withdrawal kicks in and my knee pain comes back I don’t believe I’m addicted but dependant on it I also just found out that when I forget to take it I get a symptom of what one doctor told me was called the ZAPS of when I move my eyes or head quickly it’s like a buzz in my head a vertigo problem or equilibrium part of it I’m not to sure?….does anyone else get this symptom or just me?

  5. All of my family members are addicts and so I am desperately afraid of becoming one. I have had 5 back surgeries, the most recent being an SCS implant three weeks ago. I have been taking tramadol daily for about nine weeks now and since I am still recovering from the surgery and still have some back/leg pain, I occasionally need to take one or two a day. I often will wait until I am in excruciating pain before I will take one…..last night I waited until 2 a.m. until I just couldn’t take it anymore.
    My dose is 50 mg. I take between 50-100 mg. a day and am deathly afraid I am dependent on it. The main thing that makes me question this is that the the longer i wait to take it (put it off) my legs start aching. I don’t know if this is withdrawal symptoms or just my recovery/back issues amplified because I’ve waited so long.
    I am hoping you can put my mind at ease so that I stop torturing myself.

  6. HI I desperately need help for my 30 yr old son,he says he’s dependent on tramadol,all the Drs are fed up with him he has 400 tablets a month and only just gets through to the next prescription. He says he aching leg pain drives him mad and tramadol is the only thing that works. Gp gave him a number but the rehab people said this was not for him as he’s not an addict. I don’t know how to help or what to do,I’m frightened he’ll die. Please please advise. THANKYOU joycex

    1. Hi Mrs Joyce. First, I suggest that you download our free guide ‘How To Quit Opioid Painkillers’ to learn more about the quitting process here:
      Then, advise him to speak with a doctor to help him plan an individuaized tapering schedule. Also, you may call the helpline you see on the website to get in touch with a trusted treatment consultant who can help your son find the best rehab program for him.

  7. I have 17 years sobriety, using Tramadol twice a day 50mg
    For the last week, how long before it can become a problem
    Experiencing runny nose and eyes when I wake up in the morning, do I have anything to worry about ?

  8. Good day sir/madam. I took Tramadol for just only 2months 120mg and I have stopped Tramadol for 7weeks plus now completely without even taking any at all. I have experienced the withdrawal symptoms. Is as if I still feel high at times.

    Am feeling Yawning and feeling sleeping at times. My eyes feel weak most times. When will this come off my body system completely. I seriously don’t want to take it again

  9. I’ve benn on it for 15 years wen I ran out I was taking 9 a day but I’ve taken up to 25 in one 2010 I started having seizures because
    I was taking large amounts I cracked my skull broke my nose and 2 ribs…I haven’t taken that’s much per day since but I need it to feel normal and now I have none,my head is throbbing in 3d my entire body hurts and I’m sweaty then cold
    .Is there a place that will give me something tostop these withdrawal symptoms?

  10. i stopped taking tramadol 6 months ago and i can still not get the effects of alcohol anymore (buzz) have i got brain damage?! has anyone heard of this problem?

    1. Hi Tissy. For the relief of Tramadol withdrawal symptoms, over the counter medications can be helpful. Doctors usually recommend ibuprofen, acetaminophen or paracetamol to help with pain along with other NSAIDs (non steroidal anti-inflammatory drugs). You can also use temporary sleep aids and muscle relaxers that can help take care of the cramping caused by tramadol withdrawal. Flu and cold medication can also help treat general tramadol withdrawal symptoms. You can go to the pharmacy and ask the pharmacists there for help. I hope this helps!

  11. i stopped taking tramadol 6 months ago and i can still not get the effects of alcohol anymore (buzz) have i got brain damage?! im terrified!

  12. Hello Kelli. Don’t be embarrassed! No need. Do you still need tramadol for pain management? I’d suggest that you consult with your prescribing MD (sorry, you might not want to hear that) with full disclosure on the withdrawal. You’ll need to adjust dosing, or possibly eliminate it totally, under her/his supervision.

  13. I have been on tramadol for 5 to 6 years. My prescription has always been to take 50mg PRN. However, I had gotten to where I just normally took it four times a day. This past fall it got really cold here and I don’t know if that is why my pain increased dramatically but I started taking 100mg every six to eight hours automatically (with doc approval of course). I was just wanting to prevent the pain. Now it is nice and hot out and I recently started walking, heard that is good for pain. I stopped my tramadol abruptly. I have plenty of my script. I just didn’t realize how awful the withdrawl would be. I have had a headache for three days, didn’t sleep for two, I have been nausea and or felt like I had a brick in my stomach for three, and I have had incessant itching. Ok….so here is my question. What should I do? Start taking it regularly again, only just the fifty mg three to four times per day? Just to get it back in my system? And then maybe cut one of those out after a month or two? I really don’t want to have to go see my doc again. Pretty embarressed that I just stopped taking it in the first place. I seriously don’t know what I was thinking.

  14. Hello Richard. If you’re having a hard time stopping tramadol, I’d suggest that you consult with your prescribing doctor to first set up a tapering schedule or second, to seek a referral to a detox clinic. Sometimes, a combination of psycho and/or behavioral therapy and help you during withdrawal.

  15. Hello Rhonda. Hmmm. I’d suggest that you take this question to a pharmacist or your prescribing doctor. And let us know what they say!

  16. I am detoxing off tramadol. My last dose was 7 days ago so I know it is not in my system anymore so why are my pupils still pin point?

  17. Hello i have been taking high doses of tramadol for close to 10 years i recently went to the ER with side pains and also had heart flucuations, well they did tests and said i was healthy which i know i am not. My question is If long term tram Use can weaken muscles can it also weaken your heart enough to suffer a heart attack?

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