Trust SoCal Treatment Center

Tramadol Addiction

Compassionate, evidence-based treatment for lasting recovery

Medically reviewed by Rachel Handa, Clinical Director — Updated February 1, 2026

Tramadol prescriptions in the United States exceeded 36 million annually before regulatory restrictions were tightened, and it remains one of the most commonly prescribed opioids worldwide.
The seizure risk associated with tramadol is estimated at 8 to 35 times higher than with other commonly prescribed opioids, according to multiple pharmacoepidemiologic studies.
Emergency department visits involving tramadol misuse increased over 250% between 2005 and 2019, reflecting growing recognition of its abuse liability.

Varies by treatment plan

What Is Tramadol Addiction?

Tramadol is a synthetic opioid analgesic that was initially marketed as a safer, less addictive alternative to traditional opioid painkillers. While tramadol is indeed less potent than oxycodone or hydrocodone, this characterization obscured its genuine addiction potential and unique pharmacological risks. In addition to its opioid activity, tramadol also inhibits the reuptake of serotonin and norepinephrine, giving it antidepressant-like properties that can create additional dimensions of psychological dependence. Tramadol was not classified as a controlled substance in the United States until 2014, meaning it was widely prescribed with fewer restrictions for years, contributing to widespread dependence. Its dual mechanism of action means that tramadol withdrawal can involve both opioid withdrawal symptoms and a distinct set of atypical symptoms including seizures and serotonin-related complications that require specialized medical management. Trust SoCal provides expert tramadol addiction treatment that accounts for the drug's unique pharmacological profile and associated risks.

Signs & Symptoms

Recognizing the signs of tramadol addiction is the first step toward getting help. Common indicators include:

Taking tramadol in larger doses or more frequently than prescribed, or continuing to take it after the prescribing condition has resolved
Experiencing mood elevation or a subtle euphoria from tramadol that extends beyond simple pain relief
Anxiety or agitation when a tramadol dose is due or when the medication supply is running low
Requesting early refills or obtaining tramadol from multiple sources including online pharmacies
Combining tramadol with other substances such as alcohol, benzodiazepines, or additional opioids to enhance effects

Health Effects

1Seizures, which occur at a significantly higher rate with tramadol than with other opioids, particularly at higher doses

2Serotonin syndrome, a potentially life-threatening condition when tramadol is combined with antidepressants, migraine medications, or other serotonergic drugs

3Respiratory depression and overdose, particularly when combined with other CNS depressants or in individuals with compromised liver function

4Chronic constipation, nausea, dizziness, and drowsiness that impair daily functioning

5Hormonal disruption including reduced testosterone and adrenal insufficiency with long-term use

Withdrawal & Detox

Tramadol withdrawal is clinically unique because it can produce two distinct withdrawal syndromes simultaneously. The opioid withdrawal component includes typical symptoms such as muscle aches, restlessness, diarrhea, sweating, insomnia, and cravings. The atypical component, related to tramadol's serotonin and norepinephrine reuptake inhibition, can include severe anxiety, panic attacks, hallucinations, paranoia, depersonalization, unusual sensory experiences (tingling, numbness, electric shock sensations), and, most critically, seizures. The seizure risk is particularly elevated during abrupt cessation and is not solely dose-dependent, occurring even at therapeutic doses in some individuals. This dual withdrawal profile makes medically supervised detox with a carefully managed taper essential for safe tramadol discontinuation.

Treatment at Trust SoCal

Tramadol addiction treatment at Trust SoCal is designed around the drug's unique dual pharmacology. Medical detox uses a gradual taper supplemented by seizure prophylaxis when indicated, along with symptom-targeted medications for both the opioid and atypical withdrawal components. Our physicians are experienced in managing the serotonergic complications that distinguish tramadol withdrawal from other opioid withdrawal syndromes. Following stabilization, clients engage in comprehensive behavioral treatment including Cognitive Behavioral Therapy, Motivational Interviewing, and chronic pain education for those whose tramadol use began with legitimate pain management. We develop individualized, non-opioid pain management strategies in collaboration with each client and, when appropriate, their outside medical providers. Aftercare planning includes ongoing pain management support and relapse prevention.

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Key Statistics

Tramadol prescriptions in the United States exceeded 36 million annually before regulatory restrictions were tightened, and it remains one of the most commonly prescribed opioids worldwide.

The seizure risk associated with tramadol is estimated at 8 to 35 times higher than with other commonly prescribed opioids, according to multiple pharmacoepidemiologic studies.

Emergency department visits involving tramadol misuse increased over 250% between 2005 and 2019, reflecting growing recognition of its abuse liability.

Related Addiction Types

Prescription Opioid Addiction

Prescription opioid addiction involves the compulsive misuse of medically prescribed pain relievers such as oxycodone (OxyContin, Percocet), hydrocodone (Vicodin, Norco), morphine, and codeine. These medications are among the most effective tools for managing acute and post-surgical pain, but they carry a profound risk of dependence that can develop in as little as five days of continuous use. The prescription opioid crisis in the United States was driven in large part by aggressive pharmaceutical marketing in the late 1990s and early 2000s that systematically understated addiction risk. Millions of patients who trusted their physicians developed opioid use disorder through no fault of their own. At Trust SoCal, we understand the complexity of prescription opioid addiction, including the fact that many individuals still require pain management while pursuing recovery. Our medical team designs personalized treatment plans that address both the addiction and the underlying pain condition using multimodal, non-opioid approaches whenever possible.

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Opioid Addiction

Opioid addiction encompasses dependence on prescription painkillers such as oxycodone, hydrocodone, morphine, and codeine. These medications are highly effective for managing acute pain but carry a significant risk of physical dependence and addiction, even when taken as prescribed. Opioids work by binding to receptors in the brain and spinal cord, producing pain relief and intense feelings of euphoria that drive continued use. The opioid epidemic has devastated communities across the United States, and effective, compassionate treatment is more critical than ever.

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Prescription Drug Addiction

Prescription drug addiction encompasses the misuse of and dependence on any medication obtained through legitimate medical channels, including opioid painkillers, benzodiazepine sedatives, stimulants such as Adderall and Ritalin, and sleep aids like Ambien. Because these drugs are prescribed by physicians and manufactured by pharmaceutical companies, many people underestimate their addiction potential and believe they are inherently safer than illicit drugs. In reality, prescription drug misuse is one of the most common and fastest-growing forms of substance use disorder in the United States. Treatment requires addressing both the addiction itself and the underlying medical condition that originally prompted the prescription.

Learn More

Recommended Treatment Programs

Medical Detox

A safe, medically supervised first step toward lasting recovery.

5-10 days

Residential Treatment

Immersive, structured care in a healing environment where recovery becomes your full focus.

30-90 days

Dual Diagnosis Treatment

Integrated treatment that addresses addiction and mental health together, not separately.

30-90 days

Aftercare & Alumni Program

Recovery does not end at discharge. We walk with you for the long haul.

12+ months of ongoing support

Therapies Used in Treatment

CBTCognitive Behavioral Therapy DBTDialectical Behavior Therapy EMDREye Movement Desensitization and Reprocessing MIMotivational Interviewing GGroup Therapy

Frequently Asked Questions

Is tramadol really an opioid?

Yes. Tramadol is a synthetic opioid that acts on the same mu-opioid receptors as other opioid painkillers. It was reclassified as a Schedule IV controlled substance by the DEA in 2014 after mounting evidence of its addiction potential and association with seizures and overdose deaths. While it is less potent than Schedule II opioids like oxycodone, tramadol produces genuine opioid effects, tolerance, physical dependence, and addiction in a substantial percentage of users.

Why does tramadol withdrawal cause seizures?

Tramadol's seizure risk during withdrawal relates to its dual mechanism of action. In addition to opioid activity, tramadol inhibits serotonin and norepinephrine reuptake, and sudden cessation can disrupt these neurotransmitter systems in ways that lower the seizure threshold. The seizure risk is compounded by the general neurological hyperexcitability that accompanies opioid withdrawal. This dual mechanism makes tramadol withdrawal distinct from other opioid withdrawals and underscores the necessity of medical supervision during discontinuation.

Can I stop taking tramadol on my own?

We strongly advise against stopping tramadol abruptly without medical supervision. The seizure risk associated with tramadol withdrawal is significant and can occur even at therapeutic doses. A medically supervised taper is the safest approach, allowing gradual dose reduction while monitoring for seizure activity and managing withdrawal symptoms. If you want to stop taking tramadol, please contact Trust SoCal at (949) 280-8360 or speak with your prescribing physician before making any changes to your medication regimen.

How is tramadol addiction treated differently from other opioid addictions?

The primary difference is that tramadol's serotonergic activity requires additional medical considerations during detox, including seizure monitoring and careful management of serotonin-related symptoms. The taper schedule may differ from that used for purely opioid drugs, and certain medications used in standard opioid detox must be used with caution due to serotonin interaction risk. Behaviorally, treatment is similar, focusing on CBT, relapse prevention, and addressing underlying pain or mood conditions that contributed to tramadol dependence.

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