This guide explains the effects, trends, and dangers of Ultram use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for Ultram addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general prescription opioid use, which includes Ultram, hydrocodone, codeine, morphine, and other opioids.
|Derived From||Synthetic manufacturing|
|Ways Used||Ingestion, snorting, rectal use, injection, infusion|
|Scientific Name||Tramadol hydrochloride|
|Slang/Street Names for Ultram||Ultras, Trammies, Chill pills|
|How Long in Bodily System||Half-life: 5.1 hours
Ultram typically leaves the body in 1-4 days, but it may remain in the user’s system for up to a week in chronic users.
|Punitive Legal Measures: Using/Possession||In the United States, possessing Ultram without a prescription is a crime. If it’s the user’s first offense, the prosecutor may charge it as a misdemeanor, resulting in a fine of $1,000 and/or up to one year in jail. If it’s not the user’s first offense, the penalties are likely to be harsher.|
|Punitive Legal Measures: Selling/Distributing||Selling or distributing Ultram is a much more serious offense than merely possessing it. Depending on the state, it may be charged as a misdemeanor or a felony. An individual convicted of selling or distributing Ultram can expect a fine of as much as $100,000. Under certain circumstances, an individual convicted of this offense may be sentenced to 20 years in jail.|
|DEA Drug Rating||Schedule IV|
Like other opioids, Ultram changes the way the brain and nerves interpret pain signals. Not only does Ultram relieve pain, but it also slows down the user’s respiratory rate and creates a sense of calmness. When Ultram attaches to opioid receptors, it also increases the amount of dopamine in the brain, activating a circuit involved in reinforcing behavior. The brain views the pleasurable feelings created by Ultram as a “reward,” prompting the user to seek out opportunities to enjoy this reward again and again. Over time, the individual develops a tolerance for Ultram, which means they have to take higher doses to experience the same pleasurable sensations.
Ultram usage and abuse may not have any obvious signs at first. Once an individual develops an addiction or dependence on Ultram, however, several behavioral signs may appear. Mood swings, a loss of interest in pleasurable activities, problems maintaining relationships with friends and family members, and spending more time alone than usual are all signs that someone may be abusing Ultram. For working adults, Ultram abuse may make it more difficult to manage work-related obligations and family responsibilities. The individual may miss more days of work than usual, show up late for work on many occasions, or start behaving unprofessionally in front of colleagues and clients.
Behavioral signs of Ultram abuse are almost the same in adolescents as they are in adults. Any sudden change in behavior is cause for concern, especially if an adolescent suddenly wants to spend more time alone, breaks curfew, or starts behaving in a secretive manner. An adolescent’s grades may suffer due to missed homework assignments, poor grades on tests and quizzes, skipping school, or a lack of class participation. Adolescents who abuse Ultram may also end long-term friendships and start hanging out with new friends.
Once Ultram enters the bloodstream, it is metabolized into O-desmethyltramadol, a substance that affects an individual’s rate of breathing. Some people metabolize Ultram much faster than others, leading to a more significant effect on respiratory rates. The respiratory effects of Ultram can be dangerous for anyone who already has reduced lung function. For example, Tantry et al. published a case report on a patient who suffered severe respiratory depression when he was given tramadol to relieve pain following a surgical procedure. The man had to be intubated for about 10 hours before he could breathe on his own again.
Ultram starts working quickly, within 30 to 60 minutes of administration, producing a wide range of effects. Some of these effects are considered undesirable, while others put the user at risk for overdose.
|Short-term Physical Symptoms|
|Initial (direct effects of drug, 30 – 60 min.)||Drowsiness
|Lingering (within an hour of taking the drug)||Itchy skin
|Post-Use (several hours to days after use)||Constipation
Dependence (more likely with long-term use or at higher doses)
Ultram can cause dangerous side effects if mixed with alcohol or other medications. The American College of Cardiology warns that Ultram should never be mixed with alcohol, sedatives, narcotics, tranquilizers, antidepressants, medications used to treat anxiety, or medicines used to treat any mental health disorder.
Some users experience seizures while using Ultram, especially when taking higher doses than prescribed. Seizures are more likely to occur in people who have metabolic disorders, a history of head trauma, or a history of seizures. The chance of seizures also increases when Ultram is combined with muscle relaxants, narcotics, antidepressants, or medications used to relieve nausea and vomiting.
In some users, the chronic use of Ultram can lead to loss of consciousness. This loss of consciousness may be preceded by a seizure, resulting in the hospitalization of the user until he or she can be stabilized. Loss of consciousness increases the risk of injury in people who use or abuse Ultram. For example, someone who loses consciousness may break a bone or sustain a head injury.
|Long-term Physical Symptoms|
Including all of the above effects for casual use
Increased sensitivity to pain
Increased tear production
Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription opioid addiction.
According to the 2018 World Drug Report issued by the United Nations Office on Drugs and Crime, healthcare providers and law-enforcement professionals must “raise the alarm” about the dangers of tramadol addiction. Tramadol use is increasing all over the world, but the problem is especially pronounced in Africa. Tramadol addiction is now a crisis that affects many of Africa’s most vulnerable citizens, making it critically important for officials to find ways to divert this substance from non-medical users, while also ensuring that people with a legitimate need for pain relief have access to tramadol and other opioids.
Tramadol use is also increasing in the Middle East, partially due to increased rates of tramadol use in Africa. Drug traffickers smuggle tramadol to markets in various parts of Africa; from those markets, some of the supply is trafficked to Iran, Israel, and other countries in the Middle East. Much of this trafficked tramadol comes from Asian laboratories, although some of it is diverted from legitimate sources.
Law-enforcement officials frequently seize tramadol from drug traffickers, but the large supply of tramadol available has made it difficult to stop illicit tramadol sales. As a result, 68 tons of tramadol were seized in 2016. The amount of tramadol seized in African countries accounts for 87% of the total seized worldwide.
|Regions with the Largest Quantities of Tramadol Seized in 2016||North, West, and Central Africa||Middle East||Eurasia|
|Regions with the Highest Number of Prescription Opioid Users||North America||Australia and New Zealand||Europe|
*This table includes data from users of both tramadol and general prescription opioids like hydrocodone, morphine, and codeine.
Sources: 2018 World Drug Report
According to the 2016 World Drug Report, approximately 1.6 million individuals aged 12 and older admitted that they had misused tramadol within the past 12 months. This represents approximately 0.6% of the U.S. population.
Parents, educators, and public health officials are concerned about increased rates of prescription misuse among adolescents in the United States. The Monitoring the Future Study collected data by surveying students in the eighth, tenth, and twelfth grades. Students were asked if they had misused each drug or type of drug within the past year or at any point in their lives. In 2019, 14.6% of the students surveyed reported that they had misused some type of prescription drug at some point in their lives. When asked if they had misused narcotics other than heroin, 5.3% of the students stated that they had misused a prescription narcotic at least once. Tramadol is a narcotic-like substance, not a true narcotic, but the results of the study still demonstrate how important it is to talk with adolescents about prescription misuse.
|Past Year (2018)||Lifetime|
|8th grade (14-15 yo)||No data collected||No data collected|
|10th grade (15-16 yo)||No data collected||No data collected|
|12th grade (17-18 yo)||14.6%||18.6%|
Although Ultram is an effective medication, it has several side effects that are unpleasant or downright dangerous. The risk of complications increases once a user has developed a dependence on Ultram and must take higher and higher doses to achieve the same “high” that used to come from taking a regular dose. Users who are addicted to Ultram have an increased risk of overdose and sudden death, as Ultram depresses respiratory function and may cause seizures, especially in people who have a history of epilepsy and other chronic medical conditions.
To reduce the risk of withdrawal complications, the Ultram rehabilitation process aims to help the individual taper off Ultram, instead of stopping it suddenly. With medical supervision, individuals have a better chance of avoiding severe complications and staying sober. To learn more about this multi-step process, read our Ultram rehabilitation guide.
If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.
|1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.|
|2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.|
|3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.|
|4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.|
|5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.|