Is Mixing Tramadol With Alcohol Safe? Tramadol Addiction Rehab


If you are taking a prescription Tramadol, you might think enjoying a few drinks at the end of a busy week is fine. After all, both substances are perfectly legal. However, the combination of even small amounts of Tramadol and alcohol can have a devastating effect on the body and mind and raise your risk of overdose. 

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Alternatively, you might be taking Tramadol recreationally and you’re adding the booze to heighten its effects, thinking it’s a safe way of getting a buzz. Unfortunately, you would be wrong. Here we explain why you shouldn’t mix Tramadol and alcohol, the effects the combination has on you, how to recognise when you have a problem, and how to stop taking both substances safely, successfully, and for good.

Mixing Tramadol with Alcohol Summary

  • Tramadol is a prescription painkiller and Class C party drug known as a ‘chill pill’, ‘ultra’, and ‘trammie’.
  • Tramadol and alcohol both target the central nervous system slowing down vital functions including breathing and heart rate. Together these effects can be enhanced, which means breathing and pulse rates can slow to dangerous levels.
  • Drinking even moderate amounts of alcohol while taking Tramadol can interact with the way the liver breaks the drug down and this raises your risk of seizures, overdose, and death.
  • If you are taking extended-release Tramadol, alcohol can speed up its delivery into your system which results in ‘dose dumping’ and this can overwhelm your body.
  • Tramadol addiction is subtle and can happen to anyone. There is no need to be ashamed; you just need to reach out for help.
  • Side effects of combining Tramadol and alcohol include being unable to think clearly and feeling dizzy and drowsy. Long-term abuse of both substances can lead to liver, kidney, and brain damage.
  • If you are abusing Tramadol and alcohol and then try and stop, withdrawal symptoms can be more severe, and psychiatric problems, including depression and anxiety, are more likely.
  • Having multiple addictions is harder to treat and your chance of relapse is higher than if you had just one. For this reason, residential rehab with its intense, 24/7 wraparound care is recommended.

Mixing Tramadol and Alcohol – the Side Effects and Risks 

Whether you’ve been prescribed Tramadol as a painkiller or you’ve been taking it for a bit of a buzz at parties, thinking it’s relatively safe, you might be surprised to find you can’t stop taking it. By adding alcohol into the equation – be that a glass of wine at dinner, or a few shots to enhance its feel-good effects – you are putting yourself in extreme danger. 

Tramadol is an opioid that attaches to proteins on nerve cells in the brain and blocks the pain messages the body sends to the brain. The main ingredient in alcohol – ethanol – also targets the brain. When Tramadol and alcohol are mixed together, each increases the toxicity of the other. 

Increased Sedative Potency

Both substances have sedative properties and target the central nervous system, slowing down its functions. This means combining the two can raise your risk of respiratory depression, which means breathing slows down to dangerous and even fatal levels.  

If you’re drinking because you’re in chronic pain and you’ve built up such a tolerance to Tramadol that it no longer has the effect it once had and you’re using alcohol to give it a boost, you could actually make the pain worse. You’re then stuck in a cycle of more pain and more substance abuse until it gets so bad you could be endangering your life. 

The Effects and Dangers of Combining Tramadol and Alcohol 

If you are taking Tramadol, even moderate amounts of alcohol can be dangerous due to the interaction between the two substances. Both substances are metabolised in the liver and alcohol can alter the absorption rate and distribution of Tramadol.  

This is most evident and dangerous in extended-release Tramadol which delivers the painkiller into your system gradually. Alcohol interrupts this pattern and accelerates the release which results in ‘dose dumping’.

Your body may not be able to tolerate such a  large amount of Tramadol flooding into your system at once, and this raises your risk of overdose. 

Tramadol and alcohol combined can add weight to the liver and reduce the liver’s ability to break Tramadol down and expel it from the body. This is especially important if you have already damaged your liver due to excessive alcohol. A damaged liver has even less function, and the double-pronged attack of booze and Tramadol can be overwhelming. 

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Effects of Mixing Tramadol with Alcohol

Mixing Tramadol and alcohol can make you a danger to yourself and others, especially if you are driving a car, operating machinery, or in charge of others. Psychological symptoms you may experience from mixing Tramadol with alcohol include: 

  • Being unable to think clearly
  • Reduced brainpower
  • Poor judgement and decision making
  • Being unable to concentrate 
  • Confusion
  • Memory problems
  • Paranoia
  • Unusual behaviour (ie shouting)

If you start taking Tramadol while having an existing alcohol addiction, or vice versa and you start drinking alongside a Tramadol addiction, it is a catch-22. People who abuse opiates and alcohol are less likely to be able to stop taking either substance, and people with opiate addiction are more likely to abuse alcohol.  

If you have a history of alcohol abuse you are at a greater risk of seizures when you take Tramadol. You need to be honest with your GP if offered an opioid prescription and ask for an alternative. You won’t be judged but the information could avoid you from becoming particularly unwell.  

How Do Tramadol and Alcohol Affect the Body? 

Drinking alcohol while taking Tramadol can have a damaging effect on the body. Physical symptoms include: 

  • Slow or difficult breathing 
  • Slower heart rate 
  • Lowered blood pressure 
  • Dizziness
  • Vertigo
  • Drowsiness
  • Reduced blood flow to the brain (hypoxia)
  • Loss of consciousness
  • Pain in the skull
  • Acute stomach problems
  • Seizures
  • Coma

Long-term abuse of Tramadol and alcohol can result in severe and sometimes irreversible and even fatal physical symptoms such as: 

  • Liver damage or failure
  • Kidney damage
  • Brain damage

Mixing Tramadol and alcohol can also result in atypical symptoms not listed above. As these are unpredictable and unexpected they can make your dual addiction difficult to identify and this can result in a delay in medical attention being sought. 

Tramadol and Alcohol: A Slippery Slope

Maybe you started taking Tramadol for pain and continued to enjoy a few glasses of wine at dinner. Perhaps you’ve been using Tramadol recreationally and love the heightened blissed-out feeling you get when you add a drink to the mix.  

However you’ve started using the two substances, you may find that Tramadol addiction has crept up on you. Everyone develops an addiction in a different way and it can be difficult to recognise you have a problem, and even more difficult to accept it.  

Substance abuse can be subtle. Here are the five stages that lead to addiction: 

Stage 1: Initial Use

You probably took Tramadol on doctor’s orders for pain or as part of your post-operative care and thought nothing of having a glass of wine at dinner. Alternatively, you bought it illegally on the street in clubs or on the hidden part of the internet called the ‘dark web’. 

You may have assumed that as it’s a class C drug, it was a much safer way of getting high than other opioids such as morphine or heroin. Then you had a drink and realised it made you feel even more chilled and happy.

Stage 2: Regular use:

This can be a bit of a grey area as everyone’s idea of ‘regular’ differs. While you could simply be following your Tramadol prescription, is your regular drinking once a night or once a week? One person’s regular is another person’s addiction.

This stage can be a wake-up call for many people who then stop. Maybe they feel the combination of Tramadol and alcohol is making them a bit foggy and they don’t feel as sharp as before. By stopping now they avoid spiralling into addiction.

Stage 3: Risky Use

Again, not everyone judges risk in the same way. You might think nothing of popping a Tramadol before your next dose is due if you’re in a great deal of pain. But that is risky. Reaching for the Tramadol the moment withdrawal symptoms kick in to avoid any unpleasant feelings is also risky.

Maybe you’re getting ready for a party and have more Tramadol and booze than normal as your usual amount doesn’t give you the same kick. Tolerance is a sign of substance abuse and taking more to achieve the same feelings is extremely risky. 

Stage 4: Dependence

At this stage, Tramadol or alcohol, or both, are at the forefront of your mind and you couldn’t imagine getting through the day without one, the other, or both. You are probably more spaced out and confused than you realize and this means you are a danger to yourself and others, especially if you’re driving or looking after children.

Stage 5: Addiction

Tramadol and alcohol have now taken over your life. They are in control of you and not the other way around. They govern your thoughts, mood, and behaviour and if they haven’t been done already, they will almost certainly wreak damage on your health, work, and relationships.  

 You may be in denial and not realise addiction is having an impact on your family until your partner leaves you, or that your health is suffering until you’re rushed to the hospital. You may not realise you’re taking too much until it’s too late and you overdose. 

The only route out of this is addiction treatment. Without help, 70% of people with substance problems get caught in the spiral of addiction, withdrawal symptoms, and relapse. This doesn’t have to be you. With the right help, you can be clean of substance abuse. 

If you have a dual addiction to alcohol and Tramadol you will find it very difficult to come off either or both substances without professional help and ongoing support.   

What Should You Do if You Take Tramadol and Alcohol Together? 

Firstly, don’t panic. You might not have realised that the two substances interact badly but rest assured that drinking a glass of wine while on a Tramadol prescription is not going to injure your liver overnight and give you brain damage.  

It could, however, heighten the effects of Tramadol and you need to be aware of that. Even if you’re drinking within the legal limit, you could be a danger on the road and it is unwise to drive. Mixing the two even in relatively small amounts will have an effect on your brainpower, memory, and ability to think clearly and this may negatively affect your work. 

If you are regularly abusing alcohol and have a Tramadol addiction you are in danger of seizures, respiratory failure, coma, and death. If you do try and stop taking them both the withdrawal symptoms will be severe as your body reacts to expelling both substances. If you stop for a while and then relapse, your system could be overwhelmed and you may overdose and die.   

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What is the Safest Way to Treat Alcohol and Tramadol Dependence?  

If you have a dual addiction, the chances of you completing treatment successfully is lower than if you only had one addiction. For this reason, the safest and most successful way to tackle your substance abuse is by moving into a rehab centre, which is like a hotel but as well as having all home comforts on tap there is also a variety of expert addiction treatment

Residential Rehab

At Castle Craig, we recognise that everybody is different and hence there is no one-size fits all approach, every one that comes through our doors has a personalised treatment plan created according to their needs. This can be tailormade to you and include a mixture of various therapies, one-to-one therapy, group therapy, and medically managed detox if necessary.

Not everyone responds to the same treatment and finding the right fit for you means you are more likely to complete Tramadol detox successfully and continue to be addiction free. 

Residential addiction treatment centres can monitor you 24/7 with medical support to manage the withdrawal process and minimise symptoms. Undergoing more than one detox at the same time means withdrawal symptoms will be more severe and are more likely to result in psychiatric symptoms which include depression, anxiety and stress. Constant care means you are never out of sight and this can prevent you from hurting yourself or others. 

Outpatient Treatment

While outpatient treatment can fit around your life, enabling you to stay in the family home or continue to work, it can make it difficult for you to deal with triggers – not just for a Tramadol addiction, but also for your alcohol use. With multiple addictions, the chance of relapse is 1.5 times greater than if you only had one. Residential rehab at Castle Craig will provide you with intense support that not only deals with the withdrawal process but helps you unpick why you developed these addictions in the first place.  

However, if you think an outpatient treatment programme would be best suited to you, then please contact our sister clinic CATCH Recovery for more information.

Help doesn’t stop when your stay ends. You receive ongoing care which can help you deal with triggers or protracted post-withdrawal symptoms. Contact our team today for free screening and support.

Tramadol and Alcohol FAQ

How Much Alcohol Can I Drink With Tramadol?

It is recommended that don’t drink alcohol at all while taking Tramadol.

Can I Have Just One Drink With Tramadol?

No. Even a small amount of alcohol can be dangerous while taking Tramadol.

I Forgot I’d Taken Tramadol Earlier and Now I’ve Had a Drink. What Should I Do?

Don’t panic but don’t think you are safe to drive a car or operate machinery. If you feel unwell, call 111.

I Have an Alcohol Problem but My Doctor Has Prescribed Me Tramadol. What Should I Do?

Firstly, let your GP know about your alcohol problem so you can receive help for this. Then ask if there is an alternative treatment that you can take.

How Long After Taking Tramadol Can I Drink?

Check with your GP as there are different types of Tramadol. However, even short-acting Tramadol can take days to leave your system.

Will Drinking While Taking Tramadol Kill Me?

There is always a risk of overdose if you mix Tramadol and alcohol. If you are mixing the two you need urgent addiction treatment.

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