Overdose on Tramadol, What You Need to Know

Overcoming Tramadol Overdose Addiction

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Tramadol is a prescription-only medicine commonly used as a painkiller. It is also bought illegally as a recreational drug as it makes you feel relaxed and happy. Although you may be taking it with your doctor’s blessing, or because you think it is a safer opioid than heroin, it is possible to overdose on Tramadol.  

Here we explain the dangers of taking too much Tramadol, what to look out for if you think you or someone you know is overdosing, and how Tramadol overdose is treated. 

Tramadol Overdose Summary

  • Tramadol is an opioid prescribed for moderate to severe pain, sometimes for a considerable length of time. 
  • It is also bought illegally for recreational use and is known as a ‘chill pill’, ‘trammie’, or ‘ultra’. It is easily abused as it is considered to be safer than other opioids such as heroin.
  • As it is a common medicine, and a class C ‘soft’ drug, many people don’t realise that it can cause overdose, but Tramadol can be easily addictive and overdose is possible.
  • Tramadol targets the central nervous system and too much of it can lead to breathing problems, reduced heart rate, seizures, and death.
  • You can increase your risk of overdosing on Tramadol if you mix it with other drugs – even an everyday cough and cold medicine – as well as alcohol.
  • Physical symptoms of Tramadol overdose include long gaps between breaths, sweating, and tiny pupils, while psychological symptoms include hallucinations, confusion, and paranoia.
  • Tramadol overdoses are on the rise.
  • If you think you or someone you know is overdosing on Tramadol, you need to call 999 urgently. Delaying could result in coma, brain injury, and death.
  • Treatment for Tramadol overdose depends on your symptoms as not everyone presents in the same way.
overdose on tramadol

Am I at Risk of Overdosing on Tramadol?

Tramadol targets the central nervous system slowing down its functions, including lung and heart behaviour. This means your breathing can be slower and your heart rate and blood pressure can be decreased.  

It also binds to the opioid receptors in the brain, blocking feelings of pain and releasing feel-good chemicals called dopamine which make you feel blissed out, relaxed and happy.  

You may find it hard to believe that you can be in danger of overdosing on a prescribed painkiller, or a class C party drug, especially one that is considered to be relatively weak. However, if you take Tramadol outside of a prescription or take more Tramadol than dictated (maybe your pain is so severe you feel you can’t cope without another pill), you can overdose. 

Because of the assumption that Tramadol is safe, opioid abuse is common. Those most at risk of Tramadol addiction are people with easy access to the drug (either having it prescribed or buying it illegally), those with a history of substance abuse, patients with chronic pain who rely on Tramadol to get through the day, and health professionals (who have easy access to it).  

You are at risk of overdosing on Tramadol even if you are undergoing Tramadol detox. The withdrawal process can be unpleasant and without proper help, relapsing is common. If you’ve stopped taking Tramadol for a period of time and then restart, your tolerance will be lessened and you raise the chance of overdose. 

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Tramadol addiction can happen to anyone so don’t be ashamed – you just need to ask for help. Fortunately, there is plenty of Tramadol addiction treatment available. 

What are the Signs and Symptoms of a Tramadol Overdose? 

A tramadol overdose can be difficult to recognise, especially in someone who has never touched an illegal drug in their life and has no history of substance abuse. Although there are multiple symptoms, they are not always present all the time. 

If you are aware that someone is taking more Tramadol than usual, their prescription has run out early, they’ve been asking where they can get more Tramadol or you’ve seen them at a party popping pill after pill, they are abusing Tramadol and could be in danger of overdose.  

If this is you, you need to be honest with yourself and accept that you have a Tramadol addiction and need urgent addiction treatment to manage any withdrawal symptoms safely and come off Tramadol for good. 

Signs of Tramadol overdose include: 

  • Slow and shallow breathing 
  • Irregular heartbeat
  • Extreme drowsiness
  • Slurred words
  • Unusual behaviour (eg shouting)
  • Confusion
  • Paranoia
  • Tiny pupils 
  • Cold, clammy, or discoloured skin
  • Feeling weak
  • Nausea and vomiting
  • Dizziness
  • Hypothermia
  • Purple or blue lips and nails
  • Hallucinations
  • Loss of consciousness
  • Rigid muscles
  • Seizures

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Tramadol overdose does not always present in the same way as other opioid overdoses (such as heroin), which usually results in slurred speech, drowsiness and sweating. A tramadol overdose can sometimes cause serotonin syndrome, which is when the levels of brain chemical serotonin are raised, and this can result in seizures. It can also alter your mental state which leads to confusion and hallucinations. 

What Happens During a Tramadol  Overdose? 

The first sign of a Tramadol overdose is often psychological and results in unusual behaviour. A 27-year-old woman who was on Tramadol for headaches was ‘shrieking’ in her room when her parents found her. She was confused and unable to recognise them. Aside from pinprick pupils, a fast heart rate and tremors, she had no other signs of a Tramadol overdose.  

Another example is a 45-year-old woman who was taking increasing amounts of prescription Tramadol to deal with migraines and overdosed. Her symptoms were paranoia, visual and aural hallucinations and tremors with twitching lips and jaw muscles. She had no other symptoms of Tramadol overdose. 

In many cases, a Tramadol overdose can result in severe physical side effects such as seizures and respiratory depression, which means breathing slows down to dangerous and possibly fatal levels. For this reason, action needs to be taken at the first sign of an overdose to ensure medical attention can be received before it’s too late. 

What Should You Do if You Think You Are Having (Or Witnessing) a Tramadol Overdose? 

If it is you, dial 999 or ask someone else to do it. Be honest about how much Tramadol you’ve taken and whether you’ve combined it with another drug, or alcohol. The medics aren’t going to judge you but without the right information they can’t treat you properly, and time is of the essence. Any delay could result in life-threatening seizures, a lack of oxygenated blood reaching the central nervous system or fatal brain injury. 

If someone is having a seizure…

  • try and help them to the floor and turn them onto one side (into the recovery position)
  • If you can, put something soft under their head.
  • Remove ties or scarves or anything around their neck that may hinder breathing. 

How is a Tramadol Overdose Treated? 

Treatment for Tramadol overdose depends on your symptoms and there is no one-size-fits-all approach. Once medical help arrives they will assess your vital signs including any issues with slow breathing or altered heart rate and deal with them as required – offering oxygen or CPR. This is why the best thing you can do if you suspect you or someone else is having a Tramadol overdose is calling for urgent help.  

Naloxone is a drug that blocks and reverses the symptoms of an opioid overdose. It is a ‘rescue medication’ that is given routinely following Tramadol overdose. In many cases, it can be the difference between life and death.  

If you or someone you know overdoses on Tramadol they have a serious problem and need urgent addiction treatment. If they survive this time, they might not be so lucky the next. 

What Happens if You Mix Tramadol With Other Drugs? 

Tramadol is particularly dangerous if mixed with other drugs – even over-the-counter cold and cough medicines – as it can lead to serotonin syndrome and raise the risk of seizures and mental confusion. This is because many widely accessible cold medicines contain an ingredient called dextromethorphan which interacts badly with Tramadol. 

Combining Tramadol with antidepressants should also be avoided for the same reason. Doctors don’t usually prescribe the two together, so if you are getting your Tramadol through non-regulated routes and you’re also taking antidepressants, you could be putting yourself in severe danger of overdosing.  

If you are taking any medication, regardless of whether it is an everyday remedy you’d expect to find in any home first-aid kit, tell your doctor before starting a course of Tramadol. The interactions can be unpleasant, enhancing the side effects of both drugs, exacerbating unpleasant withdrawal symptoms and raising your risk of overdose. 

If you are currently taking methadone as an alternative to heroin and you combine it with Tramadol to heighten its effects, you increase your chances of seizures, respiratory distress, coma and death. 

What Happens if You Mix Tramadol With Alcohol? 

You may think nothing about having a few glasses of wine while on an opioid prescription for a bad back. But even if you drink responsibly and take Tramadol within your dictated dose, mixing the two is not advised. 

Both alcohol and Tramadol depress the central nervous system, slowing down its vital functions, and forcing bigger gaps between breaths and heartbeats. Combining the two exacerbates the side effects of both substances and this raises the risk of respiratory failure, unconsciousness, coma, overdose and death. 

If you drink alcohol alongside an extended-release form of Tramadol (which directs the dose into your system gradually) the booze accelerates this delivery in what is called ‘dose dumping’. You may not be able to tolerate such a large amount of Tramadol entering your body in one go, and this can raise the risk of overdose.   

If you have a dual addiction to Tramadol and alcohol, you need urgent help. Specialised addiction treatment centres can unpick the reasons behind your dependencies, help manage withdrawal symptoms as you detox from both, and provide ongoing support as you navigate any future triggers, stay clean and avoid relapse. 

How Many People Overdose from Tramadol? 

In 1996, the UK recorded one death from drug poisoning by Tramadol and in 2020 that number had risen to 230. This is slightly down from the peak of 2014, which saw 240 deaths. This doesn’t mean everyone had a Tramadol addiction or a history of substance abuse, just that Tramadol was mentioned on the death certificate, which means it was regarded as the cause. 

The substantial rise in overdose is because Tramadol is more readily available. In America, between 2008 and 2013 prescriptions of Tramadol rose from 23.3 million a year to 44 million. Because it can lead to Tramadol addiction and misuse, doctors are told to consider alternative treatments, especially for people with a history of overdosing. 

What is Tramadol Abuse and Addiction? 

Tramadol addiction may have taken you by surprise, especially if you have no history of substance abuse. One minute you’re picking up a prescription from the doctor to help with your pain, and the next you find you can’t stop taking it because when you do dreaded withdrawal symptoms kick in. 

Addiction is best described as when you are no longer in charge but the substance you are taking is in charge of you. This might not be due to intentional misuse but by simply taking an extra pill when the pain is particularly bad, or reaching for the Tramadol when withdrawal symptoms kick in. Don’t be ashamed. Addiction can happen to anyone. 

Even if you have been taking Tramadol recreationally, you may have been under the impression that it is pretty safe. Now you’re shocked to find yourself confronted with unpleasant physical and psychological symptoms as you undergo the withdrawal process. In this situation, the easiest thing can be to reach for another pill. 

You need to seek help before it is too late. Long-term abuse of Tramadol can result in irreparable organ damage, seizures and neurological problems including Alzheimer’s and Parkinson’s disease. 

Whatever your reason for taking too much Tramadol, you need help from one of the many treatment centres that can offer bespoke addiction treatment. Help comes in many shapes and sizes and includes outpatient treatment and residential rehab. Professional support is the safest and most successful way to kick your Tramadol addiction. 

Tramadol Overdose FAQ 

How Can I Overdose on Prescription Medicine?

Any drug carries a risk of overdose, even if you’ve been given it by your doctor. 

How Do I Know if I’ve Taken Too Much Tramadol?

You may find it difficult to breathe or feel sleepy and slur your words. Contact 999  immediately. 

How Much Tramadol Do I Need to Take To Overdose?

That depends on many factors including your gender, weight, physical health and tolerance to Tramadol.

What Is the Difference Between Using Tramadol and Abusing Tramadol?

Even taking a pill an hour before your next dose is due is a sign of abuse. This can be unintentional – you might be simply responding to pain and not realise it is dangerous.

Will I Die if I Overdose on Tramadol?

Not if you get urgent help. Delaying can cause irreparable damage to your body and brain. 

I’m So Embarrassed. Will Everyone Know I Overdosed on Tramadol?

No, but you need professional help. Addiction treatment is private and discreet and will enable you to kick your Tramadol dependency for good. 


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