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Is Tramadol an Opioid?

By Jennifer Daluro
Considered a synthetic opioid, tramadol acts on opioid receptors in the body to relieve pain. Learn more about tramadol, its benefits, and its side effects.

Is tramadol an opioid? According to the U.S. Food & Drug Administration (FDA), it is. Classified as a narcotic and an opioid analgesic, tramadol acts on the central nervous system to relieve pain. While data indicates that the rate of tramadol misuse among patients is lower than that of many other opioids, the drug does carry the risk of dependence and addiction. Read on for important details about this medication. 

Tramadol, A Synthetic Opioid

Firstly, what is an opioid? Many people confuse opioids and opiates. Both drugs function in the same manner. They act on the body’s opioid receptors to produce powerful pain-killing effects. They also induce potent euphoric and sedating effects.

Opiates, however, are directly derived from certain poppy seeds. Some common opiates are morphine, codeine, and heroin.

The category of opioids, on the other hand, includes both naturally-derived opiates and synthetic opioids produced in labs. Some well-known synthetic opioids are oxycodone, hydrocodone, fentanyl, and tramadol.

"Tramadol, also known by the brand name Ultram, is an opioid painkiller similar to codeine, though it is synthesized in a lab,” Boris MacKey, an addiction therapist at Rehab 4 Addiction, tells WebMD Connect to Care. Doctors usually prescribe opioids like tramadol for moderate to severe pain. These drugs also help with postoperative pain and chronic pain.

Tramadol helps relieve both acute and chronic pain. But Mayo Clinic notes that prolonged tramadol use can increase your risks of mental and physical dependence. You should therefore always be careful to discuss the risks and benefits of tramadol with your prescribing physician. 

Tramadol Side Effects

Medscape lists the following tramadol side effects to watch out for:

  • Nausea and vomiting
  • Bowel movement changes (constipation is more common than diarrhea)
  • Headaches
  • Dizziness or vertigo
  • Dry mouth
  • Confusion
  • Lack of energy
  • Indigestion or dyspepsia

According to a 2018 study published by The Medical Bulletin of Sisli Etfal Hospital, tramadol appears to have a lower potential for tolerance, abuse, and dependence than stronger opioids like morphine. It also doesn't significantly depress respiratory rate, lower blood pressure, or cause rashes.

However, tramadol misuse does occur, as demonstrated in a 2020 study published by Substance Abuse: Research and Treatment. The study analyzed National Survey of Drug Use and Health data and found that approximately 4% of those prescribed tramadol between 2015 and 2017 misused the medication. Importantly, though, this misuse rate is lower than the 7%-8% misuse rate of the drug's competitors, when adjusted for drug availability. The study also notes that tramadol's lifetime misuse rate, as calculated between the years of 2002-2014, remained at 1.5% or less—which is is lower than the misuse rate of hydrocodone (6%), and oxycodone (4%), respectively.

While these figures indicate that tramadol typically poses a lower risk of misuse than many other opioids, this isn't a reason to be less serious or careful while taking the medication. “Tramadol is considered a favoured substance amongst doctors due to the lower risk of addiction it presents. However, this is not to say that it is non-addictive and caution must always be taken when consuming any drug," MacKey says.

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