Woman putting pill in her mouth

Ultram, (tramadol) is a synthetic opioid that entered the market in 1995 in order to treat severe pain. Ultram, however, was different from most painkillers in that it was originally believed to have a much lower addiction potential than other traditional opioid painkillers.

To highlight this belief, the FDA originally released Ultram as an unscheduled drug, meaning it had no special restrictions like other opioids. (1) In recent years, the true nature of Ultram’s addictive potential has come to be known.

Here we take a look at Ultram abuse and addiction.

Ultram addiction

A comprehensive 2009 study on the addiction potential of Ultram concluded, “a severe and serious dependency syndrome may develop” in individuals who regularly take the drug. (2)

Furthermore, studies have demonstrated that Ultram is addictive even in patients who do not have a previous history of substance abuse, further highlighting the addiction potential of the drug. (3)

The addiction potential of Ultram was finally recognized by the DEA in 2014 by rescheduling the drug to Schedule IV. (4)

Why is Ultram addictive?

Ultram binds the same exact receptors in the brain that cause pain-relief as other opioids. And just like other opioids, it produces euphoria as a side effect of binding these receptors.

Woman holding glass of water and putting pill in her mouth

Ultram also acts on catecholamine and serotonin receptors, which also play a part in making it addictive.

This ultimately leads to both a physical and physiological addiction to the medication. (5)

Does Ultram cause a withdrawal syndrome?

Those who use Ultram chronically become dependent on the drug. This means if they suddenly stop taking the medication, they will experience pronounced withdrawal syndrome.

Ultram withdrawal mirrors the withdrawal of other common opioids, with a similar set of symptoms. Ultram withdrawal, however, also includes serotonin withdrawal symptoms due to its binding to these receptors.

This gives Ultram a unique withdrawal syndrome that in some cases has even lead to psychosis. (6)

Is Ultram dangerous?

Ultram led to nearly 55,000 trips to the emergency room in the year 2011 alone, which in and of itself greatly highlights the abuse potential of the medication. While Ultram acts on the same receptors as other opioids, it also acts as a serotonin reuptake blocker.

Those abusing Ultram will often have a strong desire to take ever-increasing doses of the medication in order to achieve a stronger high. This can lead to seizures and serotonin syndrome, which accounts for the high number of emergency room visits every year.

Final Note

This article is intended for those considering a new way of life, free of the pain of drug and alcohol addiction. For more information on recovery and anyone seeking help with addiction and substance abuse problems, please call True Recovery at (844) 744-8783 or visit us online.


  1. https://www.medpagetoday.com/emergencymedicine/emergencymedicine/46717
  2. https://onlinelibrary.wiley.com/doi/abs/10.1002/pds.1838
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882815/
  4. https://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0702.htm
  5. https://www.ncbi.nlm.nih.gov/pubmed/15509185
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905496/
  7. https://www.samhsa.gov/data/sites/default/files/report_1965/ShortReport-1965.html