How Long Does Tramadol Stay in Your System?

Tramadol addiction

How Long Does Tramadol Stay in Your System?

Table of Contents

What is Tramadol?

Opioid addiction is increasing a concerning amount. According to the National Center for Health Statistics, nearly 50,000 people died from an opioid-related overdose in 2019. Tramadol is one of the opioids that has the potential for addiction. 1

Tramadol, which can go by the brand names Ultram, Ultram ER, Ryzolt, and Conzip, is an opioid analgesic prescribed to treat moderate to moderately severe pain. It works on pain receptors in the brain to alter how the body feels and responds to pain.

Tramadol can be taken as a pill or liquid. Doctors often prescribe Tramadol for pain after surgery or with conditions such as cancer or fibromyalgia that cause chronic pain.

Is Tramadol Addictive?

Tramadol is an opioid narcotic drug in the same category as morphine, hydrocodone, and codeine. Not only do opioids block pain receptors in the brain, but they also increase the pleasure centers. The increase produces a mellow “high” when abused and promotes a feeling of relaxation while easing stress.2 These combined effects make opioids, like Tramadol, addictive.

However, Tramadol differs from other opioids by inhibiting norepinephrine and serotonin from being reabsorbed, similar to an antidepressant. These actions cause Tramadol to have both analgesic and antidepressant effects at the same time.

Tramadol offers less of a “high” than other opioids, so it is considered to have less risk of addiction than other opioids. However, tramadol addiction and abuse are on the rise. Between 2005-2011, tramadol abuse or misuse emergency room visits grew by 250%.3 In 2017, almost 1.7 million people over the age of 12 abused Tramadol.4

Those with a previous opioid use disorder or chronic pain are at particular risk for tramadol addiction. Also, those in treatment for opioid use disorder and who are taking an opioid antagonist medication, such as Naltrexone, may abuse Tramadol. The drug sidesteps the opioid blockade to produce a high.

Side Effects of Tramadol Abuse

Tramadol abuse can result in serious side effects, such as seizures and respiratory depression. Serious tramadol side effects include:

Serotonin syndrome

Adrenal insufficiency

Suicidal thoughts

Decrease in androgen (male) hormones


Abnormally low blood pressure


Because Tramadol works as a depressant on the Central Nervous System, it slows down the lungs and heart. This aspect can lead to serious tramadol side effects if too much is taken. Taking other depressants with it, such as alcohol or benzodiazepines, can be fatal.

Other tramadol side effects include:


Slow heart rate

Slow heart rate


Muscle weakness



How Long Does Tramadol Stay in the Body?

How long Tramadol stays in the body depends on a wide variety of factors. According to research, the half-life of Tramadol in the average healthy adult is seven hours.5 This aspect means that by seven hours, half of the drug clears the body.

How to Detect Tramadol in the Body

The tests for Tramadol vary in how well they can identify the drug. Tramadol can be detected in the body weeks after it’s been taken, depending on the test:6

  • Blood Test: Up to 48 hours
  • Hair Test: 30-90 days
  • Urine Test: 24-72 hours
  • Saliva Test: Up to 48 hours

What Factors Affect How Long Tramadol Stays in the Body?

It can take up to 72 hours for Tramadol to leave the system. How long it stays depends on several factors:

  • Age: Those who are over 75 typically take longer to get rid of Tramadol.
  • Metabolism: A slower metabolic rate will slow down the body’s ability to break down the medication. Body composition, diet, and activity level will all affect metabolism and how long Tramadol stays in the body.
  • Dosage: The higher the tramadol dosage in the body, the longer it will take to leave. Also, if it was the first-time taking tramadol, it will not stay in the body as long as subsequent times.
  • Type: Immediate release tramadol will leave the body faster than extended-release.
  • Other drugs: Taking tramadol with other drugs will increase how long it is in your body.
  • Organ function: Those with reduced kidney or liver function take longer to process the medication, which means it stays in the body longer.

Tramadol Withdrawal

Tramadol addiction can cause withdrawal symptoms if opioid use suddenly stops. How soon withdrawals start, the symptoms they experience, and when symptoms end depends on several factors, including the tramadol dosage and past misuse.

Withdrawal Symptoms

Withdrawal symptoms can vary depending on the individual. These symptoms are often similar to the flu and can include:7

  • Sweating
  • Chills
  • Runny nose, sneezing, or coughing
  • Irritability
  • Gastrointestinal issues
  • Nausea or vomiting
  • Aches and pains in the muscles and joints
  • Anxiety
  • Restless leg syndrome

How Long Does Withdrawal Last?

How long and how severe the withdrawal symptoms vary from person to person. Withdrawal depends on a few factors, such as the person’s general health, if other drug misuses were involved, how long the drug was used, and how severe the misuse was.

For the average healthy adult, withdrawals begin within one to two days after the drugs leave the body. Withdrawals typically peak at day three and go away entirely within one to two weeks. Older adults over the age of 65 often take longer to metabolize and process Tramadol. As a result, withdrawals start later and can be more severe once use has stopped.

Treatment Options for Tramadol Addiction

There are several recovery options for tramadol addiction. No one must go through the process of recovery alone:


Getting tramadol out of the system is a vital first step in recovery. Depending on the circumstances and how severe the abuse, detox may require a slow taper instead of complete cessation (or “cold turkey”). Some medications can prevent severe withdrawals to make the process as comfortable as possible, like methadone or buprenorphine.


Therapy can be a very individual thing, and there are some different therapies to choose from. While some people may choose to work with a counselor one-on-one, others may prefer a 12-step model, such as Narcotics Anonymous.



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