Tramadol dependency: recognising the signs and getting treatment

Tramadol is an opioid painkiller, prescribed for pain. Diverted from this use, it is taken for energy, endurance at work or the euphoria it produces. In Africa, non-medical use has reached a particular scale: according to the United Nations Office on Drugs and Crime (World Drug Report 2024), more than 90% of global tramadol seizures over the past five years have taken place on the continent.

How dependency sets in

Tramadol acts on opioid receptors and on serotonin. With repeated use, the body adapts: higher doses are needed for the same effect, and stopping causes withdrawal. Tablets sold outside pharmacies are often strongly dosed, which speeds up the process.

Warning signs

• Daily use outside of any prescription
• Gradually increasing doses
• Irritability, anxiety, sweating or insomnia when the drug is missed
• Using it to "get through" work or the day
• Mixing with alcohol, cannabis or other medication

The risks

• Seizures, including at doses the user believes to be their usual ones.
• Serotonin syndrome, especially when combined with certain antidepressants.
• Respiratory depression, worsened by alcohol and benzodiazepines.
• Psychological disorders: anxiety, depression, dark thoughts during withdrawal.

Why withdrawal must be supervised

Stopping tramadol abruptly exposes a person to a withdrawal syndrome that is both opioid-related (pain, diarrhoea, agitation) and serotonin-related (anxiety, strange sensations, mood disturbances), with a risk of seizures. Withdrawal is managed under medical supervision, with a gradual reduction and treatment of symptoms. See medically managed detoxification and treatment for opioid addiction.

After withdrawal

Withdrawal is only one step. Psychotherapy helps understand what the substance was compensating for: fatigue, pain, stress, trauma. The residential programme generally lasts four to six weeks, followed by remote support after the return home.

Frequently asked questions

Is tramadol a drug? It is an opioid medication. Taken without a prescription or at high doses, it creates a dependency comparable to that of other opioids.

Can you stop on your own? This is not advisable after prolonged or high-dose use, because of the risk of seizures and the severity of withdrawal.

How long does treatment take? Withdrawal generally takes one to two weeks, the full programme four to six weeks. The length is set after medical assessment.

Is care provided in French? Yes, as well as in English and Arabic.

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