Tramadol Dangers: Snorting & Side Effects

Although tramadol is an opioid used to treat moderate to severe pain, some people misuse this drug and snort crushed tramadol tablets to get high. This altered route of administration bypasses the steady release of medication that would otherwise result from its intended oral administration and results in a burst of euphoria. While momentarily enjoyable for the user, there are also serious dangers and side effects of snorting tramadol, including agitation, nausea, seizures, panic, and overdose. But treatment is available for those who are struggling with the misuse of tramadol.

What Is Tramadol?

What is tramadol? Tramadol is a synthetic opioid agonist—like hydrocodone, oxycodone, codeine, fentanyl, heroin, and hydromorphone—and is  prescribed to manage moderate to severe pain as it interacts with certain opioid receptors within the brain and modifies sensations of discomfort or pain. It is sold under several commercial names, including ConZip, Ultram, and Ultram ER and can come in immediate-release as well as extended-release tablets.

What is Tramadol Used to Treat?

Tramadol is often prescribed for people with arthritis, nerve damage, and other painful chronic conditions. The extended-release version is intended to control symptoms for a longer period and is prescribed to adults who need around-the-clock pain management.

When tramadol is taken orally as prescribed by a doctor, the drug is a generally safe alternative to other pain medications. Tramadol has more powerful painkiller properties than non-steroidal anti-inflammatory medications and was designed to provide a less addictive alternative to the stronger opioid analgesics, but people can still misuse this drug.^1,2 When abused, tramadol can create a sense of pleasure that is often been compared to a morphine high, and snorting tramadol increases the risk of dependence and tramadol addiction.³

What Happens if You Snort Tramadol?

When immediate release tramadol is ingested orally, it is first processed through the liver and drug levels peak in the body in about 2 hours. If you snort tramadol, however, the drug dodges this intended “first-pass” process of liver metabolism. Instead, the mucous membranes of your nasal passages absorb tramadol and deliver it across the blood-brain barrier directly to your brain.

Since crushing tramadol and snorting tramadol skips this liver metabolism process, the effects of snorting tramadol are experienced in less than 10 minutes. Animal studies have shown that the maximum bloodstream concentration of the drug is 20 times higher when tramadol is snorted than when it is taken orally, and snorting tramadol makes the drug 500% more available to the body.⁴ This faster absorption and increased availability can be appealing to users looking for a quick and intense high.

Sniffing tramadol can also a dramatic effect on the brain. Although a synthetic opioid, meaning that its chemical makeup is man-made, tramadol works in the brain very similarly to natural opioids. It attaches to opioid receptors and alters signaling throughout the body’s pain pathways.⁵ As a result, you perceive less pain in your body when there is tramadol in your system.

Tramadol is also a somewhat unusual opioid analgesic in that it increases the availability of norepinephrine and serotonin in your brain. The drug’s effect on neurotransmitters may bolster its pain-relieving capabilities but is thought to also provide a mild antidepressant effect, elevating good feelings throughout the body.⁶ These effects can increase the risk of addiction.

What are the Side Effects of Snorting Tramadol?

People who misuse tramadol may crush multiple tablets to snort to get a euphoric high. While some side effects of snorting tramadol may be short-term and less harmful than others, other side effects can be much riskier and even lethal.

What are the side effects of tramadol? The side effects of snorting tramadol can include:⁷

• Agitation
• Diarrhea
• Dizziness
• Nausea and vomiting
• Overdose
• Panic
• Seizures
• Shaking and tremors
• Weakness

When tramadol is snorted, the medication can also cause various problems to the respiratory system. Some people will experience severe irritation of the mucous lining of the nose. Other users report a painful burning sensation.

Other Dangers & Risks of Tramadol Snorting

In addition to causing discomfort and pain, snorting tramadol increases the risk of taking too much of this medication.³ The risk of accidental death via overdose increases when snorting tramadol while drinking alcohol or taking drugs that suppress breathing and heart rate.

A 2010 study of tramadol overdose published in Clinical Toxicology indicates that 1.2% of all poisoning episodes from 2006 to 2007 were related to tramadol.⁷ Taking too much of this drug can result in what is known as serotonin syndrome, a severe drug reaction that can occur when you take medications that alter the brain’s production of the neurotransmitter serotonin.

Dangerous side effects of serotonin syndrome may include:⁷

• Delusions and hallucinations
• Elevated blood pressure
• Elevated body temperature
• Increased heart rate
• Loss of motor coordination
• Seizures

If someone does overdose on tramadol, naloxone for opioid overdose is available and may save a life.

Tramadol Withdrawal

Although tramadol is a prescription medication, it can be misused, both by those who have a prescription and those who do not. For those who misuse the drug, withdrawal symptoms are possible if they cut back on or stop their use of tramadol.

Tramadol Withdrawal Symptoms

If you are withdrawing from tramadol, after extended use or when cutting back on or stopping use of the drug, you may experience some or all of the following withdrawal symptoms:¹⁰

• Abdominal cramps
• Backache
• Sweating
• Restlessness
• Anxiety
• Irritability
• Insomnia
• Joint pain
• Nausea and vomiting
• Increased blood pressure
• Increased heart rate

These symptoms can be so uncomfortable you may feel the urge to go back to using the drug just to make them go away, which makes quitting the drug without professional help difficult. In a professional rehab facility, however, you may be given medications to help manage your withdrawal symptoms and increase your chances for success.

Help for Tramadol Addiction

If you feel that your tramadol misuse has taken over your life or your loved one’s life, physical or psychological dependence may be present. To safely quit, professional and intensive tramadol addiction treatment may be required.

Every treatment center is different, but generally patients will begin by undergoing an initial assessment that helps determine what level of care is appropriate as well as outline their opioid addiction treatment program. A professional detox may or may not be recommended to begin, but other parts of treatment will typically include therapy, education, and counseling.

Check to See if Insurance Covers Tramadol Rehab

If you are struggling with tramadol misuse, seeking help is the first step. American Addiction Centers (AAC) is a leading provider of inpatient and outpatient rehab treatment services. AAC is committed to supporting those struggling with addiction on their journey to recovery. If you are looking for information on Adderall misuse and your treatment options, you can contact us 24/7 at to learn more.

If you decide to enter treatment, the good news is that insurance often covers at least part of, if not all, the cost of treatment. You can call the number on the back of your insurance card or check your insurance coverage online by filling out the form below.