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Mixing Tramadol and Alcohol: Effects, Dangers, and Treatment

Tramadol (available as generics and under the brand names Conzip, Ultram, and Ultram ER) is a prescription opioid analgesic used to manage moderate to severe pain.1 Tramadol was introduced in 1995 as a non-controlled drug but was later reclassified as a Schedule IV controlled substance due to the potential for abuse and dependence.2

Tramadol is relatively safe when taken as prescribed by a doctor; however, when combined with alcohol, benzodiazepines, and other central nervous system (CNS) depressants, the substances can have exacerbated depressant effects. This can result in dangerous outcomes, including respiratory depression, coma, and even death.3, 4

If you use tramadol and alcohol, it is important to know the potential risks of combining these substances. This article will help you understand the effects and dangers of combining the 2, and how to seek help if you are struggling with addiction.

Tramadol and Alcohol Interaction

Similar to other opioid analgesics, tramadol works by binding to and activating opioid receptors, blocking pain signals sent from the brain and sending a sense of euphoria through the body as a result. When opioid receptors are activated, there is also an increase in dopamine activity, which can reinforce tramadol use.4, 5

In addition to pain relief, common side effects of tramadol include:4

  • Drowsiness.
  • Dizziness.
  • Constipation.
  • Nausea.
  • Vomiting.
  • Headache.

Alcohol is a central nervous system (CNS) depressant that facilitates the activation of gamma-aminobutyric acid (GABA), the primary inhibitory molecule in the CNS. GABA activation decreases excitation in the brain, which is why a person experiences calming effects (e.g., drowsiness, impaired coordination, relaxation) when they drink alcohol.6, 7 Alcohol can alter how the brain looks and works, affecting a person’s behavior, coordination, movement, and thinking. It can also stimulate the reward system in the brain, which may play a role in the development of addiction.6, 7, 8

A person may combine substances such as alcohol and tramadol for several reasons, including to:9

  • Change or intensify the effects of a substance.
  • Use one substance to compensate for the effects of another.
  • Avoid withdrawal symptoms.
  • Substitute for a drug that cannot be obtained.
  • Escape reality due to health issues, trauma, or other life circumstances.

Whether intentionally or unintentionally, concurrent tramadol and alcohol use is never safe as the interaction between the 2 substances can lead to dangerous consequences.

Tramadol and Alcohol Effects

Even when tramadol is taken as prescribed by a doctor, a person may experience adverse health effects.

Taking tramadol in combination with alcohol and other substances that depress the central nervous system enhances the sedative effects of both. When taken together, the potential effects of tramadol and drinking alcohol include:4, 10, 11

  • Profound sedation.
  • Respiratory depression.
  • Decreased motor skills.
  • Coma.
  • Death.

Taking tramadol in combination with alcohol increases a person’s risk of overdose, which can be fatal or cause permanent brain damage.10, 12 Overdose involving opioids and alcohol can be particularly dangerous as the substances can reduce a person’s breathing functions and cough reflex. This increases the risk of choking or being unable to breathe.10 The warning signs of a tramadol overdose include:3

  • Drowsiness.
  • Bradycardia (slow heartbeat).
  • Hypotension.
  • Cold, clammy skin.
  • Constricted pupils.
  • Loss of muscle control.
  • Respiratory depression.
  • Seizures.
  • Coma.
  • Cardiac arrest.
  • Death.

Other Dangers and Risks

Some opioid analgesics include acetaminophen. Ultracet, for example, is manufactured using tramadol and acetaminophen (Tylenol), which may not be apparent to a person taking the drug. Alcohol can increase a person’s risk of experiencing acetaminophen-related toxic effects on the liver, which can result in severe liver damage.10, 11

In addition to the effects above, both tramadol and alcohol have several long-term risks. Studies show that the long-term use of tramadol may be associated with several neurological disorders, including Alzheimer’s disease and Parkinson’s disease.13

Long-term use of alcohol can lead to various health issues including heart and liver disease, high blood pressure, stroke, and an increased risk of cancer. It can also lead to other serious problems, including mental health issues like anxiety and depression, and learning and memory difficulties.14

The use or misuse of tramadol and alcohol can lead to the development of a substance use disorder (SUD), a chronic but treatable condition in which it is difficult for a person to control their use of a substance despite experiencing negative health, occupational, and social consequences.4, 14, 15

When a person has 2 SUDs at the same time (e.g., co-occurring tramadol addiction and alcohol addiction), they are more likely to experience higher rates of:9

  • Overdose
  • Suicide attempts.
  • Severe medical and mental health issues.
  • Issues with money and the law.
  • Arrests and incarcerations.

How Long After Taking Tramadol Can I Drink Alcohol?

Not using tramadol in combination with alcohol at all is the safest way to prevent potentially dangerous health effects. If you are looking to drink while taking tramadol, it is best to talk to your doctor.

Finding Help

If you feel that substance use is negatively affecting your life, it may be time to seek professional help.

Fortunately, there are alcohol addiction treatment and tramadol addiction treatment options available that can help patients stop using substances and live healthy, productive lives.17

Although not always necessary, medical detox can help patients who are dependent on 1 or more substances achieve a substance-free state while under the care and supervision of medical professionals. This can help patients transition into ongoing addiction treatment, which may include a combination of behavioral counseling, medication, and more. For patients who are struggling with both tramadol and alcohol, co-occurring disorder treatment can help address both substance use disorders at the same time and may result in better outcomes.16, 17, 18

If you are ready to learn more about addiction treatment, American Addiction Centers (AAC) is ready to help. AAC is a leading provider of evidence-based addiction treatment with facilities across the U.S. You can call our free, confidential helpline at for more information about rehab, and easily verify your insurance by filling out the form below.


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