What Are the Risks of Combining Tramadol and Alcohol?

Tramadol is an opioid analgesic or pain reliever. Like other opioids, tramadol is a central nervous system (CNS) depressant that inhibits pain signals and provides relief. This is why it's used to treat severe acute or chronic pain.

Compared to other opioids like morphine, tramadol has been found to be about one-tenth as powerful.⁷ This means that tramadol has a lower potential for dependence and abuse. However, this doesn’t mean substance misuse may not occur. 

Can I Drink Alcohol While Taking Tramadol?

Drinking alcohol while taking tramadol is never a good idea. 

Mixing alcohol and tramadol intensifies each drug’s side effects, causing severe physical and mental impairment and an increased risk of overdose.

Alcohol and tramadol are both CNS depressants. This means they slow down the activities of the CNS, resulting in decreased coordination, dizziness, and drowsiness. They impair the ability to think clearly and move purposely.

What Else Should You Not Mix With Tramadol?

You shouldn’t mix tramadol with the following prescription drugs: 

• Monoamine oxidase (MAO) inhibitors
• Isocarboxazid (Marplan®)
• Linezolid (Zyvox®)
• Methylene blue
• Phenelzine (Nardil®)
• Selegiline (Eldepryl®, Emsam®, and Zelapar®)
• Tranylcypromine (Parnate®)

Discussing all your medications with your healthcare provider is essential.

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How Long After Taking Tramadol Can I Drink?

If you’ve taken tramadol, wait until it’s entirely out of your system before drinking alcohol. Short-acting and long-acting tramadol stay in the body for different amounts of time.

A dose of short-acting tramadol is out of your system within 32 hours. Long-acting tramadol takes 50 hours before all of it leaves your body. 

Waiting for tramadol to clear itself from your body will help you avoid unwanted side effects and significantly lower your risk of overdose.

Dangers of Mixing Tramadol and Alcohol 

Mixing tramadol and alcohol carries risks of severe side effects, intoxication, and even death. 

Drinking too much alcohol while taking tramadol may lead to tramadol intoxication. This is also called tramadol poisoning. In these cases, symptoms will range from:

• CNS depression and coma
• Tachycardia (fast heart rate)
• Cardiovascular failure
• Seizures
• Multiple organ dysfunction
• Respiratory depression (slow, irregular breathing)
• Respiratory arrest (when an individual stops breathing or is not breathing effectively)

Dying from tramadol intoxication is uncommon. The risk of death, however, increases when alcohol and tramadol are mixed.

The risk of seizure increases for individuals who: 

• Have received more than four tramadol prescriptions
• Are between the ages of 25 and 54
• Have a history of alcohol abuse, stroke, or head injury 

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Side Effects of Mixing Tramadol and Alcohol

Consuming alcohol while taking tramadol intensifies the drug’s side effects. Tramadol may produce some side effects, such as:

• Headaches
• Insomnia
• Nervousness
• Muscle tightness
• Mood changes 
• Dry mouth 
• Increased blood pressure 
• Heartburn 
• Uncontrollable shaking of a body part

More severe side effects of tramadol may include:

• Seizures
• Hives
• Rash
• Trouble breathing or swallowing 
• Decrease in sexual desire
• Irritability 
• Loss of coordination
• Nausea or vomiting 
• Fainting 
• Difficulty having or maintaining an erection
• Irregular menstruation

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Treatment for Tramadol and Alcohol Misuse

If you or a loved one misuses tramadol and alcohol simultaneously, addiction treatment programs are available to help you towards recovery. Choices for substance abuse rehab include:

• Detoxification: Process of eliminating drugs and alcohol from your body. Professionals support and guide you through withdrawal 
• Inpatient treatment: A residential treatment option where people receive 24-hour care and supervision
• Outpatient treatment: This program allows you to stay at home while attending appointments with a doctor or therapist during the day
• Behavioral therapy: Consists of techniques to help you identify and change negative behaviors
• Support groups: Provide a safe space for you to connect with others and share their experiences

History intake is the foundation of any excellent substance abuse treatment. A medical professional will conduct assessments to learn about:

• The person’s medical history
• History of drug abuse
• Any co-occurring mental health disorder

Never attempt to quit tramadol and alcohol cold turkey, as withdrawal symptoms may arise and lead to a possible overdose or death. Your healthcare provider can discuss treatment options and determine the most suitable route to recovery.

Summary

Tramadol and alcohol should never be mixed. Mixing the two substances can lead to severe withdrawal symptoms, overdose, and death. Seek professional help if you or someone you know is misusing tramadol and alcohol. Professionals can provide treatment options to help you quit and prevent further misuse of the substances.