What Does Tramadol Show Up As on a Drug Test?

 History and Statistics

When first marketed, tramadol appeared to offer the exceptional pain-relieving benefits of more potent painkillers without spawning the unwanted byproducts of dependency and addiction. As a result, it became considered a safer alternative to narcotics and was widely accepted by the public. It was also easier to obtain and prescribed with greater prevalence on the global market.

Prior to 1995, tramadol was massively over-prescribed and remained unregulated by the Food and Drug Administration (FDA). Tramadol’s status was eventually changed due to rampant abuse and criminal diversion. Practices included illegal selling on the street, a growing presence on the web-based black market, and skyrocketing overdose rates.

Consequently, as of 2014, tramadol was deemed a designated Schedule IV Controlled Substance by the Drug Enforcement Administration (DEA)—subject to severe criminal penalties for trafficking or unauthorized use. As of 2024, tramadol prescriptions cannot be refilled more than five times within a six-month period from the original date of the prescription. A new physician-authorized prescription is then required.

As part of the monstrous U.S. opiate epidemic, tramadol continues to pose a significant danger to public health and safety. The following statistics underscore the severity and scope of the problem:

• According to the Centers for Disease Control and Prevention’s (CDC) State Unintentional Drug Overdose Reporting System (SUDORS), approximately 187 people in the U.S. died each day in 2023 because of an opiate overdose.
• In 2022, the U.S. Congress Joint Economic Committee released an analysis that showed the opioid epidemic cost the U.S. nearly $1.5 trillion in 2020, up 37% from 2017 (the last measurement).
• According to the latest 2022 data from the National Center for Health Statistics, drug overdoses are the leading cause of accidental death in the US. That same year, the FCC estimated approximately 81,806 people died because of opioid drug overdoses.
• According to the CDC, the age-adjusted rate of drug overdose deaths involving synthetic opioids increased by approximately 2,080% from 2013 to 2021 before slightly declining in recent years. 

Side Effects of Tramadol

Although well-tolerated by most people when prescribed for severe pain management, tramadol can cause serious side effects—especially when abused in tandem with other drugs or alcohol or used habitually in excessive doses.

Common side effects of tramadol use may include, but are not limited to, the following:

• Itching.
• Incoordination.
• Hallucinations.
• Sleepiness/fatigue.
• Vomiting.
• Seizures/convulsions.
• Nausea.
• Dizziness.
• Diarrhea or constipation.
• Heartburn.
• Stomach pain.
• Anxiety and agitation.
• Accelerated heart rate.
• Coma/death.

How Long Does Tramadol Stay In Your System?

Tramadol has a half-life of approximately 6.3 hours, but it can take up to a day and a half for the substance to be eliminated from the body. Like other legal and illicit drugs, exact time frames are difficult to establish due to individual variables like age, weight, height, gender, overall physical and psychological health, etc.

Tramadol can be detected in hair, blood, saliva, and urine. Hair tests are characterized by a detection window of 10 and 90 days, with samples being sent to a lab for testing. Industry experts consider hair testing a very accurate method, detecting tramadol at levels as low as 0.176mg. 

In contrast, saliva and blood tests don’t offer an extended window for detection—in most cases, approximately 24 hours—and can’t show exact levels of the drug in the system. It will simply register as a positive or negative result.

It is important to remember that a negative outcome on a saliva or blood test doesn’t mean that the drug is not present in the system. It simply means the amount is lower than the cut-off value.

If a positive result is noted on a blood test, which indicates the drug was used within the previous three days (72 hours), another confirmatory test is required. In urine, tramadol can be detected for a period of approximately two to 40 hours, with the amount of time it takes to exit the body dependent on multiple factors. These include:

• Absorption — The time it takes for tramadol to enter the bloodstream and how much of the drug is absorbed. Factors like the type of tramadol, food intake, and digestive health can all impact absorption rates.
  
  
• Metabolism – The process of breaking down tramadol, primarily by liver enzymes. Liver conditions like hepatitis, cirrhosis, or fatty liver can slow metabolism. In older adults, reduced blood flow and medication can also extend tramadol’s half-life. 
  
  
• Distribution – How tramadol spreads through the body’s tissues after absorption. People with higher body mass can process the drug more quickly, but those with more body fat tend to retain it longer since tramadol is known to bind to fat and build up over time.
  
  
• Elimination – How tramadol and its byproducts exit the body, mainly through the kidneys. Any kidney disorder can significantly slow this process. Additionally, taking the medication with food delays elimination, while taking it with fluids speeds up its elimination from the body through urine.
  
  
• Dosage — Higher doses take longer to metabolize and are more likely to bind to fat, making them detectable for a longer period.
  
  
• Type — Tramadol comes in immediate release (which acts quickly) and extended-release (which works over 24 hours). The extended-release version stays in the body longer. The amount of time the drug is taken is also important, as someone taking the medication over a short period will have less build-up in the body than someone taking it for longer periods.
  
  
• Other Medications — Other drugs, especially in cases of polysubstance abuse, can affect how tramadol is metabolized. It is important to be aware of possible interactions.

It is also important to remember that everyone processes drugs differently. What may take one person days to clear tramadol from their system can take several hours for someone else. Again, tramadol will not appear on a standard pre-employment test—better known as a SAMHSA-5 panel drug test. However, it will appear on toxicology screenings designed specifically for detecting prescription drugs.

The Urgency of Treatment

Like other mind-altering substances, tramadol can be highly addictive when misused.

What may start as occasional use can quickly spiral into full-blown addiction. When someone dependent on the drug tries to stop, they may suffer various tramadol withdrawal symptoms, fueling the cycle of dependence.

Tramadol’s addictive potential isn’t limited to those with genetic susceptibility, a family history of substance abuse, or those who misuse it outside medical guidelines. Anyone can develop a dependence on tramadol and find themselves needing detox and rehab.

If you or a loved one is struggling with tramadol addiction, don’t wait. Reach out to our Florida rehab center today. There is no shame in asking for help.

In the event of a tramadol overdose, call 911 immediately or seek addiction treatment at the nearest hospital emergency room (ER).

For those suffering from tramadol addiction, please remember there are other alternative methods for managing pain without opiates. For further assistance and resources, please call Beach House Center for Recovery today and get back to living a clean and sober life.

Learn more about the programs available at our detox center in Florida.