Mixing Tramadol and Alcohol: Side Effects, Interactions & Risks

Combining tramadol and alcohol can increase your risk of potentially dangerous side effects, including overdose and even death.

Although alcohol is among the most common recreational substances in the U.S., it can be dangerous when combined with certain medications, including pain relievers like tramadol. This is because of an increased risk of side effects, which can be dangerous and sometimes even fatal. If you drink and take tramadol, you should be aware of the problems involved before you take them together.

What Is Tramadol? 

Tramadol is an opioid prescribed to treat pain severe enough to require an opioid. The drug is a Schedule IV controlled substance. It works by acting on the mu opioid receptors in the central nervous system and can also cause the neurotransmitters norepinephrine and serotonin to last longer in the brain.

Side Effects of Combining Tramadol With Alcohol

Because both tramadol and alcohol are central nervous system depressants, combining them can increase your risk of side effects, which can be life-threatening in some cases. Tramadol carries an FDA boxed warning about the risk of mixing it with other depressants like alcohol. 

Possible side effects of taking tramadol when you drink may include:

• Dizziness
• Drowsiness
• Confusion
• Problems concentrating
• Impaired thinking
• Poor judgment
• Difficulty with physical coordination

Alcohol withdrawal can also lead to dangerous side effects if you take tramadol. One of tramadol’s side effects is seizures, and the risk of this increases if you are in alcohol withdrawal, a condition that also increases your seizure risk.

How Long After Taking Tramadol Can You Drink Alcohol? 

After you take tramadol, you should wait until the drug is entirely out of your system before drinking. However, this time frame can differ depending on whether you have taken short or long-acting tramadol.

• Short-acting tramadol has a half-life of approximately 6.3 hours, meaning it takes around that long for your body to clear half of a single dose. Since it takes five half-lives for a drug to leave your system, a dose of short-acting tramadol should be out of your body within around 32 hours, which is usually safe to drink.
• Long-acting tramadol has a half-life of about 10 hours, meaning it takes about 50 hours for your system to clear the drug fully.

Your doctor or pharmacist should be able to advise you when it is safe to resume drinking based on the dosage form of tramadol that you take and your medical history. Waiting until tramadol is fully out of your body can help you avoid unpleasant side effects and lower your risk of an overdose.

Alcohol and Tramadol Overdose

An alcohol and tramadol overdose is both possible and very dangerous. Excessive alcohol intake alone is responsible for six deaths daily in the U.S. Tramadol by itself can also cause an overdose. However, tramadol is one of the only opioids for which an overdose is not completely reversible by naloxone (Narcan).

Because both tramadol and alcohol are central nervous system depressants whose side effects can worsen each other, the FDA has a boxed warning about increased overdose risk if they are mixed. Possible overdose effects include:

• Extreme sedation
• Slowed breathing
• Coma 
• Death

It is best to avoid mixing tramadol and alcohol for these reasons.

Find Help for Alcohol and Opioid Abuse

If you find it hard to stay away from alcohol while taking tramadol, this could be a sign of an alcohol or tramadol addiction. Quitting alcohol and tramadol is difficult, especially when you struggle with both agents, a condition called polysubstance abuse. Fortunately, help is available. The Recovery Village Cherry Hill at Cooper offers a medical detox program to cleanse your system of both alcohol and tramadol. Following medical detox, we provide a full continuum of rehab options to help you quit alcohol and tramadol for good. Contact a Recovery Advocate today to learn more, or verify your benefits instantly online.