Tramadol and Alcohol



What is tramadol?

Tramadol is an opioid pain killer which is used to treat mild to moderate pain in individuals. It is considerably weaker than most common opioids such as heroin or morphine and therefore is often used with patients who suffer from a strong dependency as a means to taper their addiction. Pharmaceutical companies sell it under several brand names such as Ultram, Ultram ER and Ultracet. 

What is alcohol?

While most people probably understand what alcohol is, it is still important to understand the effects it has on your body. Alcohol is a central nervous system depressant which slows brain function. However in low doses, alcohol is considered a stimulant. A few drinks typically allow people to ‘loosen up’ by elevating mood and can make people feel good. However, in higher doses, it demonstrates depressive traits such as slowed breathing, heart rate and cognitive function. An individual’s reaction to alcohol really depends on their drinking history and body composition. Generally, those who have a higher body mass will be less affected by alcohol and vice versa.

Mixing tramadol and alcohol:

Tramadol and alcohol are both central nervous system (CNS) depressants. Depressants slow brain and nerve activity which causes a feeling of relaxation. The major issue with combining two CNS depressants is that they collectively enhance the effects of the other drug. In essence, the alcohol will make the tramadol more potent and vice versa. This combined synergistic effect can slow brain and muscle function drastically, ultimately causing breathing to slow down or completely stop. Slowed breathing is bad for obvious reasons, but it can also cause permanent organ damage to areas such as the brain as it won’t receive the oxygen it needs, putting it into a hypoxic state

Further, the extended release form of tramadol (Ultram ER) contains a higher dose of tramadol. This design works to release into the body over a longer period of time. It’s primarily prescribed to individuals who are dealing with chronic, moderate to severe pain and those who need long term consistent relief. However, mixing it with alcohol may cause the extended-release mechanism of the drug to fail, therefore releasing the full dosage of the drug at a faster than intended pace. Furthermore, the higher dosage entering the body can cause an overdose and potentially death.

Ultracet is a combination of tramadol and acetaminophen. As previously explained, taking tramadol with alcohol is a bad idea in the first place but adding acetaminophen can further increase the risk of bodily harm. The liver processes acetaminophen and alcohol and it’s possible for the combination to cause severe liver damage. While the actual dosage of acetaminophen present in Ultracet is significantly lower than the max recommended daily dosage, it’s still an additional factor which can further the damaging effects and uncertainty of mixing tramadol and alcohol and therefore should be avoided. 

How long does tramadol stay in your system?

Tramadol has a half life of around 6 hours. In other words, it will typically take around 6 hours for the drug to reduce to half of its consumed dosage. Keep in mind, this is heavily dependent on body composition and can also vary if you took an extended release form. While you can expect the full effects of normal tramadol to wear off after 12 hours, the drug will likely still be detectable via urine, hair, blood or saliva tests. It’s possible, of course, for this to vary by person based on factors unique to them.

It’s possible to detect Tramadol in:

  • Urine for up to 2-40 hours
  • Blood for up to 12-24 hours
  • Saliva for up to 48 hours
  • Hair follicles for up to 90 days                                                                                                                Tramadol

How long does alcohol stay in your system?


A fully functioning, healthy liver can typically process one drink per hour. According to the Center for Disease Control (CDC), one drink is defined as:Tramadol-and-Alcohol

  • 12-ounces of beer (5% alcohol content)
  • 8-ounces of malt liquor (7% alcohol content)
  • 5-ounces of wine (12% alcohol content)
  • 1.5-ounces or a “shot” of 80-proof (40% alcohol content) distilled spirits or liquor 

However, this is heavily dependent on body composition. Furthermore, with alcohol it’s possible to detect via urine, hair, or blood tests for much longer. Each individual is unique and this will vary.

Alcohol can be detected in:

  • Blood for up to 24 hours
  • Urine for up to 80 hours 
  • Hair follicles for up to 3 months


Tramadol and alcohol are highly addictive substances. There is significant danger in mixing them. For anyone with a prescription, it is important to discuss how tramadol interacts with any substance. Abuse of any drug can cause serious health problems. If you or a loved one needs help, please reach out today. 

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