Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: April 23, 2026
Fact checked
Quick Summary
  • Tramadol is considered to be on the milder side of addictive drugs, yet it can still pose to be a danger if abused.
  • One may develop dependence and addiction to the drug and experience harmful side effects and withdrawal symptoms.  Combining Tramadol with another depressant such as alcohol can make things worse.
  • The side effects of the two are combined too and can prove to be lethal in some cases.
Reading time: 7 min

Tramadol is an opioid that is prescribed to patients to help relieve pain. Tramadol is considered to be on the milder side of addictive drugs, yet it can still pose to be a danger if abused. One may develop dependence and addiction to the drug and experience harmful side effects and withdrawal symptoms. 

Combining Tramadol with another depressant such as alcohol can make things worse. The side effects of the two are combined too and can prove to be lethal in some cases. It is considered best to wait for some time after tramadol use, before consuming alcohol.  

In this article, we will first assess what Tramadol is, and how it is classified in the UK. We will also glance at its side effects and potential dangers after which we will discuss the consequences of combining it with alcohol.  

Tramadol is a pain reliever administered orally. It is similar to opioids and is available only on prescription. This narcotic-like medicine eases moderate to severe pain in adults. It was first approved in 1995 and is considered to be strong medicine.   (source: NHS, 2023)

“Ultram” is the brand name given to this drug. It is advised that patients only use it as advised by their doctors. In case the patient experiences any side effects or symptoms after use, one must contact a doctor. Opioid medicines can be highly addictive; however, tramadol is not as addictive. Tramadol works by directly targeting the central nervous system, reducing pain by interrupting the passage of nervous signals.  

Tramadol Addiction and Dependence Side Effects in UK

Tramadol is considered to be a Class C drug in the UK and is only sold with a prescription. According to UK law, being in possession of tramadol without prescription can land you in prison for two years, and an unlimited fine can be imposed on you. Selling the drug, or giving it away carries a prison sentence of 14 years with an unlimited fine.  (source: NHS, 2023 (Side effects))

Although tramadol is not too addictive, it can have adverse side effects on the body. If not used as prescribed, it could even lead to addiction.  

Side effects of tramadol include, but are not limited to: 

  • Vertigo 
  • Nausea 
  • Dizziness 
  • Anxiety 
  • Hallucinations 
  • Seizures 
  • Suicidal thoughts 
  • Respiratory issues 

A high dose of tramadol can be dangerous. One may feel sleepy, dizzy, or sick after an overdose. The amount of what counts as an overdose depends on each individual. In extreme cases, you might have to rush to the hospital if you experience breathing difficulties, or if you become unconscious.   (source: NHS, 2023 (Alcohol advice))

Recent studies have shown that tramadol could prove to be a dangerous drug in itself as compared to others and could act as a catalyst of death in certain cases. Other negative consequences of consuming tramadol in increased quantities include the fact that one can develop a dependency on the drug. Thus, when the drug consumption is halted, withdrawal symptoms are inevitable. Extreme withdrawal symptoms could again cause the user to start taking tramadol, and perhaps in even larger quantities, leading to even drastic side effects.  

Although tramadol is sold as a milder type of opioid, it can still be dangerous when abused. Combining the drug with other drugs can exacerbate the side effects of tramadol. In response to whether or not it can be mixed with alcohol, it is advised not to. Consuming both at even low quantities can also prove to be very dangerous. Combining two depressants can be lethal to the nervous system and can lead to serious damage.  

As noted above, mixing these two drugs, which work as depressants, can be quite dangerous. The possible effects of mixing the two include slowing down the central nervous system. This means that other organs and organ systems will be impacted. Both drugs individually have certain negative side effects on the body. Combining the drugs means combining and enhancing these side effects.   [4]

Co-Codamol Abuse and Overdose Treatment UK

At low doses, the combination of these drugs can induce euphoria, feelings of relaxation, and well-being. Moreover, it could also affect respiration, blood pressure, and heart rate. The combination of these drugs can hinder the functioning of neurons which can, in turn, prove to be fatal if it affects the life-sustaining functions of the body. An overdose of the two can prove to be a potentially fatal dose.  

Taking tramadol in large amounts and combining it with alcohol could also have the effect of increasing the absorption of tramadol, thus increasing its effectiveness as a depressant on the CNS. The risk of overdose is also increased when both the drugs are combined. Chronic diseases are associated with each drug itself and so, when the drugs are mixed and consumed, the risk of developing these diseases increases twofold as well. These include various types of cancer, cirrhosis of the liver, ulcers, kidney issues, etc. Even one-time use of the two drugs combined runs a risk of being unable to drive and poor judgment. Men can face sexual dysfunctions whereas pregnant women could give birth to babies with disorders. Inevitably, chronic use of such depressants can lead to suicidal thoughts and attempts.   (source: NHS, n.d.)

If you’ve just taken a tramadol dosage, it’s best to wait until the tramadol is wholly out of your system before consuming alcohol again. The half-life of short-acting tramadol is about 6.3 hours, which means it takes that long for your body to eliminate half of the drug from your body. Because it takes five half-lives for a drug to be totally removed from your body, a dose of short-acting tramadol should exit your body in 32 hours. Long-acting tramadol has a half-life of around 10 hours, which means it takes about 50 hours for it to exit your system completely. 

The Dangers of mixing Co-Codamol and Alcohol

Waiting until tramadol has fully exited your body might help you prevent severe and adverse side effects and reduce your chances of overdosing.  [6]

Patients who have consumed Tramadol often complain that they feel ‘hungover’ after having taken Tramadol (or the morning after having consumed it). Following are some of the side effects of Tramadol which may cause one to feel hungover; 

The following are some of the most often reported adverse effects: 

  • Nausea 
  • Constipation 
  • Dizziness 
  • Headache 
  • uphoria 
  • Indigestion 
  • Spasticity 
  • Weakness 
  • Drowsiness 
  • Vomiting 

Furthermore, Seizures have been recorded in certain tramadol patients. When taken with other medications that enhance serotonin, it may even produce serotonin syndrome.  

FAQs

Can I drive on tramadol?  
You should refrain from driving, operating equipment, or engaging in other tasks that demand mental awareness until you have determined that: the drug’s effects are identified; you are tolerant of tramadol’s effects, and you are certain that you can safely drive. 
Can I have a glass of wine with tramadol? 
Tramadol should not be taken with any type of CNS depressant drug unless your doctor has prescribed it. Furthermore, and more importantly, while using tramadol, DO NOT consume alcohol or misuse illegal substances, street drugs, or other opioids.

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