Headaches and hallucinations, which alter perception and mental state.

Difficulty urinating and loss of appetite are indicators of physiological problems.

Seizures and slow or shallow breathing can be fatal in overdoses.

Dependence and Fatal Risks

Tramadol has an addictive profile similar to other opioids. Patients can become physically and mentally dependent on its analgesic effects, especially with prolonged use or at high doses. Tramadol-associated deaths occur primarily when users mix it with other substances, such as central nervous system depressants (alcohol, benzodiazepines), or even other painkillers. This combination amplifies its sedative effects, potentially leading to fatal respiratory depression.

In response to this crisis, Northern Ireland reclassified Tramadol as a controlled substance in 2014, banning its sale without a prescription. However, experts like Crane advocate for even stricter restrictions, arguing that current measures are insufficient to curb its devastating impact.