Dangers of Snorting Tramadol

Tramadol is a prescription pain relief medication which is used to ease chronic and acute pain. It is commonly considered a less addictive and therefore safer alternative to other pain medications and prescription opioids, however, the risks of using this substance are considerable.

Individuals who use the substance through legitimate prescription, as well as those who abuse the drug illicitly, are at risk of developing a dependency on the substance.

The added risks associated with recreational tramadol misuse are in part related to the method of use: insufflation, or snorting. This method of use increases the risk for the individual in a number of ways.

Although tramadol addiction is a challenging condition to recover from, it is possible to get better through quality addiction treatment. If you or someone you know is struggling with tramadol misuse, reach out for help today.

Prescription Drug Abuse

Throughout the United States, there is a devastating epidemic of opioid abuse, with recent figures showing there were 75,673 opioid overdose deaths in 2021. Regardless of renewed laws and advice from the Drug Enforcement Administration, this number is on the rise.

It is considered that the root of this national crisis began in the 1980s when a focus on medicating and treating pain was intensified. During this time the government supported and passed pain treatment acts which defended the right of doctors to treat pain with controlled substances which were known to carry some risks for the patient.

In the 1990s, pharmaceutical companies began formulating new opioid-based products, including fentanyl and oxycodone-based substances. It was here that prescriptions rocketed and opioids began being widely used to treat chronic pain. Through this increase of prescription opioids, it is thought the rise in substance abuse problems initiated.

Research by the National Survey of Drug Use and Health suggests that 1.6-1.8 million Americans struggle with tramadol abuse. Further research by the CDC found that tramadol abuse had risen by over 15% in the year from 2018 to 2019 alone.

Drug Addiction in Florida, USA

In Florida, it is thought that approximately 8% of the population is using illicit substances – around 1.5 million individuals. Research from the Centers for Disease Control and Prevention put the statistics from Florida on a relative scale. Of the 93,000 people who died of a drug overdose in the United States in 2020, 7,579 of these were in Florida. This means Florida is behind only California in terms of overdose deaths and has seen a severe 37% increase from 2019.

What is Tramadol?

As a prescription opioid medication, tramadol was originally designed to be a safer, less addictive drug compared to similar alternatives. Categorized as a Schedule IV controlled substance, this suggests it carries a low potential for abuse and dependency, but can still lead to harm and dependency. To be categorized as a Schedule IV controlled substance, it must comply with the following criteria:

Schedule IV Controlled Substances

  1. The drug carries a lower potential for abuse in comparison to Schedule III substances.
  2. The substance has certified and beneficial medical uses in the United States.
  3. Misusing the substance could lead to psychological and/or physical dependence.

Tramadol Prescriptions

In medical settings, this synthetic opioid can be found under these common brand names: Ultram, Ultram ER, Ultracet, and ConZip.

You can find tramadol as a capsule, tablet, or a liquid solution, and these can be one of two forms of tramadol:

  • Immediate release tramadol:

    • Contains a lower dose of the substance
    • The entire dose is immediately released into the body system.
  • Extended-release tramadol:

    • Contains a higher dose of the substance
    • The dose is released more slowly into the body system, increasing the length of time the effects can be felt.


Tramadol Abuse

Tramadol addiction can develop in individuals who are recreationally using the drug, or those who have been legitimately prescribed the substance. This is particularly true for those who are on a long-term prescription. Tramadol substance abuse is using the drug in any way that was not prescribed by your doctor. This includes taking the drug more frequently than prescribed, taking higher doses than prescribed, taking it without a prescription, and using it in different methods such as insufflating tramadol.

Some of the risks associated with tramadol include:

  • Severe physical health damage
  • Physical and psychological dependence
  • Addiction
  • Tramadol overdose

Individuals who have developed a dependency may begin to use other methods of use such as tramadol insufflation, or snorting. This increases the intensity of the drug and may be used to counteract drug tolerance.

Tramdol has previously been considered a safer option to other opioids, but as of 2014, the Drug Enforcement Administration (DEA) changed the scheduling and now doctors may be more hesitant to prescribe it.

Dangers of Snorting Tramadol

Individuals may choose to snort tramadol to increase the effects of the substance, and in some cases, produce feelings of euphoria and joy. In order to snort tramadol, users will crush the tablet and inhale the powdered pill through the nostrils.

In comparison to swallowing, snorting tramadol results in faster results. This is due to the structure of the nose: the mucous membrane has a strong blood supply and is easily permeable, enabling tramadol to quickly enter the bloodstream directly after snorting it. Additionally, this method avoids the digestive system and liver metabolism process. This results in the synthetic opioid reaching the brain much more quickly.

After snorting tramadol, some people may experience a second peak in symptoms. This is due to some of the substance traveling to the oral cavity and being absorbed into the blood stream this way. Typically the second peak is around 1.5 – 2 hours later.

A further danger of this method of use is that the feelings of euphoria diminish more quickly. This means that individuals who snort tramadol are more likely to get caught in binge drug taking.

One of the most considerable side effects of snorting tramadol is damage to the nose, sinus cavities, and throat. Additionally, a person is more likely to experience an accidental overdose if they snort tramadol rather than swallow it.

Usually people will crush tramadol tablets into a powder in order to snort it, but this means they can’t know exactly how much they are taking. Furthermore, the drug enters the system much more quickly, and in a more intense manner.

Tramadol side effects such as seizures and overdose can be dangerous and even life threatening. Tramadol can result in respiratory depression, serotonin syndrome, and as aforementioned, overdose. We look at some further risks below.

Snorting Tramadol Dangers Include:

  • Nose bleeds
  • Respiratory infections
  • Muscle pain
  • Skin conditions
  • Excessive perspiration
  • Gastrointestinal issues
  • Weight instability
  • Debilitating headaches
  • Disorientation
  • Loss of coordination
  • Mood disorders
  • Dependency or abuse

Serotonin Syndrome

Serotonin syndrome is a condition associated with snorting tramadol. This is a severe drug reaction in relation to substances which change levels of serotonin in the body. This can alter the brain’s communication pathways and result in some severe side effects.

Symptoms of serotonin syndrome may include:

  • Confusion
  • Hallucinations
  • Increased blood pressure
  • Increased body temperature
  • Increased heart rate
  • Lack of coordination skills
  • Seizures

Tramadol Addiction Treatment

Substance abuse of any form is a severe and complex illness, but with compassionate and holistic care, addiction is treatable. Substance addiction can develop quickly and often it has spiralled out of control before the individual recognizes they have a problem.

What might have started as a legitimate prescription to manage pain, can rapidly progress to a severe substance use disorder and poly-substance abuse. An increased tolerance to tramadol often leads to individuals abusing other substances to achieve the euphoria they once experienced with tramadol.

Treatment Programs: Snorting Tramadol

Treating tramadol always begins with detox; this is where all traces of the drug are removed from a person’s system. If somebody has been snorting tramadol for a considerable amount of time, the body becomes used to the presence of the drug, resulting in physical dependence. When somebody who is dependent on a substance stops using, they will experience withdrawal symptoms.

Common Tramadol Withdrawal Symptoms:

  • Anxiety
  • Paranoia
  • Excessive perspiration
  • Sleeping problems
  • Runny nose
  • Chills or fever
  • Nausea or vomiting
  • Aches and pains
  • Hallucinations

Due to the risks involved in withdrawing from tramadol, it is always advised to undergo detox with the support of medical supervision. This is known as a medical detox where doctors can support a person through this challenging process. Distressing and painful withdrawal symptoms can be incredibly upsetting and lead to relapse.

When the substance is completely removed from the individual’s body, therapeutic work can begin to work through the psychological aspects of dependency.

Inpatient substance abuse treatment for using tramadol may use a combination of medication-assisted treatment and behavioral therapies such as cognitive-behavioral therapy (CBT) to ensure that both the physical and psychological aspects of addiction are treated.

Contact Us

At NP Addiction Clinics, we serve the Florida community with a compassionate, holistic approach to addiction treatment. We use cutting-edge research and a range of new therapeutic techniques to treat a range of alcohol and drug dependencies.

If you are ready to move forward from struggles with substances, we can guide you through the early days of recovery and set you up to make empowered life choices. If you have questions about our addiction treatment options, or you would like to schedule an assessment, call us today at (888) 574-3506.

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Samantha Kelly​

Director of National Business Development & Admissions Coordinator

I am a dedicated and passionate professional with extensive experience in business development Admissions and marketing. I have an incredible passion for showing others that there is a light at the end of this dark tunnel if someone truly wants it.
Being in recovery myself I understand the struggles of addiction and alcoholism. I Started this Career path in 2009. With multiple years of experience, I bring a multi-faceted approach and am always seeking new ways to make a difference in the lives of those I work with.

Kim L. Buckner


As a Substance Abuse Motivational Speaker, Pastor, Peer Advocate, and Facilitator. Kim helps clients avoid relapse by understanding their triggers. Those people, places and things that can cause craving, as well as internal triggers like feelings, thoughts, or emotions. Kim also clients with identifying and building healthy relationships now that they’re clean and sober.

Kim’s background includes extensive experience as a motivational speaker and work in faith-based organizations helping youth and adults alike. He says he is motivated by giving back to the community, understanding, and not judging who she comes into contact with. Kim’s favorite quote is by Dr. Raymond Johnson: “The respect given to others rebounds to the giver to deny the scared in the Other is to deny it in oneself.”

Caty Burns


Caty graduated from Indiana University Bloomington in 2015 with a Bachelor of Arts in Psychology and minors in Counseling and History. Throughout her undergrad, she worked at the local CASA program, supporting volunteers advocating for children who had experienced abuse and neglect. Caty worked for seven years at a community mental health center (CMHC), partnering with children, adults, and families.

During those seven years, she taught life and coping skills as well as behavior management, provided case management and peer recovery services, and facilitated treatment teams that included the client, family, providers, and community members. I have also worked at an IOP providing group therapy services. She is currently working towards my Master of Social Work.

In her free time, Caty enjoys reading, especially historical fiction, spending time outdoors and having movie nights with her family. Disney World is her happy place, and she dreams of living among the elephants.

Madison Knowles

Mental Health Therapist

My name is Madison Knowles, I am a Mental health therapist at NPAC. I am a single-mother of two and I have a daughter who is globally delayed and has been diagnosed with autism. I have been in this industry since I was 16 years old, as I was fascinated with human behavior. I obtained my masters in applied behavioral analysis and started off working with people with disabilities. I then found my love for counseling when I worked with juveniles who had mental health and substance use issues. I then decided to go back for my mental health therapy license after that and working in a forensic treatment center. I went on to obtain my therapy credentials and since 2017, I have also been working on my PhD in forensic psychology in which I am currently working on my dissertation. I am inspired by change and how resilient people can be. My favorite inspirational quote is “Some will, Some won’t, So what, NEXT!!!” This quote has inspired me to try, try, and try again no matter how hard life gets, someone will give you a chance eventually. As a therapist at NPAC, I have been given the opportunity to work with diverse populations such as in substance use and mental health and I am known for my work with people on the schizophrenic spectrum as well as with other clients with other severe conditions including personality disorders.

Megan Carmona, LMHC

Lead Therapist

Our Lead Therapist, Megan, is a bilingual Licensed Mental Health Counselor who specializes in working with adults who struggle with addiction, anxiety, depression, and trauma. As Lead Therapist, she provides individual, family, and group therapy sessions to our clients.  Megan says “I am very passionate about therapy, especially about supporting my clients in exploring their strengths and identity. My goal is to provide individuals with the tools that can help them achieve independence in coping with their challenges and facilitating personal development.” In her free time, Megan enjoys watching docu-series and playing video games with her family. Her dream is to own acres of land so she can care for vulnerable animals, especially old dogs, cats, and horses. 

Kristen Bensley

Primary Clinician

As Primary Clinician, Kristen works with all aspects of our clinical team, from case management to primary therapy.  She has broad experience working in the mental health field. Prior to joining our team at the Neuro Psychiatric Addiction Clinic, Kristen was part of the team awarded the Evernorth Behavioral Health Center of Excellence Designation by Cigna. She says her motivation is to help people rediscover who they are and become excited about the future and all the possibilities life offers. Kristen’s favorite quote is: “You can’t go back and change the beginning, but you can start where you are and change the ending.”

Ronn Daigle, MSW

Therapist, Utilization Review Clinician

Ronn Daigle services as a Therapist and Utilization Review Clinician at the Neuro Psychiatric Addiction Clinic. He has been working in the field of substance use disorder treatment since 2011, with experience in all facility-based levels of care. Ronn earned, both an Associate of Arts in Psychology (2013) and Bachelor of Science in Human Services, with an Addiction Studies Concentration (2015) from Indian River State College. 

Ronn additionally earned a Master of Social Work degree in 2021 and is a current Registered Clinical Social Work Intern working toward licensure (LCSW). He describes himself as detail oriented, and solution focused.

Ronn says: “There is nothing more fulfilling than working with someone who doesn’t believe in himself or herself, and being there in the moment with them when the belief begins. We work with individuals who come to us at a point and time in their respective lives where they do not believe that change for others is possible; let alone for themselves…throughout the process they eventually come to a point where they realize that change is not only possible, but achievable.”

Erika Melecio, LMHC, MCAP, CEI

Assistant Clinical Director

Erika Melecio, LMHC, MCAP, CEI is the Assistant Clinical Director at Neuropsychiatric Addiction Clinic who specializes in the treatment of LGBTQ, addiction, as well as mental health disorders ranging from depression and anxiety, to Bipolar Disorder, trauma, personality disorders, psychotic disorders, and eating disorders. Erika utilizes a number of modalities including Cognitive Behavioral Therapy, Solution Focused Therapy, Motivational Interviewing, Dialectical Behavioral Therapy, and Mindfulness amongst others. Erika has been in practice for close to a decade and has earned her license in Mental Health Counseling, as well as being a Master’s Certified Addiction Professional. Erika has worked with many individuals including couples counseling and family therapy, and is fluent in Spanish.
Throughout my years of practice, one of the things I enjoy helping people find is inner peace. Whether you are in the deepest parts of depression, overrun by your anxiety, controlled by your addiction, or there are certain issues in your life that are negatively impacting your ability to function, and have a happy, healthy life, maybe now is the time to talk about it. I am a big believer in empowerment, working hard in therapy, and utilizing different techniques to help you regain that inner peace that may have been lost along the way. I want to work with you as a team because with two people, absolutely everything is possible. I want to be there as a therapist, to help build you up, support you, but also help you be honest with yourself and accountable. At the end of the day, when all is said and done, my biggest goal for you is going to be simple….for you to no longer need my services. Why? Because if you no longer need my services, it means that you have regained your peace, you have regained your strength, you have regained your confidence. It means that you now have the tools to address any issues that try to derail you, and best of all, you will have the insight to overcome and thrive. So let’s begin this journey together, and get you to the place you want to be, emotionally, mentally, psychologically, and in your sobriety.

Aurelio Ayuso, MSW, LCSW, CAP, ICADC

Clinical Director

Aurelio has worked with those that suffer from the disease of addiction in adults and juveniles alike for over 10 years, beginning in the United States Navy where he proudly served for 20 years, working with those that were succumbed by addiction due to trauma and continuing his passion for helping those in need locally in Central Florida.

He specializes in both Addictions and Trauma, he has worked first as a therapist then as the clinical supervisor to both the Juvenile and Adult Drug Court programs in Brevard County. Aurelio has been instrumental in developing substance abuse treatment programs directly tailored to help those that also suffer from complex trauma due to their addiction. He has been recognized by several organizations for his forward thinking and ability to tailor treatment to individuals in the most restrictive environments.

Mr. Ayuso received his Graduate Degree in Clinical Social Work from the University of Central Florida in Orlando. He is a Licensed Clinical Social Worker as well as Certified Addictions Professional in the State of Florida, and Internationally Certified Alcohol & Drug Counselor. Aurelio specializes in the treatment of Addiction, Trauma, and Abandonment using strength based strategies deeply rooted in Solution Focused, and Mindfulness Therapies. At the Neuropsychiatric Addiction Clinic he passionately develops holistic curriculums that foster the belief that through addressing the mind, body, and spirit together, the Disease of Addiction can be addressed successfully.

Robert Lehmann, MHSA

Chief Operating Officer

Bob Lehmann is the Chief Operating Officer at the Neuro Psychiatric Addiction Clinic. He has a Master’s Degree in Human Services Administration with a concentration in Mental Health Administration and over twenty-five years of experience as a senior executive at addiction and mental health treatment facilities.

One of the reasons for his commitment to excellence in addiction treatment was his experience related to family members who suffered from the disease of addiction. Bob has been actively involved in community organizations throughout his career. Recently he was one of the founders of the Florida Addiction Treatment Coalition (FATC) and is its present Vice President. FATC was designed to bring together treatment executives in Florida to advocate on behalf of treatment facilities and the clients they serve adhering to a foundation of integrity and service excellence.

Jose R. Toledo, M.D.

Medical Director

A well-rounded and accomplished individual, Jose R. Toledo, M.D., is the Medical Director of Neuro Psychiatric Addiction Clinic.

Dr. Toledo is a neurologist with 25 years of experience and has been in private practice since 1991 on the Treasure Coast of Florida. He completed his neurology training at the State University of New York and his Fellowship training at the University of Pittsburgh in Epilepsy and Clinical Neurophysiology.

He also completed 24 months of acute inpatient psychiatry at the Western Missouri Mental Health Center, University of Missouri in Kansas City. In 2008, Dr. Toledo participated in and was certified in the continuing medical education activity entitled “Buprenorphine and Office-Based Treatment of Opioid Dependence” from The Medical University of South Carolina during which began his quest to found and head Neuropsychiatric Addiction Clinic.

Dr. Toledo is a brain specialist with particular competence in addiction medicine and out-patient detoxification treatment and integrates the fields seamlessly. He is certified to prescribe Buprenorphine (Suboxone). He incorporates his background in neurology into the addiction field. Dr. Toledo is member/fellow of The American Medical Association, The Florida Medical Association and The American Society of Addiction Medicine