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Dossier · medication trap · Opioid painkiller

Tramadol: the "mild" opioid that isn't always

Often seen as a lighter step than oxycodone or morphine. Yet tramadol is an opioid with a real risk of habituation and dependence, and that risk is easily underestimated with this drug.

The figures

318.000people received a prescription for tramadol in the fourth quarter of 2024, 3.35% of all drug users.Source: IVM/SFK, Monitor Prescription GPs, 2025
Decreasing since 2022the percentage of tramadol users decreased from 4.22% (2022) to 3.90% (2023) to 3.35% (2024).Source: IVM/SFK, 2025
100.000+patients under GP treatment used an opioid painkiller for more than three months in 2022 (figure for strong opioids as a group, not tramadol-specific).Source: IVM, 2023

The last figure is from 2022 and concerns strong opioids as a group. We were unable to find a tramadol-specific, recent figure on long-term use from a primary source; We prefer to state this honestly rather than make up a figure.

The tramadol trap

Tramadol belongs to the opioids, the same group as oxycodone and morphine, although the effect is milder. It is precisely this reputation of "mild" that can be a pitfall.

1

A doctor prescribes tramadol for moderate to severe pain, for example after an operation or for chronic symptoms.

2

Because it is seen as "lighter" than other opioids, alertness is sometimes lower than with, for example, oxycodone.

3

With longer use, tolerance develops: the same effect requires a higher dose.

4

Repeat prescriptions via the GP tacitly maintain use, without a fixed evaluation moment.

5

Stopping can cause fear, nausea and restlessness, which feels like proof that the drug is still needed.

6

Reducing the dose on your own often leads to relapse into the old use to prevent withdrawal. relieve.

Tramadol is not the care trap. A prescription that is called "mild" and is therefore never viewed critically again. That is the care trap.

The official tapering schedule

The NHG Pain Guideline is specific about this: gradually reduce the dosage in consultation with the patient, with a reduction of 10 to 25 percent per week, based on the available dosage units. For longer-term use or at the patient's request, a slower schedule is used. The guideline also recommends discussing in advance what withdrawal symptoms may occur and arranging regular check-ups, for example before each reduction step.

If use is less than four weeks, in most cases it can be stopped in one go. This is not recommended for longer use due to the risk of serious withdrawal symptoms.

In-depth video

Video thumbnail: Tramadol explanation

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Do you recognise this pattern?

Have you or someone around you been using tramadol for longer than intended, without having had a discussion about tapering? Share your experience. Not to appoint a doctor, but to make the pattern visible.

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Justification and sources

  • IVM (Institute for Responsible Use of Medicines) in collaboration with SFK, Prescription Monitor for General Practitioners, Thematic Report on Opioids 2025: 318,000 tramadol users in Q4 2024 (3.35%), decreasing since 2022 (4.22%) through 2023 (3.90%).
  • IVM, "Increased use of tramadol in 2022": 100,000+ patients longer than 3 months of opioids at the GP (group figure for strong opioids, not tramadol specific).
  • NHG Pain Guideline: official tapering schedule, 10-25% reduction per week, slower schedule for longer-term use.
  • Pharmacotherapeutic Compass: dosage advice and risk profile of tramadol.
This file was created on the basis of public information sources. Zorgfuik does not make diagnoses and does not provide medical advice. Never stop taking tramadol abruptly after longer use; this can cause serious withdrawal symptoms. If you have any doubts about your use or if you wish to reduce it, always consult your GP.