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Tapentadol Addiction: Understanding the Risks and How to Minimize Them

Tapentadol Addiction: Understanding the Risks and How to Minimize Them


The risk of Tapentadol Addiction is very low compared to other Schedule II prescription opioid analgesics. Sign of dependency is more prevalent in people taking improper Tapentadol dosage, co-administering it with other medication, or misusing it for recreational purposes. 



Thinking of taking Tapentadol for those excruciating body pain that is coming your way of productivity? But the thought of “Tapentadol Addiction” is holding you back. Then you are not alone. 

Tapentadol is an Opioid analgesic that is approved by the FDA for treating moderate to severe chronic pain. It is also available under brand names such as Nucynta and Palexia. The increasing popularity and its availability online have potentially increased the risk of misuse. 

The Drug Enforcement Administration highlights that 3.5 tons of Tapentadol were distributed in 2020, which was 207.2% greater than the amount distributed between 2010 and 2020 [1]. Thus, addressing the potential risk of Tapentadol abuse and health risks is significantly crucial. 

This comprehensive guide on Tapentadol addiction evaluates its abuse potency and highlights its long-term effects, withdrawal, and overdosing symptoms. 


Tapentadol Addiction- The Science Behind It

Tapentadol is a single-molecule analgesic that delivers pain relief through two distinct mechanisms and is available under the brand name Aspadol. It is a key factor that differentiates Tapentadol from other analgesics. With the onset of action within 30 minutes, the analgesic's effect lasts 4 to 6 hours. 

The science or clinical reasoning behind Tapentadol addiction or Opioid Use Disorder (OUD) is mentioned below. 

  • Aspadol Price Comparison showcases that it is a much more affordable choice of opioid analgesic, thus increasing the risk of misuse.

  • It moves from the digestive tract following an oral administration to the opioid receptors present in the brain.

  • After binding to the brain receptor, it triggers a series of chemical reactions, including the secretion of dopamine in the cortisol. It helps people feel calm and relaxed. 

  • Tapentadol, including its brand drugs, Nucynta and Palexia, crosses the blood/brain barrier. 

  • This sense of relaxation can induce a euphoric feeling in people with no or mild body pain. Thus, such people keep taking Tapentadol 100 mg dosage to maintain the sedative feeling of the analgesic. 

  • Long-term use of Tapentadol in high dosages can make the brain cells accustomed to the medication. 

  • It also affects dopamine secretion, which is no longer produced easily in the absence of Tapentadol. Thus, such people feel sad and deprived without it, creating an urge and dependence on the substance.  

However, a comparative Nucynta vs Oxycodone study indicates that Tapentadol's abuse risk is much lower than other opioid analgesic, such as Oxycodone due to its noradrenaline reuptake inhibition activity. 

Causes Of Tapentadol Addiction 

When we speak of addiction, it consists of both physiological and physiological factors. Now that we have understood the physiological aspect of why Tapentadol addiction arises. Let us look into the psychological attributes of the condition. 

Misuse Of Tapentadol For Recreational Purposes 

The euphoric and sedative effect of Tapentadol is one of the key factors that contribute to its recreational use. 

Research states that the majority of people who misuse Tapentadol inject the drug with a needle. It is estimated that over 80% of the people who misuse this analgesic also take other opioids [2]. 

Adverse Childhood Experiences (ACEs)

According to the CDC, 61% of adults across the 25 states of the United States have experienced at least one or more types of ACE. Such conditions increase substance use disorder risk along with increasing chronic health problems such as diabetes, cancer, and heart disease [3]. 


Studies also suggest that the genetic makeup of a person is responsible for 40 to 60% of the possibility of substance use disorder (SUD). People with relatives with substance abuse disorder are most likely to develop it [4]. 

Mental Health Conditions

Studies suggest that there is a strong connection between mental health conditions and addiction. It is observed that half of the people who experience mental health issues also suffer from addiction [4]. 

Online Availability And Cost-Effectiveness

At the present time, getting Tapentadol 100 mg online is very easy. Most pharmacies retail Tapentadol without a prescription at a much more affordable price than local pharmacies. This makes getting a prescription drug much easier, thus resulting in a higher risk of abuse. 


Author's Note- Promoting Responsible Medication Practices

HealthNaturo also retails affordable Tapentadol 100 mg online without a prescription. 

Our key reason to retail medication online without a prescription is to enhance accessibility and convenience for people with busy schedules. However, we do not promote or advise patients to take prescription drugs without consulting a doctor.

We at HealthNaturo also display transparency by providing accurate information on all products, including their potential health risks and proper dosage guidelines. We under no circumstance promote buying any prescription drug online for abuse. 


Signs And Symptoms Of Tapentadol Addiction

Identifying the symptoms of addiction is very important and plays a crucial role in getting the right medical help at the right time. 

Some of the common signs of Tapentadol addiction and misuse include-

  • Frequent drug refills. 

  • Taking a higher dosage than the recommended one. 

  • Depression signs 

  • Taking dosage closer together. 

  • Defending their actions. 

  • Poor performance at school and work. 

  • Strained relations with friends and family


Tapentadol And Co-Occurring Substance Use Disorders

The term "co-occurring disorders" defines a person who simultaneously experiences both substance use disorder and mental health disorder, such as anxiety or depression.

It emphasizes the fact that both these conditions co-exist and influence each other.

People with a history of substance abuse may be at a higher risk of developing substance use disorder involving Tapentadol.

Treating people with co-occurring substance use disorders involving tapentadol requires a comprehensive approach. It includes addressing both the conditions and some of the effective treatment options for Tapentadol And Co-Occurring Substance Use Disorders are-

  • Medication-Assisted Treatment (Mat).

  • Support Groups.

  • Therapy (Cognitive-Behavioral Therapy).


Addiction Risk- The Combined Effects Of Tapentadol And Alcohol

The chances of developing Tapentadol dependency increase if this analgesic is taken with other medications or substances. 

Tapentadol is a benzenoid class opioid that should not be taken with alcohol. When taken with alcohol, it is known to cause moderate interaction. 

Such interaction may affect the nervous system, resulting in drowsiness, difficulty concentrating, and dizziness [5]. It may also cause depression and impaired psychomotor skills, judgment, and thinking ability. 

Some of the common effects of mixing Tapentadol and alcohol include-

  • Slower heart rate

  • Dehydration 

  • Sedation 

  • Respiratory arrest

  • Abnormal behavior 

  • Loss of consciousness 

  • Nausea 

  • Irregular heart rate 

  • Changes in blood pressure 


Tapentadol Addiction And Dependence: A Case Series

Numerous case studies have indicated and further confirmed the possibility of Tapentadol dependency and addiction. We consider a few such cases today to better understand the possibility of experiencing dependency on this opioid analgesic. 



Researcher and Publication 


Tapentadol Abuse Potential: A Postmarketing Evaluation Using a Sample of Individuals Evaluated for Substance Abuse Treatment 

Study by Stephen F. Butler, Ph.D. 

Published on 19 January 2015 in Pain Medicine Journal, Volume 16, Issue 1,  Pages 119–130. 

The study compared the abuse potency of Tapentadol immediate-release (IR) and extended-release (ER) with a few other Schedule II opioid medications to find that Tapentadol dependence was significantly less than other comparator compounds [14]. 

Tapentadol: A Real-World Look at Misuse, Abuse, and Diversion

A study by Jeffrey Fudin, PharmD. 

Published on Feb 29, 2020, on the issue of Practical Pain Management, Volume 19, Issue 7. 

The Post-marketing data suggests that Tapentadol ER and IR have a low rate of abuse and nonmedical use compared to other prescription drugs [15]. 

Diversion and Illicit Sale of Extended Release Tapentadol in the United States

A study by Richard C. Dart, MD, Ph.D. 

Published in Pain Medicine Journal, 2016 Aug. 

The objective of the study was to identify the street price for licit or illicit drugs to draw an abuse potency for these compounds. 

The study suggests that Tapentadol ER is rarely sold illicitly in the United States, thus indicating that it is not commonly abused by people. 


Tapentadol Abuse Case Study In India

The study evaluating the Tapentadol abuse cases in India found that in December 2019, among 3084 reported cases of opioid dependence, only 70 cases were for Tapentadol. This suggests that the prevalence of abuse or dependence was about 25% and is much lower compared to the other opioid medications available in the market [16]. 

Tapentadol Or Palexia Addiction Reports From Australia 

A study on Tapentadol abuse, dependence, diversion, or recreational use published in Australia highlights the following key findings. 

  • The highest sale of Tapentadol in 2019 was seen in Western Australia. 

  • Non-prescribed use of tapentadol was low (2.2% in 2019) but had increased by 0.9% since 2017. 

  • Less than 2% of people were reported to inject Tapentadol. 

  • Few people (n<5) were seen to experience an overdose of Tapentadol. 


Tapentadol Hallucinations- A Potential Consequence of Addiction

Tapentadol hallucination is not a common adverse effect of the analgesic; however, there are a few reports of hallucination seen in some individuals. 

Hallucinations are sensory experiences that appear real but are not present in reality. It results in hearing, feeling, and seeing things that do not really exist [6]. 

A study published in Therapeutic Advances in Drug Safety Journal in the year 2018 evaluates the adverse effects of Tapentadol in Australia [7]. The common psychiatric disorders reported in the study for tapentadol include delirium, hallucination, and confusion. This study also suggests that hallucination is among the four most common adverse effects of Tapentadol, as identified by the Medical Dictionary for Regulatory Activities (MedDRA).




Breakdown Of The Study-

The "n" in the above graph represent the frequency of the reported side effect of Tapentadol. 

  • Delirium- It refers to a state of confusion and rapid change in the mental focus. According to the case study, Delirium was reported in 7 individuals and accounted for 18% of the reported psychiatric disorders associated with Tapentadol.

  • Hallucination-It was reported in 5 individuals and represented 13.1% of the psychiatric disorders of this opioid analgesic. 

  • Confusional State- It is defined as mental disorientation and impaired cognition. The study suggests that 5 individuals reported suffering from a confusional state, which accounts for about 13% of adverse effects.

Another study published in 2019 takes into consideration the possibility of experiencing Opioid-induced Hallucinations [8]. In this study, Eellan Sivanesan states that Opioid-induced hallucination is an uncommon but significant side effect of opioid treatment, including Tapentadol. 

In this study, Eellan Sivanesan states that Opioid-induced hallucination is an uncommon yet significant adverse effect of opioid treatment and discovered that about Fifty-six clinical study reports the development of hallucination [8]. 


Long-Term Effects Of Tapentadol Addiction

The long-term use of Tapentadol is a key cause of developing dependency. Some of the consequences of long-term Tapentadol addiction include the following.

  • Impact on physical health- Prolong Tapentadol addiction can result in numerous physical health issues. Since it is metabolized in the liver and is eliminated through the kidney, it deeply affects the functioning of these two organ systems. 

  • Impact on Relationship and Social Life- The long-term effects of Tapentadol addiction can drastically affect the relationship of the addict with their friends and family [9]. Such people often prioritize drug use over their loved ones and their professional commitments and responsibilities. 

  • Psychological and Cognitive Impairment- The effect of Tapentadol dependency can affect the mental health of the person. It can result in anxiety, confusion, and delirium [7,9]. 

Tapentadol Or Nucynta Withdrawal

Sudden discontinuation of Tapentadol following long-term use or dependency may result in withdrawal. Thus, it is best to consult a doctor before discontinuing the treatment. In most cases, physicians prescribe the Tapentadol tapering method, which involves a gradual decrease in the Tapentadol dosage before completely stopping it. 

Some of the prevalent Tapentadol Withdrawal Symptoms are sweating, anxiety, insomnia, pain, rigors, hallucinations, tremors, piloerection, upper respiratory symptoms, and diarrhea [10]. 

Tapentadol Withdrawal Timeline and Symptom Durations

Due to every individual’s unique physiology, the Tapentadol withdrawal timeline varies from one person to another. A rough outline of the withdrawal timeline is mentioned below. 



Withdrawal Symptoms

Within 24-72 hours

  • Early withdrawal symptoms may begin to appear within the first 2 days of discontinuing the analgesic. 

  • These symptoms include irritability, muscle aches, restlessness, and insomnia. 

Around Days 3-5

  • The Peak Withdrawal Symptoms are observed within 3 to 5 days of discontinuation of the analgesic. 

  • During this period, the severity of the side effects intensified. 

  • Often causes gastrointestinal disturbances such as diarrhea, nausea, and vomiting. It may also result in cravings. 


Tapentadol Addiction And The Risk Of Overdose

The maximum recommended Tapentadol dosage in a day is about 300 to 400 mg (Tapentadol 100 mg thrice or four times a day). However, the intake of Tapentadol over the recommended dosage can result in overdosing. 



Nucynta Overdose Symptoms

The symptoms of Tapentadol overdose may vary between people; however, some of the common health risks of overdosing include-

  • Slower heart rate

  • Blurry vision

  • Muscle weakness

  • Clammy skin

  • Sweating

  • Drowsiness

  • Confusion

  • Slow breathing [10].


Tapentadol Addiction Treatment Options

Addiction Treatment plays a key role in helping people get sober. 

According to the National Survey on Drug Use and Health, in the United States, about 8.1% of people either need or are regularly receiving substance use disorder treatment [11]. 

Some of the proven Addiction Treatment options are listed below. 

  • Detoxification- It is normally the first step in the treatment. Detoxification helps in clearing the substance from the body and further helps in limiting the withdrawal reaction. 

  • Rehabilitation programs- These offer long-term treatment options that provide a 24-hour care program and all necessary medical assistance throughout the day. 

  • Medications- Certain medications may help in recovering from a substance-related disorder. They also help in managing withdrawal symptoms. After a thorough investigation of your health and medical condition, a medical professional will be able to choose the right medication for the recovering addict. 


Tapentadol Addiction And Relapse Prevention Strategies

Like any substance dependency, the possibility of relapse from Tapentadol addiction cannot be overlooked. Relapse is defined as the return to misusing or abusing a drug or substance following a period of abstinence or sobriety [12]. 

Case 1 of Tapentadol Relapse 

A case study depicting A case study of a 30-year-old man taking Tapentadol 50 mg of abdominal pain showed the following-

  • He developed tolerance and craving within 6 months and increased the dosage to 500 mg. 

  • Within 7 months, he experienced withdrawal signs such as insomnia, anhedonia, decreased self-confidence, fatigue,  pessimistic views of the future, and body aches. 

  • After 1 year, he started addiction treatment and relapsed within 1 month. Following this, he started tapering off methods to gradually stop the intake of the medication [13]. 

Case 2 of Tapentadol Relapse

A 34-year-old man with nicotine dependence since 21 years of age and alcohol dependence took Tapentadol 100 mg to quit alcohol. He experienced euphoria, hypnagogic hallucinations, and a perception of time moving fast from Tapentadol. And his timeline of dependency to relapse is-

  • Development of tolerance and craving within 2 months.

  • The dosage increased to 6,000 mg within 2 years.

  • He took Tapentadol with alcohol at times to enhance its effect. 

  • He also took Tapentadol with cannabis, which resulted in dysphoria, restlessness, and anxiety.

  • Not taking Tapentadol resulted in withdrawal symptoms, and he began to experience fatigue, low mood, decreased self-confidence, worthlessness, helplessness, and pessimistic views of the future.

  • Following detoxification, he relapsed within 1 month [13]. 

Tapentadol Relapse Prevention Strategies

People recovering from various addictions often are seen to encounter relapse. 

Some of the important factors that can trigger a relapse are-

  • Boredom

  • Money problems

  • Falling into old habits

  • Certain sights and smells

  • Stress

  • Anger

  • Relationship issues

So, here are a few effective ways that will help people prevent Tapentadol relapse. 

The Importance Of Aftercare: It includes creating a plan to stay sober. It is often done by making housing arrangements, constant monitoring by a health professional, and joining counseling sessions. 


The Role Of Therapy And Counseling: Relapse prevention counseling or therapy includes cognitive-behavioral therapy (CBT) that assists in recognizing, managing, and preventing high-risk situations that may lead to relapse. It helps such people learn coping strategies and ways to identify their triggers that will help them from relapsing. 


The Role Of Support Groups: Group therapy helps prevent relapse by giving you a safe space to share your feelings and challenges with people who are on the same journey as you. These groups help you find ways to battle the cravings. 


Is Tapentadol Addictive- Our Final Thoughts

Is all this information and case studies a little overwhelming to process at once? Don't worry; here is a summary of everything that we discussed in this article. 

The key findings-

  • Studies suggest that the possibility of Tapentadol Addiction and dependency is much lower when compared to the other Schedule II prescription opioid drugs. 

  • But we cannot completely rule out the likelihood of Tapentadol abuse in people. If overdosed, taken for a prolonged time, or co-administered with other compounds and medication, it may result in dependency. 

  • Signs of Tapentadol dependency are Depression, taking higher dosages, avoiding social gatherings, frequently using the medication, and poor performance at work and school. 

  • Sudden discontinuation of Tapentadol is not recommended as it may result in withdrawal signs. Such people should consult a doctor to plan an effective tapering-off method first. 

  • A few effective Tapentadol addiction treatment options are Detoxification and Rehabilitation programs. 

  • Studies show the possibility of relapse is within 1 month, and thus, following relapse-prevention techniques such as therapy counseling and medication is important. 

So, we suggest consulting a doctor before buying Tapentadol online. It should be administered following dosage guidelines. Overdosing, long-term use, and drug interaction should be avoided for the best effects.


Clinical studies show it takes about 6 months of continuous use of Tapentadol to develop addiction and dependence.

Tapentadol abuse can increase the risk of overdosing, which may further cause numerous other health issues.

Yes, the use of Tapentadol produces a significant amount of cortical dopamine and plays a vital role in reward and movement regulation.

Yes, the use of Tapentadol for a long time can cause dependence.

Yes, Tapentadol is an opioid medication that is classified as a narcotic analgesic.


  1. Declines and pronounced state-level variation in tapentadol use in the US, medrxiv. 

  2. Tapentadol Addiction & Misuse: Signs, Dangers & Treatment, bicyclehealth. 

  3. Addiction Risk Factors in Young People, shatterproof. 

  4. Addiction, clevelandclinic. 

  5. Tapentadol and Alcohol/Food Interactions, Drugs. 

  6. Hallucinations: Definition, Causes, Treatment & Types, citations, Cleveland Clinic. 

  7. Spontaneously reported adverse drug events related to tapentadol and oxycodone/naloxone in Australia, NCBI. 

  8. Opioid-induced Hallucinations: A Review of the Literature, Pathophysiology, Diagnosis, and Treatment, NCBI. 

  9. Tapentadol Signs, Symptoms and Side Effects, therecoveryvillage.

  10. Tapentadol Overdose, therecoveryvillage. 

  11. What are the treatments for addiction, medicalnewstoday. 

  12. Relapse - Alcohol and Drug Foundation,

  13. Tapentadol Dependence: A Case Series, psychiatrist.  

  14. Tapentadol Abuse Potential: A Postmarketing Evaluation Using a Sample of Individuals Evaluated for Substance Abuse Treatment, academic. 

  15. Tapentadol: A Real-World Look at Misuse, Abuse, and Diversion, practicalpainmanagement. 

  16. Tapentadol, the new kid on the block in India- Is it time to worry, Indian Journal of Psychiatry.