Is the questioner's feeling of self-reproach due to his use of Tramadol, and is he sinful or required to perform ghusl, taking into account that he rejects these thoughts and sometimes experiences them even without the drug?

It is impermissible to use this narcotic drug, and one must repent to Allah from it. These intrusive thoughts do not harm, nor do they necessitate ghusl (ritual bath), nor do they affect the soundness of faith as long as the person dislikes them. It is recommended to seek treatment and consult a trustworthy psychiatrist.