This study investigated the prevalence, nature and the effect of psychoactive substance (Tramadol HCl) usage among tertiary education students in Adamawa State, Nigeria. Opinion survey was adopted for the study. 300 students were purposively sampled for the study using simple random sampling technique. The World Health Organization Student?? 1/2 s Drug Use Questionnaire (WHOSDUQ, 2011) titled Students Use of Psychoactive Substance Questionnaire (SPSQ) was used adapted as instrument for data collection. Descriptive statistics of mean and percentage was used to analyze data in respect of research questions while z-test and ANOVA were used to test the null hypotheses at 0.05 level of significance. Results from the study revealed that the prevalence of psychoactive substance use among tertiary education students in Adamawa State was high; the use of the of the substance was found to be more significant among the male than female students; the nature of psychoactive substance usage was orally (swallowing) and by diluting the substance in other liquid substances; the effect of Tramadol HCl use was found to be non significant on students?? 1/2 academic achievement; and most of the respondents agreed that the substance cause them to have more fun, loss tension and become relaxed, control anger, anxiety and depression, feel at the top of the world and sometimes leads to less spending of money among others. Monitoring of children?? 1/2 s behaviour by parents at home, formation of Drug Free Clubs in schools and strong rules against use of drugs should be made by institutions as preventive techniques to curb the use of psychoactive substance by students was suggested by the study.