In 2016, 47.3 million tramadol prescriptions were dispensed in the United States.1 Tramadol is an opioid painkiller that has high addictive potential.
Many well-meaning people begin to take tramadol as prescribed by their doctor, only to find that their use quickly spirals out of control.
Tramadol acts on the brain’s monoamine reuptake systems, opioid receptors, and the body’s central nervous system, working to enhance feelings of calm and relaxation while also suppressing pain. When tramadol is used regularly, the structures and pathways of the brain can change in a way that interferes with chemical messaging. This can cause tramadol to become less effective over time, resulting in the body and brain needing more and more of the medication to create the desired effect.
Over time, changes in the brain related to tramadol can become difficult or impossible to reverse.2 This creates a condition known as dependence. When the brain and the body are dependent on tramadol, they function differently. Dependence can result in intense withdrawal and detox symptoms if tramadol use is stopped suddenly.
It can be hard to understand why some people develop a dependence on tramadol and others do not. Many factors determine whether a person will become dependent on a drug. Personal or family history of addiction and mental health issues can make it more likely that a person will become dependent on tramadol.2 Using tramadol in a way other than how it was prescribed by your doctor can increase the likelihood of dependence.
Many people who begin taking tramadol have no intention of ever using the drug outside of how it was prescribed. It’s easy to fall into the trap of using more and more of the drug to get the same pain-relieving/relaxing effect felt at the beginning of use. When you began taking tramadol, your doctor should have talked with you about an opioid taper plan if you were to use the drug for more than two weeks.
Many people find that they’re unable to follow their doctor’s prescription. They may take their prescription in ways other than how it was prescribed, use more medication than prescribed, or “doctor shop” to acquire additional medication.
People who take tramadol continue using even after they no longer need the drug for pain relief due to fear of withdrawal. Luckily, there are many options for people who need help with getting through the withdrawal period. If you’re taking tramadol in a way other than how it was prescribed by your physician, it’s essential to get help to get things back under control.
Withdrawal From Tramadol
If you’ve taken tramadol for two weeks or less and have stuck to your doctor’s instructions for use, it’s unlikely that you’ll experience any withdrawal symptoms. You should be able to simply stop taking tramadol as soon as your prescription runs out, or sooner if you’re no longer in pain.3 If you find that you have withdrawal symptoms despite only being on the medication for a short time, it’s important to talk with your doctor about creating an opioid taper plan to help you reduce and eventually stop using tramadol.
Tramadol is different than other pain management medications. Opioids like hydrocodone and oxycodone can create a high when taken in large doses. Tramadol is capable of this as well, but it works differently than traditional opioids. Tramadol doesn’t just activate the brain’s opioid receptors – it also blocks serotonin, norepinephrine, and other neurotransmitters from being absorbed back into the brain’s systems. This means that tramadol can create both atypical and traditional opioid withdrawal syndromes. People who have struggled with and recovered from addiction to other types of opioids may find that tramadol is especially difficult to stop using.
Usually, there are two phases of opioid withdrawal. Early withdrawal symptoms begin as soon as the drug starts to leave the bloodstream. Late withdrawal occurs further down the line.
Early Withdrawal From Opioids
- Physical symptoms, including runny nose, sweating, excessive eye tearing, muscle and body aches, yawning, racing heart rate, fast breathing, and/or hypertension4
- Mental/emotional symptoms, including anxiety, restlessness, agitation, and/pr trouble sleeping4
Late Withdrawal From Opioids
- Physical symptoms, including pupil dilation, loss of appetite, diarrhea, vomiting, stomach pain, cramping, chills, and/or goosebumps4
- Mental/emotional symptoms, including difficulty concentrating, difficulty thinking clearly, irritability, drug cravings, depersonalization, and/or depression4
The vast majority of people who go through withdrawal and detox from tramadol only experience typical, traditional withdrawal symptoms. In addition to typical withdrawal symptoms, up to 10% of people going through withdrawal from tramadol may also experience atypical opioid withdrawal symptoms, including tingling or numbness in the extremities, hallucinations, panic attacks, extreme paranoia, anxiety, and/or severe confusion. These symptoms can make it especially difficult to get through the detox process without the help of a medical treatment team.
For most people, tramadol acts very quickly. Immediate-release forms of tramadol are absorbed into the bloodstream and reach peak effectiveness within four hours. Extended-release forms of tramadol take up to six hours to reach maximum effectiveness. While tramadol acts fast, some people who are going through addiction find that it doesn’t act quickly enough to appease their cravings. This can lead to using the drug in ways other than how it was prescribed by their doctor, or using more of the drug than prescribed.
Most people who experience withdrawal from tramadol begin to experience some symptoms within 12 hours of the last dose. The symptoms of tramadol withdrawal often mirror the process of going through the flu. The anticipation of withdrawal can cause some symptoms (like anxiety and agitation) to set in quickly.
While no two people will go through the same withdrawal from tramadol, most people find that their symptoms peak within a few days after their last use. Physical withdrawal symptoms usually taper off first, while mental and emotional effects may last longer.
Many factors can affect the difficulty of the withdrawal process, including the amount of tramadol used, genetics, stress levels, body weight, social support, and more. Generally, the more dependent the body and brain have become on tramadol, the more severe and long-lasting withdrawal symptoms will be.
Mental health conditions can also play a role in the severity of withdrawal. Underlying medical conditions that have yet to be diagnosed can also make the withdrawal period more difficult.
When the brain is dependent on tramadol, it can take more time to get back to base level. People who have taken tramadol for a long time and/or have used large amounts of the drug are more likely to experience long-lasting, severe withdrawal.
If tramadol is used as directed, withdrawal is likely to be less severe than when the drug is taken differently. Taking the drug in pill form as directed may be less likely to result in severe withdrawals than smoking, snorting, or injecting the drug.
Medical Detox: Why It Makes Sense
If you or a loved one are choosing to begin the detox process, it’s normal to be apprehensive about what will happen next. It’s a good idea to become familiar with the different methods of detox so you can decide what makes the most sense for your needs.
Some people choose to detox at home, but medical experts agree that this isn’t a good idea. Opioid withdrawal can be life-threatening, and it’s important to have a medical treatment team in place to stay safe during the detox process.5 When detox is not properly managed, many people who want to get well find that they quickly turn back to drugs, no matter how strong their desire is to quit using.
Working with a treatment center that can help people who are experiencing withdrawal through the detox process as quickly, comfortably, and safely as possible. This increases the likelihood of completing the detox process.
Going through withdrawal is incredibly difficult, and it can be hard to think straight when a person is dealing with the psychological effects of tramadol leaving the body. When someone is dependent on tramadol, it can be hard to know the correct steps to take to detox as safely as possible.
During medical detox, patients receive 24-hour monitoring from a medical treatment team. After evaluating symptoms, the medical detox team can provide medications that help to alleviate withdrawal. This can make it easier to deal with symptoms including depression, cravings, anxiety, and more. When these psychological symptoms are effectively managed, it can increase the likelihood that the person going through withdrawal can complete a medical detox.
Three medications have been approved by the FDA for opioid withdrawal:
This drug fills the brain’s opioid recepts for a longer time than tramadol, but it doesn’t activate opioid receptors in the same way as tramadol. Buprenorphine can reduce withdrawal symptoms, and it doesn’t create a high in the same way that tramadol does. There are several brand names of buprenorphine, including Suboxone, Zubsolv, Bunavail, and Subutex. For many people, buprenorphine can have a plateau effect. This means that the drug does nothing when the person using it attempts to take more than the recommended dose.
Methadone has a much longer half-life than that of tramadol, which makes it a good substitute to help people through the withdrawal process. It’s important to note that methadone is still an opioid, even though the risk for dependence is lower than that of other opioids. If methadone is used after the detox process is complete, it’s important for the person who is in recovery to be closely monitored to ensure that they aren’t developing a methadone dependence.
Known as Vivitrol, ReVia, and Depade, naltrexone is best used after the early stages of withdrawal are complete. Naltrexone can is an opioid antagonist and blocks the brain’s opioid receptors from responding to opioid drugs.
Recovery is Possible. We Can Help.
If you’re going through withdrawal, or you want to get well but are scared of the withdrawal process, you’re not alone. Many people put off asking for help because they’re scared of the process of getting opioids out of their system. Luckily, there are many ways that a qualified treatment team can help to manage your withdrawal symptoms.
At Harmony Place, we know that it’s not easy to reach out for help. Our caring staff members are here to support you as you decide to get well. We understand the gravity of deciding to begin your recovery, and we want to get to know you and support you throughout this change.
While the factors that led to your addiction were not your fault, it’s your responsibility to take charge and make a positive change in your life. Pick up the phone today to learn more about our treatment options and how we can support you in your path to recovery.
1Drug Enforcement Administration. Tramadol.
3Mayo Clinic. Tapering off opioids: When and how.
4Medline Plus. Opiate and opioid withdrawal.
5National Center for Biotechnology Information. Opioid Withdrawal.