In 2012, more than 3 million people used tramadol, a synthetic opioid drug, for non-medical purposes and approximately 20,000 emergency department visits occurred due to tramadol abuse 1. Quitting tramadol after a period of heavy or long-term use may result in a number of unpleasant withdrawal symptoms. If you or someone you care for suffers from a tramadol addiction, there are professional opioid detox services available to help manage withdrawal and start you on the road to recovery.
This article will help you better understand tramadol withdrawal by:
- Discussing tramadol withdrawal symptoms.
- Describing withdrawal timeline.
- Explaining post-acute withdrawal syndrome.
- Detailing tramadol withdrawal treatment.
- Listing medications used for tramadol detox.
- Outlining various aftercare treatment options.
- Helping you find detoxification assistance.
Tramadol Withdrawal Symptoms
Tramadol addiction may develop after repeated abuse. When used, opioid drugs influence the activities of certain neurotransmitters—including those responsible for pleasure and motivation. As tolerance develops, the brain requires ever-increasing doses to achieve the same effect. Physical dependence, which means that a user must continue taking tramadol in order to function normally and avoid withdrawal syndrome, can also develop due to long-term tramadol use. Dependence is not synonymous with addiction, as people who are taking the drug for medical reasons also often develop some level of dependence but do not meet the criteria for a substance use disorder, or tramadol addiction. However, a growing level of physiologic dependence can drive compulsive use of the drug and ultimately influence the development of a tramadol addiction.
The tramadol withdrawal syndrome shares many similarities with that associated with quitting other opioids. Symptom severity depends on the quantity of tramadol taken, the length of addiction, other drugs the user takes, and the individual’s biological makeup.
Typical tramadol withdrawal symptoms may include 2,3:
- Severe cravings.
- Restlessness and anxiety.
- Excessive yawning.
- Teary eyes and runny nose.
- Excessive sweating.
- Diarrhea, nausea, and vomiting.
- Muscle aches and tremors.
About 10% of people withdrawing from tramadol experience atypical, or abnormal, symptoms, due to tramadol’s dual mechanism of action. It is both an opioid agonist, meaning that it targets opioid receptors in the brain, and a reuptake inhibitor of serotonin and norepinephrine, which means that it increases the activity of those two neurotransmitters, similar to how antidepressants work 8.
Some atypical withdrawal symptoms may include 1:
- Extreme anxiety.
- Panic attacks.
- Tingling and numbness sensations in the extremities.
For many, these withdrawal symptoms—both typical and atypical—become so severe that the user will continue use of the drug at all costs to alleviate them and, in doing so, is unable to break the tramadol addiction cycle. Tramadol detox treatment can help you withdraw safely and comfortably. Call our helpline at 1-888-241-8971 and find a detox program that is best for you.
The tramadol withdrawal timeline greatly depends on whether the medication is a short-acting or long-acting formulation. Tramadol is available as an immediate release tablet (Ultram), an extended-release capsule (ConZip), and an extended-release tablet (Ultram ER) 3. Withdrawal symptoms for the short-acting, immediate release tablet may appear within several hours of the most recent dose, while withdrawal symptoms for the longer-acting, extended-release formulas may, in some cases, not emerge for 1 or 2 days following the last dose 2.
The nature of the tramadol-associated withdrawal syndrome experienced by detoxing individuals will depend on a number of factors, such as:
- Length of tramadol abuse or addiction.
- Dose of tramadol taken.
- Method of administration (orally, snorting, or dissolving in water and injecting).
- Presence of polydrug abuse.
- The user’s individual physiology.
The majority of the physical symptoms of tramadol withdrawal last between a few days and a couple weeks 2, but the psychological or mental withdrawal symptoms may linger for months or even years.
Post-Acute Withdrawal Syndrome
Chronic tramadol abuse can result in changes in brain chemistry that impact behavior and emotions, effects which last well after the resolution of acute withdrawal, or the predictable withdrawal symptoms that occur with abrupt discontinuation of tramadol use 4. These brain adaptations can cause prolonged withdrawal symptoms, known as Post-Acute Withdrawal Syndrome (PAWS) 4. PAWS can also be referred to as protracted withdrawal or prolonged withdrawal.
Protracted withdrawal symptoms can persist for weeks, months, or even years after someone has detoxed from tramadol 4. For opioids like tramadol, nearly 90% of users experience PAWS in some form 5. Severity varies by individual, but potential symptoms include 4,5:
- Emotional blunting or numbness.
- Obsessive-compulsive behaviors.
- Panic attacks.
- Memory problems.
- Difficulty problem solving and learning.
- Tramadol cravings.
- Sleep difficulties.
The greatest threat from PAWS is relapsing into drug use again. However, participation in an ongoing substance abuse treatment program and, later, diligent aftercare efforts can help a person to manage these symptoms and set the stage for effective, long-term recovery.
Tramadol Withdrawal Treatment
Tramadol withdrawal can be a challenge to overcome. Furthermore, some effects, if left unmanaged, can lead to potentially serious health outcomes. Severe vomiting and diarrhea contribute to dehydration and electrolyte disturbances. Powerful cravings may provoke desperate, even hazardous and illegal efforts to obtain tramadol. Associated mental health issues can trigger or worsen depression and suicidal thoughts. Numerous detox and treatment options can minimize or mitigate these dangers and help facilitate positive change.
The first step toward recovery begins with an effective short-term drug detox program or detox within either an inpatient/residential or outpatient treatment program. Tramadol detox is the process by which the body rids itself of the drug. Detoxification’s primary goal is to manage the tramadol withdrawal syndrome that is likely to occur in wake of quitting the drug 6. It involves monitoring and managing any medical complications to arise throughout the withdrawal process. At times, medications may be administered to alleviate some of the more distressing withdrawal symptoms.
It’s important to note that although drug detox is a vital first step in the recovery process, it is not considered to be adequate addiction treatment on its own since, on its own, it does little to address the underlying reasons that influence tramadol abuse and addiction. Once detox is complete, an ongoing treatment program can help you to obtain and maintain sobriety in the long-term. Substance abuse treatment consists of an intake evaluation necessary to create a personalized treatment plan, individual therapy, group counseling, relapse prevention classes, and medication-assisted treatment.
After you complete a short-term detox program, there are a number of different tramadol addiction treatment programs available, such as:
- Population-specific programs: Some treatment programs specialize in treating specific populations, such as men-only, women-only, veterans, teens, and LGBTQ individuals.
- Inpatient rehab: Requires that the patient lives at the facility for the duration of treatment, which is typically 30, 60, or 90 days, although it can be longer if necessary. A trained treatment team will provide you with 24-hour psychological and physical care.
- Outpatient rehab: Provides varying levels of addiction treatment including behavioral counseling in both a group and individual setting, but with minimal impact on vocational or educational pursuits. Examples of outpatient programs include Partial Hospitalization Program (PHP) and Intensive Outpatient Programs (IOP).
- Luxury treatment: These inpatient programs are in desirable locations and provide patients with resort-like amenities, such as pools, massage therapy, exercise facilities, golf courses, and gourmet meals.
- Executive treatment: These inpatient programs cater to working professionals who are reluctant or unable to forsake work duties while recovering from tramadol addiction. These facilities provide patients with internet access and private work rooms.
- Holistic treatment: These programs combine traditional modalities, such as individual therapy and group counseling, with complementary and alternative methods, such as meditation and mindfulness, yoga, music and arts therapy, acupuncture, and equine therapy.
- 12-step programs: 12-step programs, such as Narcotics Anonymous (NA) and Pills Anonymous (PA), provide members with a supportive and encouraging environment.
To find out more about these and other tramadol treatment options, call our helpline at 1-888-241-8971 to speak to a caring and compassionate support advisor.
There are a number of medications (e.g., acetaminophen, Zofran) that may be used to manage symptoms such as fever and nausea that are associated with tramadol withdrawal. Other drugs that are typically reserved for the management of more potent opioid withdrawal symptoms (e.g., Clonidine, which is often used in cases of heroin or oxycodone withdrawal) may not be necessary if symptoms are mild and can be mitigated by gradually weaning the patient off of the medication.
As with any other medical condition, drug abuse relapse happens; and between 40% and 60% of users revert to drug use 7. Aftercare programs, which are any form of treatment once an initial recovery program has been completed, make all the hard work that goes into detox and addiction treatment stick by helping prevent relapse. Aftercare can help you to remain clean and build upon the coping strategies you learned in treatment. Examples of aftercare include:
- Sober living homes: Sober living homes, or halfway houses, provide recovering addicts with a safe and drug-free environment to live. People living there usually have to follow house rules, such as curfew or doing chores.
- 12-step programs: Many people attend 12-step meetings for the rest of their lives, due to the supportive, sober culture created by members.
- Non-12-step programs: Alternative groups, such as SMART Recovery and Secular Organizations for Sobriety (SOS), utilize evidence-based methods based on evolving scientific and addiction research.
- Individual counseling: Therapy helps users understand addiction’s roots, recognize triggers, and use coping mechanisms.
- Group counseling: Group counseling provides those in recovery with an opportunity to learn sober social skills and learn from peers in recovery.
Find a Detox Program Today
If you or someone you love is addicted to tramadol, help is available. Call our helpline at 1-888-241-8971 to speak to an addiction treatment support specialist about detox and treatment options.
- U.S. Drug Enforcement Administration (2014). Tramadol.
- American Psychiatric Association. (2015). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C.: American Psychiatric Association
- U.S. National Library of Medicine: MedlinePlus (2016). Tramadol.
- U.S. Substance Abuse and Health Services Administration (2010). Substance Abuse Treatment Advisory: Protracted Withdrawal.
- The University of California at Los Angeles: UCLA Dual Diagnosis Program (2016). Post-Acute Withdrawal Syndrome (PAWS).
- U.S. Substance Abuse and Health Services Administration (2006). Detoxification and Substance Abuse Treatment.
- National Institute on Drug Abuse (2014). Drugs, Brains and Behavior: The Science of Addiction: Treatment and Recovery.
- Beakley, B.D., Kaye, A.M., Kaye, A.D. (2015). Tramadol, Pharmacology, Side Effects, and Serotonin Syndrome: A Review. Pain Physician, 18, 395-400.