How to Taper Off TramadolAnna Ciulla
Tramadol is an opiate pain medication that is regularly sold under the brand name of Ultram, Conzam, and Ultracet. On the streets, these pills are commonly referred to as Trammies or Ultras. Sometimes, it is referred to as “Oxycontin Lite” since it is less potent than its opiate cousin. This nickname has led many into a false sense of security, causing many tramadol recreational users to underestimate its addictiveness and the potentially life-threatening consequences of abuse.
Tapering is a drug detox technique that slowly eases patients off tramadol pills by gradually reducing their typical dose. In most circumstances, it is the safest option and the most successful method of detoxing. In order to fully understand the importance of tapering off of tramadol, you should know:
- How tramadol works
- How to recognize a tramadol addiction
- How to safely taper doses under medical supervision
- The advantages of professional inpatient drug rehab centers for tapering off tramadol
What is Tramadol?
In 1995, the Food and Drug Administration first approved Tramadol for the market. Since then, it has been an effective prescription medicine used for the relief of moderate to severe pain. Tramadol is generally prescribed after surgeries but is also effective for painful conditions like acute arthritis. Today, the fact that approximately 45 million tramadol prescriptions are written annually speaks to the drug’s efficacy.
Tramadol is a synthetic opiate that functions by inhibiting pain receptors in the brain and preventing pain signals from being registered. It also provides antidepressant effects by increasing the release of the serotonin and norepinephrine neurotransmitters.
- Serotonin – Contributes to feelings of well-being and happiness.
- Norepinephrine – Boosts energy and attention.
There are two forms of tramadol: immediate-release and sustained-release. Immediate-release forms will start affecting the body within 30 to 60 minutes and wear off between 4 to 6 hours later. Sustained-release forms distribute the drug over a 12-hour period, making it ideal for people suffering from chronic pain.
Tramadol Side Effects
As with all medications, tramadol does have its side effects. The most common being:
- Blurred vision
- Nausea and vomiting
- Sleep problems like insomnia
Uncommon side effects include itching, excessive sweating, diarrhea, skin rashes, or dry mouth.
Taking tramadol for long periods of time may diminish the side effects as your body adapts to the medication. However, if they do not subside, a different pain treatment should be explored. Always report any side effects that you experience to your doctor. If the following severe side effects occur, you should seek medical attention immediately:
- Weak or labored breathing
- Extremely low blood pressure
- Allergic reactions: characterized by swelling or inflammation on any part of the body
- Angioedema: a buildup of fluid under the skin, making the body appear bloated or bulging
- Serotonin syndrome: muscle rigidity or stiffness, confusion, and a rapid pulse
- Suicidal thoughts
In 2014, the U.S. Drug Enforcement Administration classified tramadol as a schedule IV controlled substance, meaning:
- A single prescription is only good for up to 6 months
- A maximum of five refills is all that is allowed
Technically, schedule IV drugs are considered low-risk for drug abuse and physical dependency; however, tramadol has been abused for recreational purposes by hundreds of thousands of Americans. Taking tramadol in large doses can produce a euphoric effect or “high” quite similar to other opiates. Whether you are pleasure chasing or self-medicating, misusing tramadol is a dangerous activity that increases your chances of developing dependence or overdosing.
How It’s Used
Tramadol is designed to be swallowed in its full pill form. Chewing, splitting, crushing, snorting, smoking, or injecting it can lead to an overdose. Signs that someone is experiencing an overdose are decreased pupil size, shallow breathing, weak heartbeat, and cold and clammy skin. Overdoses can result in:
- Loss of consciousness
- Heart attacks
- Seizures—Tramadol taken with alcohol can increase the chances of seizures
- Death—Each year, tens of thousands of deaths are related to opiate overdoses.
Tramadol Dependence and Opioid Withdrawal Symptoms
Although tramadol misuse can increase the risk of dependence, a dependence can develop even when Tramadol is used as prescribed for medical purposes. Dependence is when the brain’s neurological pathways rewire to the point where they need the drug to function normally. Under the prolonged influence of tramadol, the brain begins to mistake the drug for a natural chemical it needs to maintain stability. As a result, if tramadol is gone, the previously inhibited pain pathway will react strongly in the presence of even mild pain signals.
Since tramadol also acts as an antidepressant, dependence can manifest in another way. When tramadol is removed, the body’s serotonin and norepinephrine are left imbalanced, resulting in irritability and low energy.
Tramadol Withdrawal Symptoms
Tramadol withdrawal symptoms can range from mild to severe and may last for varying amounts of time, dependent on several factors such as length of use, biological factors, and method of use. How long withdrawal symptoms last will vary on a case-by-case basis. The most common ailments associated with opiate withdrawal include:
- Loss of appetite
- Nausea, diarrhea, and vomiting
- Severe muscle cramping or throbbing pain, especially around the abdominal region
- Shaking or convulsions
- Mood swings
- Profuse sweating
- Flu-like or feverish symptoms
The DEA reports that 90 percent of those suffering from tramadol withdrawals experience one or more of the above opiate withdrawal symptoms, while the other 10 percent will (additionally) show symptoms associated with antidepressant withdrawals. These include:
- Confusion, paranoia, and mild hallucinations
- Anxiety and panic attacks
- Sleeping troubles such as insomnia and nightmares
- Suicidal thoughts
- Tingling or numbness in extremities
- Sensory overload
Tramadol Withdrawal Timeline
You may be wondering how long do tramadol withdrawals last. When detoxing, it typically takes 1-3 days for Tramadol to leave your system completely. About 7 percent of people are “poor metabolizers” of tramadol, meaning it takes longer for the drug to be broken down by the liver, filtered by the kidneys, and excreted in urine. As a result, the drug remains present in their bloodstream for longer and extends the withdrawal timeline.
As tramadol leaves the body, the first withdrawal symptoms to appear are generally increased vital signs—racing heart rate, increased blood pressure, and elevated temperature. This is accompanied with tingling sensations, excessive sweating, and anxiety.
Drug cravings may peak around this time. Confusion, insomnia, and blurred vision can also develop.
Physical symptoms tend to lessen at this point, however psychological side effects can persist. Depression, anxiety, and irrational thoughts may require therapy to resolve. The exact timeline for an individual experiencing withdrawal will vary based on how long they were taking tramadol, how high the doses were, what other drugs were taken in conjunction, and what resources and support that person has during treatment.
When the urge to use tramadol cannot be ignored and its effects interfere with one’s work, social, and family life, that person is diagnosed with a tramadol addiction. People who have a history of substance misuse and addiction have a higher chance of becoming addicted to Tramadol but anyone that takes tramadol is at risk of dependence.
The ongoing discomfort that comes with cutting out tramadol can discourage users from trying to quit. When the only way users know how to alleviate withdrawal symptoms is by turning back to tramadol, the cycle of dependence grows stronger, thus strengthening the addiction. This is why tramadol addiction can be difficult to overcome.
However, it’s important to realize that no matter how uncomfortable withdrawal symptoms are, they rarely ever have long-term physical effects. Breaking free from any substance addiction and changing your life for the better has more health benefits in the long-run than avoiding withdrawal symptoms altogether.
Since tramadol detox can pose serious health risks, many people choose to detox at a rehabilitation facility such as Beach House Recovery. There, medical professionals will facilitate the tapering process but can also prescribe medications that help mitigate withdrawal symptoms.
Tapering Off Tramadol
“Tapering” is the most common form of tramadol detox. In such instances, tramadol dosage is gradually reduced, allowing the body and brain to slowly re-adjust. Eventually, the dose becomes small enough to be ignorable and, while withdrawal symptoms are present, they are less extreme than if the person were to quit “cold turkey.”
Most medical professionals agree that a 10% reduction each day is effective for short-term users, whereas a 10% reduction each week is healthier for long-term users. However, these rates are not set in stone. A physician will work with a patient to determine what level of tramadol reduction is best suited for them specifically. The advantages of tapering are:
- The severity of withdrawal symptoms lessens
- Cravings are not as strong
- The body and brain can ease into abstinence
Dangers of Cold Turkey Quits
Some people with mild withdrawal symptoms may feel the desire to quit tramadol “cold turkey.” While it is useful in detoxing quickly, it can also cause intense withdrawal symptoms—enough to cause serious health complications. Therefore, it is not generally advised to do a drug detox at home and quit cold turkey. Additionally, if the user is emotionally volatile, detoxing at home can send them reeling into depression.
If tramadol is aggravating a separate health condition, it may be necessary to quit abruptly. If this is the case for you, discuss your options at a medical detox center to avoid any complications. This could mean a more rigorous tapering schedule.
Medications for Tramadol Addiction
Because of its weaker potency, tramadol can be a substitute drug that eases the tapering of stronger opiates. Finding a substitute for tramadol can be difficult because other opiates with significantly weaker strength are a rarity. However, there are a few substitutions that may be used in a medication-assisted treatment to reduce symptoms.
- Methadone – Has a much longer half-life than tramadol, meaning it stays in the bloodstream longer and can space out the onset of withdrawal.
- Buprenorphine – Is a partial opiate agonist. It minimizes opiate withdrawal symptoms and discourages drug abuse because it does not provide a euphoric high, yet can satisfy cravings.
- Naltrexone – Can help prevent relapse by blocking the “euphoria” that drives people to use opiates.
These medications must only be used under direct medical supervision, either with a doctor or licensed professional at a clinic.
Advantages of Rehabilitation Centers
Quitting opiates—of any kind—can be a trying endeavor. The withdrawal symptoms can be ceaseless, relapse lurks around the corner, and emotional turmoil is expected. For tramadol addiction, it is best for an individual to utilize a rehab center in order to ensure a safe detox, effective treatment, and lasting aftercare.
An individual can choose an inpatient program, where they live in the rehab center, or an outpatient program, where they will live at home but check into the center regularly. Both forms of treatment will require that you perform an in-house, medically-assisted detox.
Additionally, the therapy provided at a reputable rehab center like our Florida rehab center can help you develop the tools you’ll need to stay sober. The support group contains addiction specialists and other former addicts, meaning you are surrounded by love and understanding. Truthfully, if you’re considering kicking tramadol on your own, at the very least call a clinic to gain some insight on what you’re bound to expect.
Treating Tramadol Addictions
Tramadol addiction is relentless—especially because many who take it do not think it poses the risk for addiction (being that it’s a “lesser” opiate). Nonetheless, it can ruin lives, break families, and cause problems in society. If you or someone you love is dealing with a tramadol addiction, then reach out to Beach House Recovery and ask about the tapering process, as well as the programs offered.
The sad reality is that tramadol addiction often opens the door to stronger opiates. For that reason, it’s crucial that you free yourself of the chains of addiction as quickly as possible.
- Blum, Karen (2017, November 14). “Tramadol: A Viable Detox Alternative?” Johns Hopkins Medicine. Retrieved from https://www.hopkinsmedicine.org/news/articles/potentially-viable-detox-alternative
- Drug Enforcement Agency, Diversion Control Division (2018, October). “Tramadol” Retrieved from https://www.deadiversion.usdoj.gov/drug_chem_info/tramadol.pdf
- Grond, S. & Sablotzki. Clinical Pharmacology of Tramadol. A. Clin Pharmacokinet (2004) 43: 879. https://doi.org/10.2165/00003088-200443130-00004
- McIntosh, James (2018, February 2). “What Is Serotonin and What Does It Do?” Medical News Today. Retrieved from https://www.medicalnewstoday.com/kc/serotonin-facts-232248
- National Institute on Drug Abuse (2018, January). “Drug Addiction Treatment in the United States.” Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states