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“Ultram,” or “Ultracet,” is the brand name for the narcotic painkiller medication tramadol, which is an opioid analgesic drug. Thought to be safer and less addictive than other opiate painkillers like oxycodone and hydrocodone, Ultram was first introduced to U.S. markets in 1995, having been in use in Europe since the 1970s. However, within three years of Ultram’s introduction to U.S. markets, it became evident that the drug not only carried a potential for abuse, (in light of reports that patients were abusing the medication) but also caused opioid-like, atypical withdrawal symptoms. (This was reportedly the explanation in 40 percent of tramadol-related adverse effects.)
In other words, a painkiller that was not supposed to be addicting because it displayed weaker opioid-like effects than other opiate drugs, was, in fact, both addictive and potentially dangerous to withdraw from.
In August 2014, Ultram was designated a Schedule IV substance by the Drug Enforcement Administration (DEA)— a designation that connotes “a low potential for abuse and low risk of dependence.” This begs the question: for the unlucky minority that do get hooked to Ultram, what does “detox” look like? This guide will provide a detailed picture, starting with what to expect in the form of withdrawal symptoms.
Ultram Withdrawal Symptoms
For a drug that is supposedly only mildly addictive, the slate of withdrawal symptoms that can occur with the cessation of Ultram is both impressive and alarming. This is because Ultram acts similarly to antidepressants within a class of drugs known as “SSRI’s,” or “selective serotonin reuptake inhibitors.” When abruptly discontinued, these SSRI drugs can unleash a torrent of withdrawal symptoms that are uncomfortable enough to earn a name: “SSRI discontinuation or withdrawal syndrome.”
Symptoms associated with withdrawal from Ultram, many of which are also associated with SSRI withdrawal syndrome, can include the following:
- Abdominal cramps – These are a commonly reported symptom of withdrawal.
- Anxiety, even panic attacks – Because Ultram affects serotonin levels, the drug has anti-anxiety effects— not unlike those elicited by SSRI antidepressants. These anti-anxiety effects cease with the cessation of Ultram, with the result that the user may experience an uptick in anxiety (which for some people can be dramatic).
- Brain zaps and/or goosebumps – Electrical shock sensations in the brain, which have often been reported, can happen when stopping Ultram; so can widespread bumps and tingling sensations (goosebumps) across the body.
- Cravings – These often peak in the days and weeks following withdrawal.
- Depression and/or suicidal thoughts – Depression—and its more severe extension in the form of suicidal thoughts—can occur during withdrawal for the same reasons that anxiety can occur during withdrawal. Because Ultram acts on serotonin and norepinephrine, two neurotransmitters that modulate mood and happiness, quitting Ultram can decrease the levels of these neurotransmitters, thereby causing depression.
- Diarrhea – Constipation is a well-known side effect of opioid drugs— including Ultram. During withdrawal, changes to bowel functioning can lead to the opposite problem: diarrhea.
Still, other symptoms associated with withdrawal from Ultram:
- Headaches and/or muscle cramps
- Irritability and mood swings
- Nausea and/or vomiting
Ultram Withdrawal Timeline
The time that it takes for Ultram to leave your body after the last dose can be anywhere between three to five days. Some longer-term users with more severe dependency can expect a longer withdrawal timeline in the whereabouts of one week.
Additionally, individual variations in the withdrawal timeline can occur on the basis of these other factors:
- State of mental and physical health
- How much Ultram someone has been using
- Method of intake (whether it was injecting Ultram, crushing it into a powder or swallowing a pill)
- History of past addictions and/or other co-occurring mental disorders
- Whether you discontinue your use of Ultram by going cold turkey or by following a more gradual taper
These factors make it impossible to say there is one universal timeline that can be applied to every recovering user of the drug. That said, here is a rough timeline for Ultram withdrawal:
- 6-12 hours – This is the window of time that it takes for an original dose of Ultram to reach its “half-life” (meaning half of the drug’s original blood-level concentration)— at which point, the first physical, flu-like withdrawal symptoms begin to appear.
- 24-36 hours – At this stage of withdrawal, the physical symptoms of withdrawal peak, causing some of the worst discomforts.
- 7-10 days – By the time you reach roughly one week in the detox process, most withdrawal symptoms should be over. The mental and psychological symptoms, however—anxiety, depression, insomnia, etc.—may linger on.
“Post-acute withdrawal syndrome,” also known as “PAWS,” can occur in some cases. PAWS describes the protracted symptoms of withdrawal, usually mental and psychological in nature, that can persist for months following physical detox from Ultram. These can include:
- Mood and sleep disturbances
- Poor coordination
- Difficulties with concentration
- Suicidal thoughts
Inpatient Treatment for Ultram
Inpatient treatment may be a good option for anyone considering detox from Ultram. That’s because an inpatient rehab program, by virtue of being residential, provides the highest level of medical care and safety during the withdrawal process. A team of medical professionals is available 24/7 to monitor your safety and watch for any complications that could require intervention. And, because more often than not withdrawal involves mental and psychological symptoms, you’ll also be able to participate in therapies that address these roots of addiction and dependency— and at a higher level of intensity than many outpatient programs.
Outpatient Treatment for Ultram
While inpatient treatment is often the ideal option for anyone who wants a safe and thorough detox from Ultram, the reality is that a residential rehab program may not be possible for various reasons. Fortunately, in these cases, outpatient treatment may be another viable and equally effective option. Most outpatient programs allow you to live at home and commute to a treatment center. They won’t provide the same level of round-the-clock medical care that a residential inpatient program ensures— but you’ll likely still have access to medical professionals and therapists who can monitor your progress in the withdrawal process and support your recovery.
Can Ultram Detox Be Done at Home?
Detoxing from Ultram at home can be dangerous. Before attempting this on your own, consult your doctor— especially if:
- You have a history of mental illness or heart problems.
- You are in poor health.
- You use Ultram with other drugs.
In these circumstances, undergoing withdrawal on your own without professional medical supervision can be risky. Even if you are sure that none of the above factors describe you, complications can occur. Nausea and vomiting can quickly lead to dehydration. Or, depression and suicidal thoughts can arise suddenly and seemingly out of nowhere.
There is also the added complexity of detoxing from a drug that, like SSRI’s, can result in symptoms that are very uncomfortable, making it hard to complete detox as a result.
Similarly, cravings for Ultram—these are especially intense during the first week—can disrupt the best intentions of getting clean.
Tapered vs. Cold Turkey
Should you go “cold turkey” and quit Ultram all at once? The answer is “no.” That’s because going cold turkey can subject you to significantly more pronounced withdrawal symptoms, thereby also raising the risk of an aborted detox that ultimately keeps you in the same addictive grip of Ultram.
Tapering, as in a gradual reduction over time of the amount of Ultram that you are taking, is a better choice. But don’t do this at home without consulting your physician. In fact, the smartest way to taper off of Ultram when you’re dependent on the drug is to consult a rehab treatment program that can oversee your taper and provide you with holistic care (mental and psychological) that supports your long-term recovery.
Considerations/How to Decide What Is Right for You
When considering your options and whether to pursue formal detox services, your first consideration should be the quality of the prospective rehab program. You’ll want to know what their treatment approach is, and ideally, have some sense of their treatment outcomes and how these compare to competitors’. (For advice regarding the questions to ask in vetting a rehab provider, check out these “12 Tips for How to Find Quality Addiction Treatment You Can Trust.”)
Another consideration that may play into a decision about where to undertake rehab for Ultram: the cost of the treatment program. Thankfully, many treatment providers accept private insurance plans, which cover a substantial portion of the costs, if not all of them. The cost of treatment should never be a barrier to getting professional help— even in situations where insurance coverage is not available. Some treatment programs provide affordable payment plans, and in some cases sliding scale assistance. Veterans may be able to receive assistance through the Veterans Administration.
Ultimately, you will need to decide what rehab program will be a good fit for you, based on your individual treatment and lifestyle needs.
Recovery Success and Aftercare Services for Ultram
Recovery success and aftercare services are another important consideration when you’re vetting prospective treatment programs. That’s because research has shown that these elements of a healthy recovery lifestyle following rehab are associated with higher recovery success rates:
- 12-step groups
- Continuing medication management
- Continuing therapy
- Healthy diet and regular exercise
- Life and job skills coaching
- Random drug testing
A good treatment provider should provide a mix of these post-rehab supports as part of an aftercare program for its clients.
Who Needs Ultram Rehab?
If you’re using Ultram and have tried unsuccessfully to get clean before, are finding that you need more and more of the medication to control your pain, and/or are experiencing negative consequences from your use of the drug, then you may need rehab. Feeling dependent on Ultram can be incredibly deflating and even a source of shame— but the good news is that you don’t have to live like that. With detox and treatment, you can discover a life that is free of Ultram and free for your hopes, dreams and the people you love.
For related information about Ultram detox and withdrawal, check out these articles: