What Are the Withdrawal Effects of Tramadol?
Tramadol is one of many types of pain-relieving drugs in the opioid category, which are prescribed for people who do not get sufficient relief from over-the-counter pain medications, usually in situations like after surgery or a traumatic injury. Unlike other narcotic painkillers, however, tramadol contains a mild antidepressant medication that enhances pain management by increasing neurochemicals that cause a person to feel relaxed, at peace, and happy.
Like other opioid medications, using tramadol for long periods of time can result in dependence on the drug, and even lead to abuse and addiction. When this happens, it can be important for the individual to stop using the drug to decrease risk of overdose and death. Nevertheless, stopping use of a drug like tramadol can be a challenge because of the frustrating and sometimes painful symptoms of withdrawal.
Tramadol is a unique painkiller in that it does more than just activate opiate receptors in the body and diminish the sensation of pain. It also works on neuropathic pain, as described by an article from Pharmacology Biochemistry and Behavior, because of ways it works within the brain. While the full mechanism by which the drug works is not understood, it is known that, along with the typical opiate reaction, it also increases serotonin and norepinephrine in the brain. These neurochemicals help to foster a feeling of calm, peace, happiness, and even euphoria. In fact, the drug can also eliminate some of the feelings of depression and anxiety that can happen with pain or injury.
The euphoria that can result from tramadol use may lead people to develop an addiction. When this happens, the person may be at risk of overdose, which can lead to death. The best way to minimize this risk is for the individual to stop using tramadol.
Withdrawal from Tramadol
The process of detox from tramadol can be different from that of other opioid drug types, partly because of the additional activity the drug causes in the brain. In fact, according to the Drug Enforcement Agency, the individual may experience one of two types of withdrawal. For the first type, the symptoms are typical of other types of opioid withdrawal, including flu-like symptoms like:
- Body aches and pains
- Nausea, stomach upset, diarrhea, and vomiting
- Restlessness or nervousness
- Trembling or shivering
However, the second type of withdrawal, referred to as atypical withdrawal, can include symptoms like:
- Paranoia or extreme anxiety
- Panic attacks
- Numbness or tingling of the extremities
Cravings are generally included in the symptoms of withdrawal in either case. Neither of these withdrawal syndromes is likely to result in death; however, they can be extremely uncomfortable, leading the person to be unable to stop abuse of the drug without support. Depression and other psychiatric symptoms that can result from stopping Tramadol have the potential to drive the person to self-harming thoughts or behaviors.
Quitting Cold Turkey
Because of the withdrawal symptoms, quitting Tramadol use cold turkey can be challenging for any individual, creating multiple risks. The person experiencing the symptoms may require emergency care to overcome them or, worse, may begin abusing the drug again, leading to a higher risk of dangerous overdose. This is because the extreme discomfort, combined with the intense cravings that may arise, often results in the person giving up on detox and going back to using the drug just to stop the symptoms.
Because of this, an option that can be used instead is to taper the dosage of the drug over time, leading the person to be able to stop using it without experiencing some of the worst symptoms, including cravings.
Tapering or Weaning off the Drug
This alternative – to stop using the drug gradually over time – allows the body and brain to adjust to lower and lower doses of the drug until use is fully stopped. As explained by the Drug Withdrawal Research Foundation, this won’t necessarily prevent withdrawal symptoms completely, but it will help minimize them until few to no withdrawal symptoms occur when the drug is stopped.
The challenge is often to get the taper just right. Too steep a taper can lead to intense withdrawal, requiring the person to return to the previous dose and take smaller steps, drawing out the withdrawal process. Because each person’s body is different and may respond differently to the drug, no two people are likely to experience withdrawal exactly the same, and there’s no one-size-fits-all tapering program.
Professional help increases the chances that tapering will go smoothly. It is not recommended that individuals attempt a taper on their own.
Timeline and Duration of Withdrawal
In general, withdrawal from opioids follows a predictable pattern based on the drug’s half-life, or how long it takes the body to eliminate the drug from the bloodstream. Symptoms start within a few days of stopping use – sometimes even within hours, depending on the level of addiction, or other factors like the person’s weight, general health, or use or abuse of other drugs along with tramadol. These factors can also affect how long it takes for the symptoms to peak, usually a few days to a week, and how long it takes for them to diminish after the drug has been fully stopped. On average, opiate withdrawal takes 2-3 weeks.
Of course, tapering will extend this timeline. Depending on how swiftly the person can step down the dosage, the process may take anywhere from one to six months or even longer. This process is much longer, but it is also more likely to help a person stop using the drugs, as described by research from the University Health Network, especially when it is combined with psychological tools to help the person cope with pain or cravings for the drug.
How Medical Detox Helps
Medical detox can help by offering professional supervision for a tapered withdrawal and by providing other forms of relief, such as nutritional support and medical treatment of some of the more severe symptoms. In addition, undergoing detox in a professional treatment program can make sure the person begins some of the therapies that can lead to recovery from tramadol abuse.
As explained by Healthline, opioid withdrawal symptoms sometimes require more than just over-the-counter support. Prescription medications for diarrhea and other symptoms can be provided by experienced addiction treatment professionals while avoiding medications or drugs that might inadvertently become a new target of addiction. Also, as mentioned above, a reputable, research-based treatment program can provide psychological tools to give the person a better chance at achieving sustained recovery from tramadol addiction.
Medications Used in Tramadol Detox
Some of the medications used for tramadol detox and withdrawal may include:
- Acetaminophen or ibuprofen for pain relief
- Antidiarrheal medications
- Prescription hydroxyzine for nausea
- Antidepressant medications to deal with symptoms of depression
With these medications and the support of treatment professionals, a person trying to stop tramadol use can get through withdrawal, and gain the tools and skills needed to continue abstinence for years to come.