Tramadol Withdrawal and Detox

Those with a dependence on tramadol will experience withdrawal symptoms if they quit taking the drug. Symptoms are typically flu-like and moderate in severity.

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What is Tramadol Withdrawal?

Sweating and headaches are common tramadol withdrawal symptoms.Once a person develops a dependence to tramadol, quitting the drug will cause unpleasant withdrawal symptoms. Even using tramadol as prescribed can lead to dependence and withdrawal.

Withdrawal is the result of the body becoming chemically addicted, or altered, from taking tramadol on a continuous basis—even after only a few weeks. This happens because users develop a tolerance to tramadol, meaning they must take more frequent and larger doses to feel the same effects, (ie. pain relief or euphoria). In response, the brain adapts to the constant presence of the drug and adjusts chemically. Tramadol withdrawal symptoms generally last between 5-7 days.

Because of the influx of tramadol, the brain attempts to self regulate by speeding up and slowing down some of its processes. When the user suddenly stops taking the drug, the brain goes into “overdrive,” causing mild, moderate, or severe withdrawal symptoms.

Most experts recommend tapering off of tramadol instead of stopping “cold turkey” to ease withdrawal symptoms. While most people detoxing from Tramadol describe the symptoms as flu-like, there is the potential for serious withdrawal effects, such as severe anxiety, panic attacks and hallucinations.

How Is Tramadol Withdrawal Different from Other Opioids?

Tramadol withdrawal relieves pain differently than most opioids, such as hydrocodone, as it relieves pain by two mechanisms: stimulating opioids receptors in the brain, and inhibiting the reuptake of two neurotransmitters, serotonin and norepinephrine. Therefore, there are two forms of withdrawal that may be experienced: traditional opioid withdrawal and atypical opioid withdrawal syndrome. This is unique as it does not occur in other opioids. This also means that those going through tramadol withdrawal may experience two unique sets of symptoms.

Traditional opioid withdrawal symptoms include:

  • Nausea
  • Gastrointestinal pain
  • Diarrhea
  • Vomiting
  • Muscle aches
  • Body pains

Atypical opioid withdrawal syndrome symptoms include:

  • Hallucinations
  • Intense paranoia
  • High anxiety and panic attacks
  • Confusion and disorientation
  • Depersonalization
  • Unusual sensory experiences including numbness and prickling in the extremities

These atypical symptoms are generally not life-threatening; however, they do put the individual at high risk of making bad decisions or putting themselves in dangerous situations. Therefore, it is highly recommended to detox in an inpatient, medically-supervised detox center.

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Symptoms of Withdrawal

Tramadol withdrawal symptoms vary from individual to individual. It is best to taper off the drug over time in order to minimize negative withdrawal symptoms.

Tapering off tramadol involves slowly reducing the dosage over time.

Common tramadol withdrawal symptoms include:

  • Agitation
  • Anxiety
  • Depression
  • Cravings
  • Nausea and vomiting
  • Headaches
  • Confusion
  • Restlessness
  • Loss of appetite
  • Sweating
  • Muscle pain
  • Blurred vision
  • Insomnia
  • Mood swings
  • Irritability
  • Tingling sensations
  • Diarrhea
  • Nightmares
  • Dizziness
  • Abdominal cramps
  • Tremors

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Duration of Withdrawal

Withdrawal symptoms usually begin within hours of discontinuing or dramatically reducing use of tramadol. Symptoms can linger for several weeks. Certain factors can influence the duration and severity of withdrawal symptoms, such as the length of time spent using tramadol, how often they took the drug and the dose. However, most withdrawal periods last about two weeks.

Tramadol Withdrawal Timeline

Days 1-3 Onset of general withdrawal symptoms, including feelings of pins and needles, sweating, nervousness, nausea, anxiety, palpitations, insomnia and drug cravings.
Days 4-7 Drug cravings persist, along with insomnia, disorientation, and confusion.
Days 8-14 Symptoms should be fairly mild by this point. Depression, anxiety, and irrational thoughts may persist.

Tramadol Detox

Tramadol detox can vary from mild, moderate, to severe depending on the severity of usage, along with any administered drugs or medications. It can potentially be very uncomfortable and should be done under the supervision of a doctor supervision. Because tapering the dosage is a common practice to aid in the withdrawal process, a doctor may schedule a stepped down dosing protocol and monitor the withdrawal symptoms over a period of weeks.

Generally, tramadol withdrawal symptoms will last for only 5-7 days if a proper tapering method is used. Any symptoms that last longer than a week are considered post-acute withdrawal symptoms, or PAWS. PAWS include, but are not limited to, anxiety, depression, mood-swings, insomnia, decreased appetite, irritability, and poor concentration. PAWS can last between 18-24 months but decrease in severity over time.

If symptoms are not tolerated well, a doctor may recommend over-the-counter medications or prescribe medications (Medication-assisted treatment or MAT) to help manage the withdrawal symptoms, such as:

  • Metocloperimide for nausea and vomiting
  • Loperimide for diarrhea
  • Ibuprofen or acetaminophen for muscle aches
  • Clonidine for anxiety and sweating
  • Valium for anxiety and insomnia
  • Buprenorphine (Subutex) for relieving withdrawal symptoms
  • Suboxone (a combination of Buprenorphine and Naloxone) for relieving withdrawal symptoms and to eliminate the euphoric effects of opioids

[My moment of clarity was] when my mother came and took my children away from me. I entered treatment that night…I was given meds to keep me comfortable. [Detox] lasted about 10 days.

- Samantha, in recovery from painkiller and other drug addiction
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Treatment for Tramadol Addiction

Due to an increase in individuals abusing tramadol, despite it’s lower potential of abuse when compared to other opioids, the Drug Enforcement Administration (DEA) reclassified tramadol in 1994 as a Schedule IV Controlled Substance, implying that Substances in this Schedule have a “low potential for abuse in relation to substances in Schedule III, II and I.

Treatment for tramadol addiction is needed when an individual has developed the behaviors outlined in the DSM’s diagnostic criteria for determining the signs of addiction. Depending on the severity of the addiction, there are several treatment options for tramadol users, including detox, inpatient rehab, outpatient treatment and ongoing therapy and support.

Because of the withdrawal symptoms associated with tramadol addiction, users should always detox under the supervision of a medical professional—especially those with severe addictions.

Inpatient and outpatient programs often offer medically assisted detox to lessen the symptoms of withdrawal. Various therapies, support groups and ongoing treatment options are also available to help maintain sobriety in recovery from tramadol addiction.

For help finding a detox or treatment program for tramadol addiction, contact a dedicated treatment provider today.

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