An in depth look at Tramadol and its depedancy plus more!

This is posted to help those going through tramdol withdraw and dependecy. It is also an in depth look at the drug and how it is over used. I hope it will serve as a guide for those who are debating whether to use it, for those just starting to use it, for those going through withdraw, and for those abusing it.

First off, regardless of what any doctor tells you, it is synthetic opiate analogue of codine. It's often not classified as a "true narcotic" because it is only a partial agonist of MU opiate receptors, and because its secondary effects are that of anti depressants in which it effects the reuptake of certain chemicals. However, make no false assumptions, it is an opoid medication.

It is not a scheduled narcotic and until recently, many doctors, websites, ect considered it to be an anaglesic althernative to opoid mdications. Although now days, it is slowly being listed as a narcotic or alteast an opoid medication.

It is less adictive then most opoids and has a lower potential for abuse (not to be confused with dependancy). It also has a less euphoric effect than most opoid medications. This is why many users don't get a "high", but for some users (especially new ones) it can still create a euphoria similiar to codine. It has a weak affinity for MU receptors, making it a fairly weak pain killer. However, it also has a longer duration of effect then some opoid medications lasting up to 8 hours per dose.

It is one of the most over prescribed medications on the market today. This is partially because its not scheduled, giving doctors less liability. Although it is less addicitive, when used for exptended periods of time, it is prone to causing dependency. Furthermore, because it is weaker then most opid medications, users are more likely to take more medication to relieve the pain, increasing the dependecy potential. While prescriptions like oxycodone are given in prescritions of 10, 20, and 30 tabs, it is not uncommon to see prescriptions of tramadol given in counts of 50 to 200 pills per prescription, often with refills. It is treated by most doctors as a single step up from tylonol and ibuprofin. Also, because it is not a controlled substance, it can be prescribed by both physician assistants as well as actual MDs.

Unlike other opoids, it can easily be purchased over the internet with ease due to its lack of restrictions. Phamacy websites highly advertise it and grant online prescriptions for it with ease (just say you are in pain).

Some warning labels will tell you that its only for very short term use (1 week or less). However, most doctors ignore this precaution and many perscrition warning labels do not include this warning.

This medicine is intended to ONLY be used for a short time to treat acute pain. The problem is that many doctors are using it for long term chronic treatment of pain because they believe it is safer (and in some respects it is).
Before I down it, it does have some legitimate uses.

1. For acute pain less than 7 days
2. For people allergic to other opoids (or those with histamine reactions). Also for those with breathing issues will find that it causes less respitory depression.
3. For urgent care visits in which a PA is precribing the meds and cant prescribe strong opoids (and as long as the pain treatment is short term with no refills.

Outside of this, it really shouldn't be used, and MDs should consider giving vicodin over tramadol whenever possible because vicodin has stronger pain relief properties. Most doctors are also unaware of the extremely severve withdraw caused by the medication. It is longer lasting then vicodin and is more severe then vicodin in most cases, making it more comparable to methadone withdraw.

The problem is that more effective pain medications like vicodin are under prescribe and in its place tramadol is often used. Doctors should really reassess their use of medicines in lew of these finding and use low dose vicodin as a first line opoid pain medication whenever possible.

People that don't like eurphoric effects are more prone to use tramadol regularly and request it (as mentioned before, it still does have some euphric effects) and for the lower abuse potential and less euphoria, docots are overly eager to prescribe tramadol and often on a long term basis.

This is a niche medication and should not be petitioned to be removed from the market, but rather petitioned for more controlled use.

Some clinics are using tramadol to help patients come off of methadone therapy. This is a very poor choice because the withdraws of tramadol are often as long and as extreme as methadone. Vicodin, subutex, (or perhaps darvocet IF used less than 1 month) should be the drugs of choice for someone coming off methadone maintenance.

IF you are looking to get off of tramadol you definately should not quit cold turkey. Weaning off is more acceptable but is still described as very unpleasant by many users. I have listed a way to clean yourself off of tramadol if you are looking to stop using the drug OR are going through tramadol withdraw. However, before you take my advice, your best option is still to talk to your doctor honestly and get his or her advice on how to tapper off, unless you feel unreliant in their professional opinion.

1. For the first part of the day, take your normal dose of tramadol. For the second or third doses, subsititute the tramadol for lose dose vicodin. Because tramadol effects the reuptake of nuerological chemicals, taking your first dose of opoids to be tramadol should help to reduce the depressionary effects of withdrawing from tramadol. Vicodin has many of the narcotic properties of tramadol and is a suitable substitute.

2. After 2 weeks of doing this, use only vicodin for all opoid doses. The following week, reduce your opoid dose by 20 percent, then the next week another 20 percent and so on. Talk to your doctor about a vicodin prescription (OR tylonol 3) and how you plan to use it as a step down plan. Vicodin still has somewhat severe withdraw symptoms, but they are a little less intense and the duration of the withdraw is generally shorter. IF you cannot wean yourself completely off the vicodin, talk to your doctor about taking darvocet for 1 week.
IF you are currently taking tramadol for chronic pain, talk to your doctor about switching to vicodin. You may experience some mild withdraw when switching but it should be relatively mild and short lived.

I hope this helps.

[dakota71403]

if you do some more research you will see that you cannot take vicodin until tramadol is out of your system because it will cause a very bad reaction...i accidentally did this once and i was VERY sick.

[studyingpharms_101]

It is possible that it COULD cause a reaction but this is rare. In a few cases, the possibility of immediate withdraw does exist and if the withdraw that occurs is the same as if you were to quit tramadol cold turkey after dependency has occured. It is not dangerous or life threatening but is quite unpleasant. This is the same rare reaction that can occur when switching from tramadol to any other narcotic. Therefore for some this method will work well and for a few, they will have to find another means.

I have personally used this method before with no complications as have others. It worth a try since the worst that can happen is withdraw.

[usarmymedic1]

whats going on SGT yes I can see the rank in the picture.. just wanted to say hi to a fellow NCO

[studyingpharms_101]

One more note. Thank you Dakota for bringing up that valid point. Although again not common, you do need to be aware that switching narcotics can produce withdraw. I appologized if I seemed to be belitling these point, but due to tramadol's EXTREME withdraw symptoms, it is definately worth a try. If you are especially prone to withdraw or have experienced withdraw in the past by switching narcotics, you could try staying completely abstinent from tramadol for 2 days (which will cause intense withdraw for about a day) and then trying ONLY the hydrocodone. This might help allieviate the switch over possibility of withdraw and the overall symptoms of withdraw would be roughly one day. There is no easy answer to withdraw, and even hydrocodone can cause withdraw if used over a period of time, though not nearly as long as percocet.

A shout out to US army medic. I'm wondering if you could add anything to this my fellow NCO with your experience in dealing with dependency and patients being able to free themselves from these curses?

[usarmymedic1]

if trying to get off any opiate or synthic like tramadal it is just best to do a slow taper which will minimze the W/D but switching from a dependecy of tram to hydro for any addict would be detramental to the cause since the ephoric high would be so called better I have used both and that would be my opinion it would cause the abuse of the hydro's almost emidatly. so for some one dependent or addicted i would recomend taper to get off the med. now switching between the two I went from percs to tram and then back after my last surgery and had no problem with any of it. using tram to get off hydro's not a good idea in my book becouse of the chance of abuse.

medic1

[studyingpharms_101]

I do agree with tapering as being the best method overall, but i think its definately one of the hardest methods because it takes time and discipline. A lot of people attempt tappering but fail. It is the most doctor approved method though, and for that reason, I do believe people should try it as the first step before trying other metods like opoid replecement.

I can see your point in the risk of abuse with hydrocodone, but for someone struggling with years of tramadol risk, i think the method is worth a shot, especially if they have tried tappering down first and were unsucessful. If they become addicted to hydrocodone or codine, ect in the opiate replacement method, they really are only left with one option. commitment to a detox facility. With all the cases of tramadol depedency, I hope they finally make it a controlled nacotic!

I definately agree that switching to tramadol to come off of hydrocodone is a bad move. IF a person is on hydrocodone, sometimes a switch over to Darvocet is successful. Darvocet though specifically is known to cause withdraw in people switching from other narcotics to it.

Again, sadly there's just no easy answer.

[avisg]

Us armys post has it right on , STUDY there is some great info about tramadol in your post but using vic to get of tram is asking to change over from one addiction to another .
Tapering of tramdol is not easy but many here because of seizure possibility's have done it.

[Avalancheblanche]

Thank you for that information.  I hope it will help someone, or deter anyone from using this drug.  
I am one of the ones who became addicted.  Now, almost 3 months clean and hoping there will be more of an awareness of the potential for addiction to this med.

[studyingpharms_101]

As stated, try tappering off first. Exchanging one opiate for another has its risks BUT it might be the only way someone can come off a substance with long drawn out and severve withdraws. Subunex and methadone are often used for harder drugs as an opoid replacement therapy.

make no mistake about it. Vicodin is addictive, but if you have tried everything else to get off of tramadol, it might be a last resort option.

I know some of you highly disagree with this information, but again I feel for a select few, it may be beneficial. Don't forget it is possible to experience withdraw when switching medications. Again, this is a last ditch effort, as the only other thing you can do beyond this is goto a detox center. Opoid replacement therapy is controversial. Before trying it, as I stated above, consult a health professional please. It has worked for me in the past!!!!!

IF you tapper, try the 20 percent per week rule, and when you get to 20 overall, taper down by 5. That 4 weeks to get to 1/5 dose.

Tramadol is the worst narcotic developed over the past 30 years. IF YOU CAN AVOID IT, DONT USE IT!  And thats another thing. The rate of seizures is quite high for such a "mild narcotic". a 300 mg dose is can easily cause a siezure. This coupled with the fact that its 8 hours between dosing and the medications effects can wear off in far less time then that. So the risk is you take 150 MGs for pain and then 5 hours later you are in pain again so you take another 150. The problem is that much of the tramadol is still active in your system so youve just increased your risk of siezures.

[coconuts27]

So this is what the doc gave me yesterday for pain while I was detoxing. Given the fact that I only take two norcos a day, do you think this was the right thing for him to do???

[worried878]

Everone is different and yu have to choose what works for you...often addictive drugs like benzos are recommended for detox...and in the perfect case scenario it would be nice to wd withot anything at  all to help...this is not a perfect world...darvacet is much eaker than hydrocodone and could help with a taper...perhaps with a tramadol taper...a few get high off of darvacet taken in multplr does but dot usually at the prescribed dose...lots of tylenol too in darvacet....there are those who get a high from tramdol usually if the dose is abused..or someone who never has taken narcotics my get high from a darvacet...neither make me high and would doubt i would abuse darvact unless i started chewing 10 of them at a time....tramadol i dont know...i have taken 2 without a high but they say they sneak up on you...i am not sure of the dose than tram abusers used that had a rough wd so i dont know...be safe and many taper with a weaker narc and get off clean and happy if they use common sense and dont take bottle of darvact   just as prescribed then quit those as well

[studyingpharms_101]

Coconuts,

IF you must use tramadol, use it for a period of 14 days or less and at the lowest possible dose. If you use it for 7 to 14 days, your risk for developing a tolerance should be relatively low.

Remember that depedancy for this drug can form in about 1 month, LESS if you use higher doses. I'm not your doctor coconuts but if hes expecting you to use the medication for more than 14 days, I would consult with him to explain your concerns.

[studyingpharms_101]

ohh, and coconuts, another thing.

If you must use it, remember that it can still cause sedation so use caution while driving, ect. Tramadol (-) molucules prevent the reuptake of seretonin and using saint johns wart or other anti depressants has the potential to cause seratonin syndrome, which could be fatal.

How long does your doctor want you taking it and how much?

[Mike_B_]

Wow that's some good info on the ultram.  I had a hard time adjusting to not taking it and switching over to hydros.  I have been off them i guess for about 3 months now and i am just now starting to come out of the funk.  And the small amount of hydros I'm taking now are starting to work better for me.

[studyingpharms_101]

I definately feel hydrocodone is overall safer and more effective for pain relief then tramadol, yet not as sedating or addictive as percocet. Like I said, they still can be addictive, especially if taken in high doses so try to keep your dosing at 5 to 10 mgs if possible.

I've found that taking 800 mgs of ibuprofin is a good secondary pain reliever for treating moderate pain and moderate severe pain. For mild moderate pain, you might even be able to half your vicodin doses or not take it at all if you use ibuprofin 800. For me, I have moderate range chronic back pain so I try to take 1200 mgs of Ibu a day to try and minimize my need for vicodin. So my average day will consist of 800 mgs of ibu and 5 mgs of vicodin, and then for my late day dose 400 ibu and 5 mgs of vicodin again. anymore than 1200 ibu a day tends to tear up my stomach as I am very sensitive to ibu.

[tztlady]

I used it to get off norcos.  I took 300 mg on day one and two (2 pills, 3 times a day) and then the next two days took 250 mg,  the next two 200, and went down 50 mgs every two days.  At the end of it all I still had minor wds, sniffles a bit of the runs and restlessness.

I agree that if you do choose to use it, use it for only 10-12 days and then just go off everything.  As always, it effects us all differently and some seem to get more addicted to ultram than vicodin.
I just know that in my case it helped because without I would have had to take time off work.

[studyingpharms_101]

I definately see your point tzt. I mean like I said, ultra-tramadol can be used for withdraw treatment and pain management, as long as its done on a very short term basis. Personally, I still have tramadol that I keep on hand. If my pain is on the mild spectrum of moderate, ill sometimes use tramadol instead of stronger pain medicine, but I keep my use of it very limited and only for a short period of time due to the risks of long term and high doses. So I keep my use infrequent.

Everyone is different and they react different ways to medication. Some use pain killers for a year and come off with zero withdraw. Some use it for 3 weeks and have issues. Some get no euphoria while others get quite high. Some get sedated. Some get naseua. ect ect ect.

I think the biggest thing doctors need to do is to educate themselves better about tramadol and opiates and inform their patients more throughly of the risks and benefits.

RLS supposedly responds to tramadol therapy. In cases where RLS can be controlled by low doses of tramadol (37 to 50mgs), the risks of long term use in that instance might warrant using the medication. THERE ARE JUST SO MANY FACTORS AT PLAY!

Because tramadol has an anti depressant effect, someone who is depressed and in pain might benefit more from short term use of tramadol then someone whose socially happy. Labeling of products are often to short and more research needs to be spent by the manufacturer so that they can get more conclusive facts published.

[Raj786]

Yes in my own experience, even though it doesn't give a good enuf high, the withdrawals from it can be just as bad as other opoids.... therefore, it's best to avoid Tramadol for fun and for pain relief as well....

[Dawn911]

Can you tell me if i took tramadol with my methadone will taking the tramadol cause withdrawal from the methadone.The people at the clinic said that it would but they also say other things that I found werent true.I would only be taking it for a few days so getting addicted wouldnt be a problem.

[studyingpharms_101]

Dawn,

http://www.drugpolicy.org/docUploads/aboutmethadone.pdf

According to the Methadone factbook, taking tramadol while already on methadone treatment will cause withdraw symptoms "in most cases". Withdraw is less likely to occur if you are on a low dose of methadone vs being on a high dose of methadone, but remember that everyone is different and that even low doses of methadone mixed with tramadol can still produce withdraw. Also, remember that methadone is a potent pain killer and that mixing other opoids might increase the effects of side effects such as respitory depression, which can be life threatening.

I would highly recommend consulting a pharmcist before taking tramadol with methadone. Above all the warnings I gave, IF you must use both together, make sure the tramadol is a very low dose (37-50 mgs) so that if you do get side effects or withdraw, they are minimized.

[chanch]

Can you take tramadol while on percocet, instead of percocet, for one or two doses?

[studyingpharms_101]

Yes you can take them separately at different doses, as long as it has been 6 hours since your last percocet dose. In rare cases, it could cause withdraw symptoms but this is uncommon.

I wouldn't mix both together though without talking to your pharmacist first.

[SH30]

My husband has been taking around 10 50mg Tramadol tablets a day for five years. He's just tapered down to 3 35mg pills a day but he's about out. Will going cold turkey from this point be a dramatic difference? He already has a lot of symptoms... just trying to be prepared so I can help as best as I can. Thanks.