I have been on ultram for 4 years...prescribed the max dosage of 300 mg/day...because of severe recurring back pain following a gastric bypass in 2003 with a 185 lb weight loss. Whether that is the cause of my back problems or not...the pain is still there. I was sent to a local pain management clinic by my family MD- where, of course, I was increased to Ultram (300 mg/day) AND Loratab (30 mg/day) in addition to many other things. Needless to say, my body (and mind) developed a tolerance to these meds. The pain doc refused to increase my meds after 4 months so I told him where to go and began self medicating (buying) large quantities of Ultram and Loratab (off the "streets"). Last month, I went through over 650 Ultram 50s, plus 800-900 dollars of Loratab. BTW, I went through inpatient "rehab/detox" in August... Only to relapse two weeks after discharge. I couldn't manage the pain - physically and psychologically. While in detox, the MD asked if I was having any type of black out/seizure activity because of the quantity of Ultram I take. To date, I do not recall any type activity (tolerance?). Forward to today, I have not had any type of pain medication for 2 days. Not for lack of trying to find it... Just none of my "dealers" can get anything. I feel like my insides are coming out... I shake, I cry, I truly wish that I could have the courage to just end it all (untreated bi-polar thrown into the mix, too). Guess depression really is part of the withdrawals, huh!. Worst part is... I am a teacher. Couldn't even go to work today. Never thought I would get to this point in my life. Now what? Does it ever get better? Or am I actually gonna have to just run my car into a lake with me strapped inside? If it weren't for my sons, I would have already done it!