How low to go

[Dylan465]

Hello Doctor,

I was taking 2 1/4 of a tab of tramadol for about 3-4 days. Yesterday, I tried to make it even less. I want the least discomfort possible. I have a sick husband and have to take him somewhere Tuesday. I'd like to know what amt is it time to just stop.

I am taking morphine sulfate also 30er 2x a day. I want to stop that too and don't think my own doctor knows much. When I get to getting off of that also when is time to stop, at how many mgs?

Thank you.  

[J T Junig, MD PhD]

Hi Dylan,

The answer to your question is really going to be different for different people.  Please read my answer earlier tonight, about tramadol withdrawal--  the issue isn't the withdrawal, because most people (by far) go back to using over and over.  Yes, everyone says 'not me-- not after what I went through!!'  EVERYONE says that, and thinks that.  So I encourage you to set a limit-- say 'if I relapse ONCE, that shows I need treatment'.  If you do that, you will save yourself years of misery.

There is NO way to avoid discomfort when going from a high tolerance to a normal tolerance;  tapering more slowly reduces the intensity of the misery, but increases the duration.  The 'net misery' remains the same.  Some people simply cannot do a gradual taper;  they get to a certain point and they can't resist going back up to a higher dose, essentially a 'mini-relapse'.  For those people the only option is to just stop 'cold turkey'-- although for many people (like me) that only works when in a locked, inpatient unit.  Another factor in the decision is your personal schedule;  some people want to take one week off work for the worst of it.

One should never go 'cold turkey' off a benzodiazepine-- meds like valium, xanax, ativan-- as the withdrawal from that class of medication can cause seizures and can even be fatal.

[Dylan465]

Hello Doctor,

I never took the tramadol today so need to answer but for a reference--how low does one go on any drug before they just stop? I intend to get off the morphine I am on, which is 30 mg 2x a day and valium (it depends) maybe I take bewtween 10-30 mg a day.

Thanks so much