Julia M Aharonov, DO
Julia M Aharonov, DO
Female, 50
Southfield, MI
Specialties: Addiction, Drug abuse and dependence
Interests: My family
Female, 50
Southfield, MI
Specialties: Addiction, Drug abuse and dependence
Interests: My family
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Sep 11, 2011 - 56 comments
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I am becoming somewhat frustrated with the way a lot of my colleagues practice medicine. Disenchanted, angry would be the other words that could be used. We all get ostensibly that same training and all of us are supposedly in it to help our patients. So, how come have I been getting so many letters lately on my addiction forum from desperate people unable to quit taking the tramadol pills that their own kind doctors have so freely prescribed for them?
These doctors seem to forget their pharmacology training. They also forget to use their independent thinking and ability to look up information for themselves. They assume that if the medication is not a controlled substance (and it very well should be as we will discuss), then it is not an opiate, it is not addictive and they can just give it like candy without any consequence to their patient.
Here are just a few excerpts of many letters that I have been getting just in the last few weeks:
"I have discovered that if I go more than 10 or 12 hours without my tramadol I begin getting a headache which progresses to nausea, upset stomach and a generally not feeling well, to the point that I have to lie down. Sometimes I even have cold sweats and chills. I have found myself taking one just to relieve those symptoms I am concerned that I am dependent on the tramadol and it doesn’t look like I am going to get rid of the pain, and the need, any time soon."
"I have been taking 10-15 Tramadol 50MG for about 5 years now and I am trying to get off of them. I have tried tapering down and that is not working... I have gotten myself to the point that I am out of medication and I am now dealing with the withdrawal symptoms without any relief. I cannot handle the restless leg and the sweating and chills along with not sleeping. I have called my dr to see if he can call me in anything to help with the symptoms but I don’t think he will help me out."
"He is sick of taking tablets and wants to feel 'normal', so he has decided to stop the tramadol. This has left him being sick, hot cold flushes, unable to sleep, lethargic and in pain all over, unable to eat or drink anything as it comes straight back up."
All of these desperate people were prescribed tramadol by their "caring" doctors for legitimate reasons such as migraines, chronic pain, endometriosis, etc. There is an appropriate use for each and every medication on the market, including the strongest narcotics, which I used in my daily practice for controlling acute pain in postoperative patients. Some patients in intractable, chronic or cancer pain need to be on long term opiates under close supervision of a physician. However, pharmaceutical companies have been successful in persuading the FDA in not scheduling tramadol, also known by its brand name Ultram, as a non-controlled substance. Its mode of action is often described as "unknown", even though it is already well know that it acts on μu receptors just like any other opiate drug. It is also well known that increases both serotonin and norepinephrine at the receptor level.
In May 2009, the United States Food and Drug Administration issued a warning letter to Johnson & Johnson, alleging that a manufacturer's promotional website had "overstated the efficacy" of the drug, and "minimized the serious risks". The company which originally produced tramadol, the German pharmaceutical company Grünenthal GmbH, was the one supposedly guilty of "minimizing" its addictive nature, although it allegedly showed little abuse liability in preliminary tests. The 2010 PDR contains warnings from the manufacturer, which were not present in previous years. The warnings include more compelling language regarding "the addictive potential of tramadol, the possibility of difficulty breathing while on the medication", a new list of more serious side effects, and a notice that tramadol is "not to be used in place of opiate medications for addicts". Tramadol is also "not to be used in efforts to wean addict patients from opiate drugs, nor to be used to manage long-term opiate addiction".
Besides the addiction, tramadol has serious side effects and is contraindicated to be taken concomitantly with some other medications as well as if the patient has certain medical conditions. It decreases seizure threshold and can cause seizures in susceptible individuals. It can also cause serotonin syndrome in people taking SSRI antidepressants. Of course, it possesses all the possible side effects of the regular opiate: hallucinations, drowsiness, insomnia, headaches, swelling of the throat and face, nausea, vomiting, muscle tightness or weakness, rash, and constipation. When consumed in higher doses, Tramadol can cause a euphoric feeling as well as shallow breathing and death from overdose.
Nonetheless, the physicians persist on thinking about this medication in the way they got used to when it first came out and the way it was "sold" to them by the pharmaceutical reps. They have this warm and fuzzy feeling of safety when they write for tramadol and keep reassuring their unsuspecting patients that it is safe, non-addicting, sort of like strong version of Tylenol. (I actually heard it described like that to residents on pain rotation!)
Well over thirty million tramadol prescriptions were dispensed in US pharmacies alone last year according to government statistics and those numbers continue to rise. But not only is it widely available by prescription, anyone, even teenagers or children can obtain tramadol simply by clicking the computer. Incredibly, it is there on hundreds of websites, some without prescriptions at all for as low as few pennies a pill. Authorities are saying that millions and millions of tramadol tablets are being diverted for illegal uses.
It is shocking, but true. Tramadol abusers compare its high favorably to heroin, morphine and OxyContin and they say it lasts somewhat longer. No wonder the popularity of tramadol as addictive substance is growing by the day. Physicians continue to be unconcerned and when faced with patient complains often pooh-pooh them and simply refuse to treat symptoms of withdrawals.
As you have read in patient letters above, the withdrawals from tramadol are no different from any other narcotic. It is nasty, it lasts a long time and most people can get though it cold turkey. In fact, because of the serotonin re-uptake inhibition of this drug, the depression aspect of withdrawal after tramadol is much more severe and lasts much longer. It needs to be specifically addressed. So what are we doing to our patients? Are we acting in your best interests? We must treat this medication with care it deserves as we must treat each patient with the care s/he deserves.
My hope is that FDA will soon reassess the scheduling of tramadol and address the availability of it on the web. The medical industry has to look at itself and evaluate the education of its doctors about the side effects and drug interactions. We also have learned how to listen to our patients, which is not easy with the busy schedules and busy waiting rooms. However, no matter how busy, a doctor cannot practice good medicine if he does not take time to educate him/herself and carefully listen to the patient.
These doctors seem to forget their pharmacology training. They also forget to use their independent thinking and ability to look up information for themselves. They assume that if the medication is not a controlled substance (and it very well should be as we will discuss), then it is not an opiate, it is not addictive and they can just give it like candy without any consequence to their patient.
Here are just a few excerpts of many letters that I have been getting just in the last few weeks:
"I have discovered that if I go more than 10 or 12 hours without my tramadol I begin getting a headache which progresses to nausea, upset stomach and a generally not feeling well, to the point that I have to lie down. Sometimes I even have cold sweats and chills. I have found myself taking one just to relieve those symptoms I am concerned that I am dependent on the tramadol and it doesn’t look like I am going to get rid of the pain, and the need, any time soon."
"I have been taking 10-15 Tramadol 50MG for about 5 years now and I am trying to get off of them. I have tried tapering down and that is not working... I have gotten myself to the point that I am out of medication and I am now dealing with the withdrawal symptoms without any relief. I cannot handle the restless leg and the sweating and chills along with not sleeping. I have called my dr to see if he can call me in anything to help with the symptoms but I don’t think he will help me out."
"He is sick of taking tablets and wants to feel 'normal', so he has decided to stop the tramadol. This has left him being sick, hot cold flushes, unable to sleep, lethargic and in pain all over, unable to eat or drink anything as it comes straight back up."
All of these desperate people were prescribed tramadol by their "caring" doctors for legitimate reasons such as migraines, chronic pain, endometriosis, etc. There is an appropriate use for each and every medication on the market, including the strongest narcotics, which I used in my daily practice for controlling acute pain in postoperative patients. Some patients in intractable, chronic or cancer pain need to be on long term opiates under close supervision of a physician. However, pharmaceutical companies have been successful in persuading the FDA in not scheduling tramadol, also known by its brand name Ultram, as a non-controlled substance. Its mode of action is often described as "unknown", even though it is already well know that it acts on μu receptors just like any other opiate drug. It is also well known that increases both serotonin and norepinephrine at the receptor level.
In May 2009, the United States Food and Drug Administration issued a warning letter to Johnson & Johnson, alleging that a manufacturer's promotional website had "overstated the efficacy" of the drug, and "minimized the serious risks". The company which originally produced tramadol, the German pharmaceutical company Grünenthal GmbH, was the one supposedly guilty of "minimizing" its addictive nature, although it allegedly showed little abuse liability in preliminary tests. The 2010 PDR contains warnings from the manufacturer, which were not present in previous years. The warnings include more compelling language regarding "the addictive potential of tramadol, the possibility of difficulty breathing while on the medication", a new list of more serious side effects, and a notice that tramadol is "not to be used in place of opiate medications for addicts". Tramadol is also "not to be used in efforts to wean addict patients from opiate drugs, nor to be used to manage long-term opiate addiction".
Besides the addiction, tramadol has serious side effects and is contraindicated to be taken concomitantly with some other medications as well as if the patient has certain medical conditions. It decreases seizure threshold and can cause seizures in susceptible individuals. It can also cause serotonin syndrome in people taking SSRI antidepressants. Of course, it possesses all the possible side effects of the regular opiate: hallucinations, drowsiness, insomnia, headaches, swelling of the throat and face, nausea, vomiting, muscle tightness or weakness, rash, and constipation. When consumed in higher doses, Tramadol can cause a euphoric feeling as well as shallow breathing and death from overdose.
Nonetheless, the physicians persist on thinking about this medication in the way they got used to when it first came out and the way it was "sold" to them by the pharmaceutical reps. They have this warm and fuzzy feeling of safety when they write for tramadol and keep reassuring their unsuspecting patients that it is safe, non-addicting, sort of like strong version of Tylenol. (I actually heard it described like that to residents on pain rotation!)
Well over thirty million tramadol prescriptions were dispensed in US pharmacies alone last year according to government statistics and those numbers continue to rise. But not only is it widely available by prescription, anyone, even teenagers or children can obtain tramadol simply by clicking the computer. Incredibly, it is there on hundreds of websites, some without prescriptions at all for as low as few pennies a pill. Authorities are saying that millions and millions of tramadol tablets are being diverted for illegal uses.
It is shocking, but true. Tramadol abusers compare its high favorably to heroin, morphine and OxyContin and they say it lasts somewhat longer. No wonder the popularity of tramadol as addictive substance is growing by the day. Physicians continue to be unconcerned and when faced with patient complains often pooh-pooh them and simply refuse to treat symptoms of withdrawals.
As you have read in patient letters above, the withdrawals from tramadol are no different from any other narcotic. It is nasty, it lasts a long time and most people can get though it cold turkey. In fact, because of the serotonin re-uptake inhibition of this drug, the depression aspect of withdrawal after tramadol is much more severe and lasts much longer. It needs to be specifically addressed. So what are we doing to our patients? Are we acting in your best interests? We must treat this medication with care it deserves as we must treat each patient with the care s/he deserves.
My hope is that FDA will soon reassess the scheduling of tramadol and address the availability of it on the web. The medical industry has to look at itself and evaluate the education of its doctors about the side effects and drug interactions. We also have learned how to listen to our patients, which is not easy with the busy schedules and busy waiting rooms. However, no matter how busy, a doctor cannot practice good medicine if he does not take time to educate him/herself and carefully listen to the patient.
Hi There
I am currently taking 200mg 12 hour slow release Tramadol tablets twice a day and after reading this I am really worried !!! I have been taking them since early July so about two months so far . I was told that when I stopped taking them I would have to do it gradually over a number of weeks cutting down but I wasn't told about any other problems like the leg shaking chills and sweats and the lasting depression!!! I still have the pain and it is as yet still undiagnosed. I am seeing the doctor tomorrow for the results of my second Trans vaginal ultrasound and will need a repeat prescription of my tablets which as well as tramadol are diclofenac and an anti constipation tablet (that isn't actually working) I am not sure what to do now .
I am currently taking 200mg 12 hour slow release Tramadol tablets twice a day and after reading this I am really worried !!! I have been taking them since early July so about two months so far . I was told that when I stopped taking them I would have to do it gradually over a number of weeks cutting down but I wasn't told about any other problems like the leg shaking chills and sweats and the lasting depression!!! I still have the pain and it is as yet still undiagnosed. I am seeing the doctor tomorrow for the results of my second Trans vaginal ultrasound and will need a repeat prescription of my tablets which as well as tramadol are diclofenac and an anti constipation tablet (that isn't actually working) I am not sure what to do now .
It was not my goal to unduly worry you and others like you. If you taper it down slowly and gently you may not have too many withdrawal symptoms. Just by saying that you have to taper it down shows that they were aware of the problems that could be caused by stopping it abruptly. It tells me that s/he is aware of its side effects, so I think you should relax and just tells them that you are aware of the issues and voice your concerns and discuss what steps can be taken if issues and symptoms arise.
What you need to do is deal with your pain, figure out what to do with it and treat it appropriately. Opiates are never a long term answer to pain for a young mother like you. Good luck and let me know what happens.
What you need to do is deal with your pain, figure out what to do with it and treat it appropriately. Opiates are never a long term answer to pain for a young mother like you. Good luck and let me know what happens.
My doctor prescribed me tramadol 50 mg for arthritis in my back i take about 8-10 a day for pain just to be able to move around .She never once told me about tapering off she continues to refill every 3 months. i never thought it was addictive because it was not a controlled substance i thought i was taking something i would not have a problem getting off of. thank you for your artical it has really opened my eyes now i know why when i take less i feel the way i do and one time when i was late getting my refill and had only taken 1 tramadol over a period of 10 hours i started feeling really bad and agitated i thought it was because of my pain now i am thinking it was withdraw and once i took my pills i was fine i am going to be talking to my doctor about the risks next visit thanks.
Hi to all...
I've read all of the comments above with real interest. I've been on Tramadol for 3 plus years. I wasn’t told it was addictive, but at the same time, the fact you wean on them and off them told its own story to me. I couldn’t cope with my pain level. So for me, it was a blessed release from the pain levels I had. I have to add, without the Tramadol, the Pregablin and the co-codamol, I think I would have cut my own throat by now. Not having this pain relief scares me, my pain level is bad enough with all those pain meds, without them, it doesn’t bear thinking about. So for me, addiction is not the appropriate word I use, it is a dependency, because I depend on it to help my pain. I won’t ever come off it, so for me; 'addiction' isn’t a problem. It’s something I don’t worry about. I look at it like this;
I can’t live with the pain without the medications, my pain will never cease, and my pain is great. I have steroid injections into my ribs. And I have epidural steroids into my lower back. I know everyone is different. But I didn’t go on this lightly. My GP wouldn’t put me on it, told me my pain Specialist would have to do that. On telling my specialist that, he laughed and said;
'Yeah, so if you die it’s not her fault, but mine.'
We laughed, cos basically, I'm quite lucky to be here. I have many conditions, but I will concentrate on the spine. I have osteoporosis; osteoarthritis and the whole of my body (bones/joints) are affected. I fractured my spine when I was 40. I'd had a radical hysterectomy at 30, and no HRT, yep, this is my legacy. Anyway, at 55 now, my spine is a mess. I have a severe scoliosis; I am bent to the right. This is causing terrible pain in my right ribs. I have spondylitis, crush fractures; my spine has very limited movement, and I have 3 prolapsed discs. The last lower back disc is totally herniated and crushing my sciatica’s, pain it great, and that’s with the pain meds, without them, like I say, I wouldn’t be here, cos I wouldn’t cope.
What I’m saying is, taking onboard all that’s been said in the negative, for me, it is the positive. Addiction isn’t always addiction. To me, addiction is when someone takes it as a ‘recreational’, drug abuse. That’s addiction in my mind. Whereas dependency is just that, I depend on my pain relief. Ok, so it’s still great, but it’s a lot better than without. (Oh, and PS, I’m also wheelchair dependant, I forgot about that, I class that as my pain relief too! Without it, I am housebound. I live in a little bungalow and weight-bear, but once I hit the front door, I need that chair, my spine won’t support me for more than a couple of minutes you see. So I have no choice. Well, I do, stay in and be full of pride. Or; use the chair and be independent…I chose the latter. It works for me.
For people like me, I am all for Tramadol, for those who need short term pain relief, then that’s a whole new ball game.
Anyway, just my thoughts: I just didn’t want Tramadol to look all bad. When at times, it’s not, it’s good.
Good luck to those who need to get off it! Stick with it and I’m sure you’ll be just fine. But more, for some, I hope this info I've given gives some solace to those who are worried.
Catherine
I've read all of the comments above with real interest. I've been on Tramadol for 3 plus years. I wasn’t told it was addictive, but at the same time, the fact you wean on them and off them told its own story to me. I couldn’t cope with my pain level. So for me, it was a blessed release from the pain levels I had. I have to add, without the Tramadol, the Pregablin and the co-codamol, I think I would have cut my own throat by now. Not having this pain relief scares me, my pain level is bad enough with all those pain meds, without them, it doesn’t bear thinking about. So for me, addiction is not the appropriate word I use, it is a dependency, because I depend on it to help my pain. I won’t ever come off it, so for me; 'addiction' isn’t a problem. It’s something I don’t worry about. I look at it like this;
I can’t live with the pain without the medications, my pain will never cease, and my pain is great. I have steroid injections into my ribs. And I have epidural steroids into my lower back. I know everyone is different. But I didn’t go on this lightly. My GP wouldn’t put me on it, told me my pain Specialist would have to do that. On telling my specialist that, he laughed and said;
'Yeah, so if you die it’s not her fault, but mine.'
We laughed, cos basically, I'm quite lucky to be here. I have many conditions, but I will concentrate on the spine. I have osteoporosis; osteoarthritis and the whole of my body (bones/joints) are affected. I fractured my spine when I was 40. I'd had a radical hysterectomy at 30, and no HRT, yep, this is my legacy. Anyway, at 55 now, my spine is a mess. I have a severe scoliosis; I am bent to the right. This is causing terrible pain in my right ribs. I have spondylitis, crush fractures; my spine has very limited movement, and I have 3 prolapsed discs. The last lower back disc is totally herniated and crushing my sciatica’s, pain it great, and that’s with the pain meds, without them, like I say, I wouldn’t be here, cos I wouldn’t cope.
What I’m saying is, taking onboard all that’s been said in the negative, for me, it is the positive. Addiction isn’t always addiction. To me, addiction is when someone takes it as a ‘recreational’, drug abuse. That’s addiction in my mind. Whereas dependency is just that, I depend on my pain relief. Ok, so it’s still great, but it’s a lot better than without. (Oh, and PS, I’m also wheelchair dependant, I forgot about that, I class that as my pain relief too! Without it, I am housebound. I live in a little bungalow and weight-bear, but once I hit the front door, I need that chair, my spine won’t support me for more than a couple of minutes you see. So I have no choice. Well, I do, stay in and be full of pride. Or; use the chair and be independent…I chose the latter. It works for me.
For people like me, I am all for Tramadol, for those who need short term pain relief, then that’s a whole new ball game.
Anyway, just my thoughts: I just didn’t want Tramadol to look all bad. When at times, it’s not, it’s good.
Good luck to those who need to get off it! Stick with it and I’m sure you’ll be just fine. But more, for some, I hope this info I've given gives some solace to those who are worried.
Catherine
P.S.
I forgot to mention, my spine is also breaking up, bits are snapping off it. Just to give an idea of my pain level, and just what my meds do for me.
I forgot to mention, my spine is also breaking up, bits are snapping off it. Just to give an idea of my pain level, and just what my meds do for me.
Every medications has its proper uses. Tramadol certainly does as well. In my daily practice of anesthesia I use opiates to control acute and chronic pain when approriate. Every patient has to be approached in a thoughtful and considerated manner. It seems that you are very lucky to have physicians who are doing just that. Thank you for sharing your experiences with this forum.
Catherine,
For your situation, I am deeply grateful that you have Ultram to rely on. I agree with your use of the term "dependence," and it makes sense to equate Ultram to a wheelchair, both necessary aides in your case. As for my situation, I'm very happy to be off of Ultram. I have been diagnosed with CRPS in my left foot and ankle; I've had this for 15 years, though the early diagnoses included small fiber peripheral neuropathy and RSD. I had a hysterectomy at 41--just the uterus--and woke up from the surgery with burning and spasms, aching and lightning bolts in my left foot and leg. Nothing relieves it, but a combination of neurontin (2700 mgs) and tramadol (50 mgs 4xday) turned the volume down for a while. My doc clearly explained that the research showed tramadol to be non-addictive and without worrisome side effects. Then a pain clinic opened up in town and my Doc sent me there. I was switched to 300 mg. time release Ultram once a day and 100 mg. Lyrica 3xday. Within a couple of months, I was having serious cognitive difficulty (I'm an English professor and couldn't remember what I was saying in front of class--bad!) and had two seizure episodes that scared the hell out of my husband. I thought I was following, somewhat early, my mother's and grandmother's alzheimers fate! Coincidentally, I forgot (in my state of mind, not a surprise) to take the Ultram one day, and the next day I had every symptom of a bad flu. I didn't understand it--I'd had a flu shot. I got better after a week, and then after a few weeks I accidentally forgot the Ultram again and had the same reaction! I contacted the pain clinic, who didn't believe the symptoms could be withdrawal related. But I asked them to help me titrate down on the Ultram just the same because I was having trouble with cognitive tracking. Suffice it to say it took me two months to get down to none, and four more months to feel like my thinking was back on track. Others noticed the marked improvement, too. This year I dialed back my workload (a luxury, I know; most people don't have that option) and have been trying with my Doc's help to get back to the level of pain relief I experienced with the tramadol--physical therapy, acupuncture, massage, celebrex, and now baclofen 10 mg. at night so I can sleep. I haven't slept well since leaving the tramadol behind. Sorry--I haven't discovered a magic formula for myself yet and have no suggestions. But I will say that my experience with tramadol is exactly as Dr. Aharonov has warned us about, and I agree that it is handed out a little too freely.
For your situation, I am deeply grateful that you have Ultram to rely on. I agree with your use of the term "dependence," and it makes sense to equate Ultram to a wheelchair, both necessary aides in your case. As for my situation, I'm very happy to be off of Ultram. I have been diagnosed with CRPS in my left foot and ankle; I've had this for 15 years, though the early diagnoses included small fiber peripheral neuropathy and RSD. I had a hysterectomy at 41--just the uterus--and woke up from the surgery with burning and spasms, aching and lightning bolts in my left foot and leg. Nothing relieves it, but a combination of neurontin (2700 mgs) and tramadol (50 mgs 4xday) turned the volume down for a while. My doc clearly explained that the research showed tramadol to be non-addictive and without worrisome side effects. Then a pain clinic opened up in town and my Doc sent me there. I was switched to 300 mg. time release Ultram once a day and 100 mg. Lyrica 3xday. Within a couple of months, I was having serious cognitive difficulty (I'm an English professor and couldn't remember what I was saying in front of class--bad!) and had two seizure episodes that scared the hell out of my husband. I thought I was following, somewhat early, my mother's and grandmother's alzheimers fate! Coincidentally, I forgot (in my state of mind, not a surprise) to take the Ultram one day, and the next day I had every symptom of a bad flu. I didn't understand it--I'd had a flu shot. I got better after a week, and then after a few weeks I accidentally forgot the Ultram again and had the same reaction! I contacted the pain clinic, who didn't believe the symptoms could be withdrawal related. But I asked them to help me titrate down on the Ultram just the same because I was having trouble with cognitive tracking. Suffice it to say it took me two months to get down to none, and four more months to feel like my thinking was back on track. Others noticed the marked improvement, too. This year I dialed back my workload (a luxury, I know; most people don't have that option) and have been trying with my Doc's help to get back to the level of pain relief I experienced with the tramadol--physical therapy, acupuncture, massage, celebrex, and now baclofen 10 mg. at night so I can sleep. I haven't slept well since leaving the tramadol behind. Sorry--I haven't discovered a magic formula for myself yet and have no suggestions. But I will say that my experience with tramadol is exactly as Dr. Aharonov has warned us about, and I agree that it is handed out a little too freely.
I have acid reflux from years of using ibuprofen products so I was persribed tramadol for my back and other joint issues. I wasn't told it would be habit forming at all but lucky for my the first thing I do when I get a med I don't know anything about, I google it to find out what the side effects are. I was sure surprised to find out it was addictive. I think patients should be told right up front about it when it is perscribed and let them have a voice in whether they want to take the risk of becoming addicted. Because I informed myself, I use mine sparingly. I can refill it 4 more times but I don't plan on it. I've tried more natural approaches such as magnesium for relaxing my tight muscles and stretching out more. Tramadol is for emergency only!
I have had an alarming sun sensitivity as my use of tramadol has increased. I have degenerative disc disease and have had episodes where my back locks up for week long periods on a regular basis. I GREATLY appreciate the way that Ultram alleviates the pain, however, the itching and rash that I have been getting lately has been getting worse. At first the itching was only on my arms, then arms and neck, and more recently increasing to my abdomen. I have tried lots of over the counter and "natural" remedies, but it has been getting progressively worse...
I have mentioned my situation to two different pharmacists and they both asked the same question, "what medications hare you taking".
They suggested changing pain medications... Are there good alternative pain meds?
I have mentioned my situation to two different pharmacists and they both asked the same question, "what medications hare you taking".
They suggested changing pain medications... Are there good alternative pain meds?
Tramadol is a scary substance! I'm 22 days off of it- I think eventually it will be scheduled -it should be. I had the rash too-now it's completely gone. Name brand Ultram doesn't normally cause rash-usually just generics in my experience. I think a true narcotic is a good alternative to Tramadol- strong pain relief and easier, shorter withdrawals! Good luck!!
thank you for this article, I have been taking tramacet/tramadol for many years now due to recurrent pancraetitis. I found myself becoming addicted to codeine so my Dr switched me to this drug - gee thanks fo rthe help, non-addictive my butt! I finally reached a point where I am ready to give the pills up so for the past few weeks have been weaning down. I get very anxious when thinking about not taking them and sometimes feel like my skin is crawling when I don't have enough in my system. I am trying to be strong and want to stop being dependent on these drugs however with my medical situation also know it is unrealistic to think I will never use again, I just need to be responsible and not slip back into old patterns. I do relate to your statement about the euphoric feeling I get from taking them, it just seems to take everything down a notch. Wish me luck in this struggle!
Thank you so much for sharing your experience! It is greatly appreciated.
Thank you for posting these opinions; it means a lot given your MD status. I think the question for the medical industry is whether the first rule is "Do no harm", or "shrink no profit". At some point, we need to take a look at everything with a wide lens. When drug commercials last 45 - 80 seconds instead of 30, and most of the time is spent discussing side effects, we should think, "Hmm". When the drugs side effects increase the symptom they are prescribed to treat, "hmm". When the side effect is worse than the illness (i.e. death or blindness, when treating for skin blemishes), "hmm". Really? When they are allowed to refer to fatigue as "tired felling" because some marketing clown realized it sounded less severe, you wonder where the Federal Government is. Then you realize that if nicotine was being sold out of the back of a pickup truck in East LA instead of by BIG business, it would be scheduled right there with morphine.
Hmmm.
I know developing these drugs is difficult and everyone is different, but I really don’t recall a time when so many drugs are causing the high blood pressure or clogged arteries they were meant to treat. And commercials seem geared toward hypochondriacs.
- Be well, all.
Hmmm.
I know developing these drugs is difficult and everyone is different, but I really don’t recall a time when so many drugs are causing the high blood pressure or clogged arteries they were meant to treat. And commercials seem geared toward hypochondriacs.
- Be well, all.
i take tramadol and have done for some time now, i have arthiritis in my neck, my lower spine, my shoulders, my knees, my ankles and my hands. i'm waiting for an operation on my right hand at the moment, i've allready had my left one done, i've also had both shoulders done. before my ops i had numerous steroid injections in my shoulders and my hands. is it no wonder i take antidepressants i've taken all sorts of medication over the years that didn't take the pain away. i also take 2 lots of blood pressure tablets, 2 lots of antacid medication, tablet for overactive bladder, antidepressants, paracetamol, statins and thyroxin, as i also have underactive thyroid. [i rattle when i walk.] after my first operation, on my shoulder the hospital couldn't control my pain so they put me on morphine, it didn't do anything for me but sting. my gp gave me morphine patches once but they just irratated my skin. he eventually gave me tramadol, i was still in a lot of pain. my doctor said there's not much more you can try, i didn't take my painkillers for a couple of days, i realised they did work as i was in so much more pain without them so i started taking them again. i didn't have any withdrawls from the tramadol, i have continued to take them because it's better than not taking them. i used to take an antidepressant called trazadone, i was given it to help me sleep. it helped for quite a long time, then i just stopped. taking them as i felt better in my self apart from the pain. my doctor said i should have weaned my self off them, he was surprised i didn't have withdrawal. my sister has been on seroxat for over 10 years, if she misses one tablet she is ill. i must be an odd one as nothing makes much difference to me. i don't get high on morphine or anything else. i think i just haven't got an addictive nature. i never came on this site about me, i came on to find out what is wrong with my grandson, he's 9, he gets alopicia and has started making strange noises in his throat and nose, the doctor is sending him to a specialist. this last week or so he's twitching and he can't stop. he twitches his head and neck, he also does it with his right arm, he clicks his fingers when he does it. i'm really worried about him. his mum is going to the doctors agai on monday. i can't wait that long, can yoy give me some idea what's wrong. linda
I've had a doctor blithely unaware of the addictive properties of opioids, only in this case it was codeine. I'd had to take it for a month for an attack of calcific tendinitis, and while the first time that happened three years previously (along with taking tramadol; it was acute calcific tendinitis that time, which even doctors call "excruciating") I hadn't had withdrawal problems, this time (no tramadol, just co-codamol) I did. So I rang my surgery, and the GP I got (not my usual one) told me that co-codamol isn't addictive and doesn't cause withdrawal symptoms. Yeah, right. I googled it, found that valium is commonly used to help the withdrawal symptoms, but since I didn't want to jump out of the frying pan into the fire, I ended up using valerian to help with the insomnia and jitteriness I was experiencing.
On the other hand, doctors can be over-cautious with potentially addictive meds. I have PMDD, and had to wait two years before anyone even suggested using valium for it. I only need 2mg a few times a month, and not even every month at that. Meanwhile they'd been putting me on far more invasive drugs full-time, none of which had worked for the PMDD. Anyone who looks at my medical records and chats to me for five minutes will realise that I am not going to abuse drugs, and in fact I am wary of taking medication and like to keep it to a minimum. Is no one capable of screening patients for addictive potential?
Another problem I've found is that doctors often do not want to admit the side effects of these strong meds. When I had the acute calcific tendinitis and had to take codeine and tramadol for a month, the GP who was then handling my care was absolutely hopeless with the very substantial side effects, and it didn't help that I was extremely groggy (in other words, stoned) from all the meds and having trouble holding a conversation with him. And then there was the fun time when I was given zolpidem (ambien) for sleep (because doctors in this country don't generally recognise circadian rhythm disorders such as Non-24 Sleep-Wake Cycle and haven't a clue how to treat them), hallucinated, was ill for a week afterwards, and was told that hallucinations are not a known side effect of this drug. Er, they're incredibly well known, and I have no idea why they are not listed on the patient information leaflets in the UK when they are in the US.
On the other hand, doctors can be over-cautious with potentially addictive meds. I have PMDD, and had to wait two years before anyone even suggested using valium for it. I only need 2mg a few times a month, and not even every month at that. Meanwhile they'd been putting me on far more invasive drugs full-time, none of which had worked for the PMDD. Anyone who looks at my medical records and chats to me for five minutes will realise that I am not going to abuse drugs, and in fact I am wary of taking medication and like to keep it to a minimum. Is no one capable of screening patients for addictive potential?
Another problem I've found is that doctors often do not want to admit the side effects of these strong meds. When I had the acute calcific tendinitis and had to take codeine and tramadol for a month, the GP who was then handling my care was absolutely hopeless with the very substantial side effects, and it didn't help that I was extremely groggy (in other words, stoned) from all the meds and having trouble holding a conversation with him. And then there was the fun time when I was given zolpidem (ambien) for sleep (because doctors in this country don't generally recognise circadian rhythm disorders such as Non-24 Sleep-Wake Cycle and haven't a clue how to treat them), hallucinated, was ill for a week afterwards, and was told that hallucinations are not a known side effect of this drug. Er, they're incredibly well known, and I have no idea why they are not listed on the patient information leaflets in the UK when they are in the US.
I see you have the same issues with doctors in UK as we do here in the USA. I had a lot of fun (and heartache) reading your comment.
Dr. Aharonov
Dr. Aharonov
I have end stage cirrhosis and hepatic encephalopathy so along with that comes muscle and joint pain. I have been prescribed 50mg tablets of Tramadol and have not felt any relief. I have even increased the dosaged to 150mg and still it didn't help. So I just dont take the pills since they seem useless. Any idea why they dont seem to help?
I do find that stretching and light exercise seems to help increase the blood flow to the muscles which helps to clear the toxins and relieves a lot of the pain. Take care Dr. Aharonov :)
Randy
I do find that stretching and light exercise seems to help increase the blood flow to the muscles which helps to clear the toxins and relieves a lot of the pain. Take care Dr. Aharonov :)
Randy
I would like to first thank you for making it clear to everyone exactly how serious of a drug Ultram/tramadol really is. My cousin was sent to a residential rehabilitation center upstate for a serious addiction to narcotic pain medication. He was taking vicodin, percocet, oxycotton etc. anything he could possibly get his hands on. This went on for years until he eventually lost everything and almost losing his life. While in rehab, he saw all different kinds of doctors on site for several different reasons. The second he came across a doctor that dealt with pain management he found his opportunity to do the same thing he did in the past. Unless you undergo serious surgery during your rehabilitation period, they would never prescribe anyone a "narcotic". My cousin on the other hand convinced this doctor that he had unbearable back pain and could not sit for longer than 10 minutes at a time. The doctor prescribed him ultram/tramadol for his "pain" during his first month of rehabilitation. He continued taking the tramadol all through the process and learned absolutely nothing. He completed the program, came home and in a matter of days he started with the more serious pain pills. I feel as if all the tramadol did was hold him over until he completed, and he could do what he wanted to do all along. It really is a shame how some things turn out. I just don't understand how the doctors didn't send him out for x-rays or an MRI before giving him that medication. Maybe if the tests were done and it was obvious he was lying, tramadol wouldn't have been an option. Maybe if the tests were done, along with NO option of the tramadol, I wouldn't be sharing in this forum at 3 am in the morning on a Tuesday thinking about him. My cousin passed away 6 months ago from today, from an overdose of prescription pain killers and I miss him. I sometimes wonder if he didn't have access to that medication, he may have thought more clearly. If his mind wasn't clouded 11 out of the 12 months of rehab, maybe he would have learned something great one day in treatment enabling him to live a sober productive life style.
What I am trying to say is if you can do without prescription narcotic pain killers INCLUDING tramadol/ultram please do. You don't want to potentially leave a loved one with a bunch of "Maybes" or "what ifs" missing you with all of their heart and wondering what they could have done differently. My cousins name is Danny and he was 24 when he passed. I really miss him and would go above and beyond to have him back.
Please be careful everyone.
What I am trying to say is if you can do without prescription narcotic pain killers INCLUDING tramadol/ultram please do. You don't want to potentially leave a loved one with a bunch of "Maybes" or "what ifs" missing you with all of their heart and wondering what they could have done differently. My cousins name is Danny and he was 24 when he passed. I really miss him and would go above and beyond to have him back.
Please be careful everyone.
Suffices to say then if a person is allergic to codeine/morphine/similiar products then Tramadol as well??
No, the chemical structure is sufficiently different not to automatically come to such conclusion.
I am in agreement with one of the prior post in that, for me Tramadol works very well at what it is supposed to do. I could not work or even take care of my chores with out it. I do not take excessive amounts and I do get off it and grin and bear it some times but it gets to where I just lay in bed because every move hurts. I have arthritis through out my body. I really should not work I suppose but I like to eat and pay my bills so that is not an option. My wife is disabled and has dementia so I have to care for her also. It is just like any thing else I guess, be it alcohol or what ever you have use it responsibly. Hydrocodone did nothing for me and just made feel bad and did not control the pain like Tramadol.
I am not insane thank you for Julia for your efforts. I need help! I am in so much pain! I am 47 I am a auto Mechanic by trade have been since 84 The last 3 years I was working in the Natural gas fields as a mechanic on the gas compressors very physically demanding work but i loved it. Feb 28 2011 I was in my 1 ton crew cab work truck stopped for a car in front of me to make a left hand turn when a 1 Ton delivery van rear ended me he was doing 70 mph I woke up under my cross box and a air compressor in the bed of my truck being thrown through the rear glass I remember hearing someone moaning in pain and was trying to find them then I realized it was me. well I was already taking Tramadol for chronic pain due to surgery from a ruptured disc back in 98 it has been 7 months and the only treatment I have received has been pain pills I quit the tramadol cause it was not doing the job anymore I would run out and OMG!! what a nightmare they put me on hydrocodone it works and I can function normally on it but they can't let me have my job back while I am taking it. I am cutting back and my pain is unbearable. I am working at a local shop to pay some bills and I am able to do my job but my coworkers are allways telling me to take my meds they can tell I am in pain but at night when I go to bed that's when the real pain starts almost immediately after I lay down my knees and hips hurt so bad I can't take it. I cant go on like this. The doctors say I am ok . I am not, I don't know what to do. the only time my pain is bearable is when I am on my feet, only when I reach exhaustion do I sleep. oh I almost forgot the last 3 days my left arm has been numb and hurting.
Hi there :-)
Just want to tell you that in my country (Denmark) it's the same. I've been using / abusing tramadol for 5 years. Had to increase the dose myself when my body got more and more tolerant, so for the last year (at least) the dose was 20-24 tablets a day. 7,5 weeks ago I just got enough and decided to taper here and now. Tapered for five days and then cold turkey. Got w/d's and what we call "tramaflue" and wasn't able to do anything but lay in bed for a couple of days. Took my time and after a week or so, I was able to take on smaller tasks - like doing dishes etc.
I have read so many posts in here from people like me. Fighting that horrible drug. But I have realized that I'm extremely lucky. I haven't had any kind of depression. I'm just happy. I get grumpy once in a while, and I know that's w/d's and probably PAWS. But on the other hand - we all get grumpy from time to time, so no biggie. Also I have been able to sleep through most of the w/d's and tramaflue. No insomnia at all. So I am really lucky. Just the thought of going through that hell again, with both depression and insomnia... Don't know why I'm not suffering from that though. Haven't been taking anything but vitamin C ever since I stopped.
And a little extra trivia - Tramadol is not on the market in Greece. It was found too addictive and dangerous.
Just want to tell you that in my country (Denmark) it's the same. I've been using / abusing tramadol for 5 years. Had to increase the dose myself when my body got more and more tolerant, so for the last year (at least) the dose was 20-24 tablets a day. 7,5 weeks ago I just got enough and decided to taper here and now. Tapered for five days and then cold turkey. Got w/d's and what we call "tramaflue" and wasn't able to do anything but lay in bed for a couple of days. Took my time and after a week or so, I was able to take on smaller tasks - like doing dishes etc.
I have read so many posts in here from people like me. Fighting that horrible drug. But I have realized that I'm extremely lucky. I haven't had any kind of depression. I'm just happy. I get grumpy once in a while, and I know that's w/d's and probably PAWS. But on the other hand - we all get grumpy from time to time, so no biggie. Also I have been able to sleep through most of the w/d's and tramaflue. No insomnia at all. So I am really lucky. Just the thought of going through that hell again, with both depression and insomnia... Don't know why I'm not suffering from that though. Haven't been taking anything but vitamin C ever since I stopped.
And a little extra trivia - Tramadol is not on the market in Greece. It was found too addictive and dangerous.
Thank you so much for sharing you experience. I will add 'tramaflue' as a new word in my vocabulary. :)
I stumbled upon this blog today and found it amazing.
For a while I though I was crazy with the problems I was having with Tramadol.
I've been in pain management for roughly a year with severe endometriosis, and at 25 years old I've been a little wary of taking the step of a hysterectomy. So I went in to pain management... I started with 120 - 7.5mg norco per month. After just a couple of months my doctor wanted to drop my dose but threw in 90- 50mg Tramadols, with directions to use it to elongate the time between Norco doses. I took it as prescribed for months and it was fine. Then I started to build a tolerance and had to take more of the Tramadol to get the benefits, and the doctor was still lessening my Norco. At this point I'm on 60 Norco per month, and 90 Tramadol. A few months ago the Tramadol ran out before the end of the month, and the withdrawls were awful! I couldn't sleep, couldn't sit still(Restless leg syndrome... I had restless body syndrome). After about a week the bulk of the withdrawls passed but I felt so unmotivated to do anything!
I told my doctor about this experience, and explained to him I would rather up the dose on the Norco, because the withdrawls from that have never been as bad for me as Tramadol are. He seemed to think I was crazy, and just said I need to focus on using the Tramadol more than the Norco, however I've learned otherwise.
I'm terrified to switch doctors and start over, but this is just a mess. I'm in and out of withdrawls, on the Tramadol and off the Tramadol. And my dosing fluctuates because I don't think my doctor remembers or looks up what he gave me the month before, so sometimes I get 60 of them, sometimes 120.
I wish the best to anyone, but I'd never recommend extended daily use of Tramadol! Hydrocodone or Codeine are easier to get off, and there seems to be more that can help in symtom relief from those withdrawls, versus the withdrawls of Tramadol.
Such is life...
For a while I though I was crazy with the problems I was having with Tramadol.
I've been in pain management for roughly a year with severe endometriosis, and at 25 years old I've been a little wary of taking the step of a hysterectomy. So I went in to pain management... I started with 120 - 7.5mg norco per month. After just a couple of months my doctor wanted to drop my dose but threw in 90- 50mg Tramadols, with directions to use it to elongate the time between Norco doses. I took it as prescribed for months and it was fine. Then I started to build a tolerance and had to take more of the Tramadol to get the benefits, and the doctor was still lessening my Norco. At this point I'm on 60 Norco per month, and 90 Tramadol. A few months ago the Tramadol ran out before the end of the month, and the withdrawls were awful! I couldn't sleep, couldn't sit still(Restless leg syndrome... I had restless body syndrome). After about a week the bulk of the withdrawls passed but I felt so unmotivated to do anything!
I told my doctor about this experience, and explained to him I would rather up the dose on the Norco, because the withdrawls from that have never been as bad for me as Tramadol are. He seemed to think I was crazy, and just said I need to focus on using the Tramadol more than the Norco, however I've learned otherwise.
I'm terrified to switch doctors and start over, but this is just a mess. I'm in and out of withdrawls, on the Tramadol and off the Tramadol. And my dosing fluctuates because I don't think my doctor remembers or looks up what he gave me the month before, so sometimes I get 60 of them, sometimes 120.
I wish the best to anyone, but I'd never recommend extended daily use of Tramadol! Hydrocodone or Codeine are easier to get off, and there seems to be more that can help in symtom relief from those withdrawls, versus the withdrawls of Tramadol.
Such is life...
I have taken Ultram for 14 years. I was told I had post-herpetic neuralgia from contacting the chicken pox in my early thirties. For 12 years I went from doctor to doctor complaining about my pain. Only one doctor suggested that I might not be in pain anymore, but was suffering from rebound pain, when the drug would wear off. Every day for fourteen years, I went through the cold sweats and achy, restless legs until I took my next dose. My entire life revolved around my next dose so that I wouldn't be in pain. After consulting a neurology text online, I decided that I most likely no longer had pain...but was experiencing pain from my body's inability to manufacture it's own opiates.
On September 11, 2011 I took my last dose. I was only on 200 mgs. a day for the past year, and on 100 mgs. the laste three months before quitting. You would think that the Ultram (tramadol) would have been mostly out of my system. No. Let me tell you about my withdrawal. After 14 years, the tramadol must have permeated every cell in my body. Withdrawal was worse than anything you can imagine. The first week my skin broke out all over my mouht, I was white as a ghost and so weak I could barely stand. I was sweating, freezing and had goose bumps all over. I dressed and undressed every five minutes. I ached like I was being tortured, and my legs were kicking like a mule. I wanted to die. After about ten days the worst of it was over.
The next three and a half months would consist of horrid depression and a continuation of hot/cold sweats, goosebumps and an overall feeling of having the flue. I was suicidal with the psychological and physical pain I experienced. A plant by the name of Kratom got me through the worst of it. In fact, without the Kratom that blocked the Mu receptor....I wouldn't have been able to do it alone. I also used magnesium, B6, immodium (an opiate that doesn't clear the blood brain barrier), hot baths and exercise. I would rate my withdrawal as a 12 out of a 10, probably because the 14 years of chemical saturation.
I am furious that my doctor didn't warn me, that the FDA knowingly allowed J and J to schedule this drug as a Schedule 5 drug (no potential for addiction), and for J and J for hiding studies and deliberately misleading the public. I will be suing Johnson and Johnson for fraud and any other consumer remedies available. They stole 14 years from me and I can never get it back. Instead of focusing on raising my children, I focused on my next fix. I was nothing but an addict, and not one doctor I visited did anything but write another prescription for tramadol.
On September 11, 2011 I took my last dose. I was only on 200 mgs. a day for the past year, and on 100 mgs. the laste three months before quitting. You would think that the Ultram (tramadol) would have been mostly out of my system. No. Let me tell you about my withdrawal. After 14 years, the tramadol must have permeated every cell in my body. Withdrawal was worse than anything you can imagine. The first week my skin broke out all over my mouht, I was white as a ghost and so weak I could barely stand. I was sweating, freezing and had goose bumps all over. I dressed and undressed every five minutes. I ached like I was being tortured, and my legs were kicking like a mule. I wanted to die. After about ten days the worst of it was over.
The next three and a half months would consist of horrid depression and a continuation of hot/cold sweats, goosebumps and an overall feeling of having the flue. I was suicidal with the psychological and physical pain I experienced. A plant by the name of Kratom got me through the worst of it. In fact, without the Kratom that blocked the Mu receptor....I wouldn't have been able to do it alone. I also used magnesium, B6, immodium (an opiate that doesn't clear the blood brain barrier), hot baths and exercise. I would rate my withdrawal as a 12 out of a 10, probably because the 14 years of chemical saturation.
I am furious that my doctor didn't warn me, that the FDA knowingly allowed J and J to schedule this drug as a Schedule 5 drug (no potential for addiction), and for J and J for hiding studies and deliberately misleading the public. I will be suing Johnson and Johnson for fraud and any other consumer remedies available. They stole 14 years from me and I can never get it back. Instead of focusing on raising my children, I focused on my next fix. I was nothing but an addict, and not one doctor I visited did anything but write another prescription for tramadol.
Day 7 of withdrawing, that's all I can say as when I think about it to type it brings back the panic attacks. I am on FB under Kathy Riches, maybe we can talk down the road :)
I have been on tramadol for about 2 years. Same thing, back pain, minor arthritis. When I took that first pill, I thought my life was now complete!! Well, 2years later, and thousands of pills in my body, I am singing a different toon. I am on day 7 of CT, and am sorta kinda functioning when I am at home, but the second I get to work, I am angry, tired, really dizzy and foggy. I have no choice, I must work, like most people! Bult I work in the mall, and deal with people constantly, I am afraid I am going to lose my job because I want to punch everybody, or at least tell them to shove it where the sun don't shine(that is being nice by the way) when is this terrible irritability going to stop. I have another docs apt. On Tuesday, I feel like I need to be on one evil, to surpress another, but I CAN'T lose my job. So, here is my question, please, any suggestions on how to rid my head of the dizzy, foggy, irritability!?!?! I do not mind another prescription drug, if it gets me over this hump. I feel like all the other stuff is coming to a stop...insomnia (still a bit of an issue) leg cramps, diarrea, nausea, I even got my appetite back, but I feel like my head is gonna explode when I am at work. The tramadol really gave me that false sense of awesomeness, that I now feel like I lack. I just want to laugh, and be my own self, but I feel like I need a stepping block to get there. Any suggestions? Good or bad, I just want some advice. Thanx for listening everyone...ps... I have one more re fills on the trams, give me the streng
Oops, wasn't done yet....give me the strength to simply not go and get them, because there is a part of me that feels that is the only thing that is going to get me back to my old self. Everyone at work thinks I have mono or something, and I am fine with that for now, but I am solo terrified, if I do not get back to normal, that I will cave, so I don't lose my job. Well, that is all for now. Gotta go to bed, gotta work tomorrow ( oh yippie) bye guys, and wish me. Luck.
Oops, wasn't done yet....give me the strength to simply not go and get them, because there is a part of me that feels that is the only thing that is going to get me back to my old self. Everyone at work thinks I have mono or something, and I am fine with that for now, but I am solo terrified, if I do not get back to normal, that I will cave, so I don't lose my job. Well, that is all for now. Gotta go to bed, gotta work tomorrow ( oh yippie) bye guys, and wish me. Luck.
Ps doctor, I live in Michigan too. Maybe you can give me some referrals, I live up here in Lapeer county!
im about 5 months pregnant an i have had bad back paind for a while now when i became pregnant i was on a pain patch my doc of course told me to stop the pain patch but gave me ultram to take so i have bee takinh pretty much my whole pregnancy, now my gynocoligist told me to stop takin them but my back hurts so bad i have to take im pretty scared that this will hurt my baby can it become addicted to ultram i would die if that happen . i just dont know what els to do about my pain while pregnant i cant just take an easy cuz i have 3 young children i have to take care of also pleade what should i do
.,
.,
Your OB/GYN is right to tell you to stop taking them because you do not want to have your baby born addicted to opiates and then start withdrawals. It will need to go to neonatal ICU and spend time on Morphine taper. Some hospital neonatologists (baby intensivists) are not familiar with the withdrawal process and can unduly prolong it keeping you from being able to take your baby home for longer than necessary. It is important to get off all opiates while you are still pregnant so that the baby can withdraw safely with you. Do it slowly or ask to be prescribed Subutex instead to taper on those. Subutex is a partial opioid agonist, so is somewhat safer during pregnancy and even delivery and nursing, if you are unable to get off of it. Please get your OB involved in this process. Good luck to you.
Dear Dr. Aharonov,
I don't know a lot about computers but I hope my comments will come to you. I have taken tramadol for approx 2 yrs., 400mgs in the last year. I did this for severe sustained headaches in the back of my head, neck, shoulders and shoulder blades. I thought this medication was relaxing and so released these muscles of tension. I gradually upped my dose and used to prevent these headaches. I suffered constipation and thought it worth it. I thought I was taking a non narcotic pain/relaxant in the same class as nsaids. I did not do my homework this one time and put full trust in my Dr. My mother's Dr. put her on tramadol at my reccommendation and he told her it was an opiate. I argued with my mom and told her "My Dr." would never do this to me. I researched and found out this drug is extreme. I thought I had lost my mind and was beyond stupid, especially when I should have known there is no perfect drug solution. Your comments and knowledge that you have put forth have been an incredible encouragement to me. I don't blame my Dr. but see him as an overworked person with no time for patients or family or life really. My heart goes out to him. But, like you, he is also a DO and I trusted him and he trusted that I would do my homework. We all pay a high cost for healthcare and I expected my Dr. to be my savior. I hope that you will continue in your path of shedding light on this drug to your colleagues and I hope to your patients that you will encourage them to also do their do diligence. As a woman of 51 I was astounded that I was addicted to an opiate and to experience these withdrawals are mind and body shaking. I try not to feel ashamed but there it is. I am a grandmother. I look at these sights with all these young people experiencing so much pain and it hurts to my soul. I will continue to pray for those who are addicted for the rest of my life and for people like you who do their job with integrity but most importantly with caution and care. Thank you again. Cyndi
I don't know a lot about computers but I hope my comments will come to you. I have taken tramadol for approx 2 yrs., 400mgs in the last year. I did this for severe sustained headaches in the back of my head, neck, shoulders and shoulder blades. I thought this medication was relaxing and so released these muscles of tension. I gradually upped my dose and used to prevent these headaches. I suffered constipation and thought it worth it. I thought I was taking a non narcotic pain/relaxant in the same class as nsaids. I did not do my homework this one time and put full trust in my Dr. My mother's Dr. put her on tramadol at my reccommendation and he told her it was an opiate. I argued with my mom and told her "My Dr." would never do this to me. I researched and found out this drug is extreme. I thought I had lost my mind and was beyond stupid, especially when I should have known there is no perfect drug solution. Your comments and knowledge that you have put forth have been an incredible encouragement to me. I don't blame my Dr. but see him as an overworked person with no time for patients or family or life really. My heart goes out to him. But, like you, he is also a DO and I trusted him and he trusted that I would do my homework. We all pay a high cost for healthcare and I expected my Dr. to be my savior. I hope that you will continue in your path of shedding light on this drug to your colleagues and I hope to your patients that you will encourage them to also do their do diligence. As a woman of 51 I was astounded that I was addicted to an opiate and to experience these withdrawals are mind and body shaking. I try not to feel ashamed but there it is. I am a grandmother. I look at these sights with all these young people experiencing so much pain and it hurts to my soul. I will continue to pray for those who are addicted for the rest of my life and for people like you who do their job with integrity but most importantly with caution and care. Thank you again. Cyndi
My husband was prescribed Tramadol for a shoulder inhury and has had pain pill addiction problems in the past and so he asked the doctor for a non narcotic pain pill and he was told it was not addictive what a HORRIBLE lie that was! The last three months a man who was the most loving and affectionate man became ridden with anxiety and depression like symptoms and his anger was just so close to the surface that anything no matter how small sent him into a rage. His personality changed dramatically. ONce a fun loving person became isolated and told me he felt nothing for me or his children...he only wants to be alone. The anger became such an issue that we are no longer together and talking with him is impossible. Has anyone else experienced a complete personality change on this drug or knows someone who did. I miss the man I once loved so much. Please help.
i was prescribed tramadol 2 different times from 2 different doctors for 2 different ailments. one time i had fallen down the stairs and hurt my back, knee and arch of foot. went to urgent care center. tramadol. next time i had gone to the dentist where she took some of my gum away from around my tooth. tramadol. both times i took half a tramadol and then wished i had been on a sinking ship to get away from the horrible effects and still in pain.
i agree this is prescribed too often possibly b ecause it is cheap and easy to prescribe.
i agree this is prescribed too often possibly b ecause it is cheap and easy to prescribe.
I just posted a minute ago. But i've been on tramadol (about 200mg/day give or take) for about a year now. My doc decided to stop it cold turkey and i've felt so horrible. Just super anxious. I have had issues with anxiety in the past, so i take Lexapro and Alprazolam also. Nothing has made me feel "normal" like tramadol. It was almost my answer, but i guess i'm seeing its not. I'm only taking 10mg lexapro. Should I up the lexapro to help with the loss of the SSRI component in the tramadol? Thanks.
It would make sense to go up on Lexapro for a few months, but that is something you would need to discuss with your doctor, and he does not seem to be too knowledgeable about tramadol, since he did cut you off cold turkey. Getting a second opinion might be a good idea. The withdrawal from tramadol cold turkey is a painful process and your doctor should not have put you though it without some pharmaceutic help. Ask him to at least bump up Lexapro to 20mg a day.
Good luck to you and try not to get addicted to alprazolam.
Good luck to you and try not to get addicted to alprazolam.
Wow, I have been hearing so many things about tramadol. I never knew this but I happened to talk to my old highschool boyfriend and he told me he is on "trammies" I said what? He said tramadol. I said no way. He told me to take more than 2 at a time and I would feel better than after taking a few percocets. I admit I tried it because I am an addict, I personnaly felt a little hyper but I got scared and stopped right away. He and his brother quite cold turkey but could not do it without smoking pot on a regular basis to help with the month long withdrawal they went through. My suboxone doctor perscribed me tramadol now is that revulting. I don't take them. I even said but I am an addict and he said no problem it's OK. So yes something must be done. Especially since sober addicts are probably getting tramadol for pain and guess where that will lead, sad just sad.
I was prescribed Tramdol 100mg by a phsyician some 10 days ago. For head and back pain. I took 1 tablet for two days and since then my life has been hell. The pain did went away but i became very lethargic, sleepy all the time. The 3rd it started itching in my internal ears, and penis ( internally under glans). by 4th day its also started itching on palms and soles with GERD symptoms. I have a severe bout of cough midnight which keeps me wake for good one hour with tightness in chest and diffuclty breathing. I was given Zyrtec and Rigix at first and was told to see the results for 2 days but no success. Itching in penis and ears gone by 5th day. developed Hives on palms and soles.I was able to see another GP yesterday who gave me a shot of Decadron (Dexamethasone), with Fexet 60MG (Fexofenadine) twice daily, an acyfylin syrup for cough. I felt great after the shot, my hives reduced significantly ithcing was still there but not as intense. Mentally i became my old self by evening, alert otherwise i wise sleepy and lethargic the whole week. But the rashes started coming back around 1AM night, I managed to sleep by 3 AM and now woke up at 9 AM. The hives are back, and they are more then before with intense ithcing.
Hi. I was so surprised to find this this forum today and so grateful. I began taking tramadol 50mg 8years ago. Well on the on the 4th of July, nine days ago I was at my mothers our family was getting ready for the fun I walked into my moms bedroom and had a seizure never had one before in my life I was lucky she was behind me and she called for my nephew, I say I am lucky lucky because I stopped breathing , my heart stopped stopped beating my nephew just learned CPR at Rucker. I spent 3 days in the hospital. I was taking 15 to 20 a day now I take none. Stay away from Tramadol it can kill you. I know!
I think I have found an option for the withdrawal symptoms after a week of SUFFERING. I have been on Tramadol 3-4 50 mg tabs daily for about 7 or 8 years for arthritis in multiple joints. I just decided that I was tired of being on them for many of the same reasons that others have voiced. Luckily, I've never had seizures. I have stopped smoking 3 packs of cigarettes and drinking >12 pack of diet sodas daily cold turkey so I'm a pretty strong and determined girl. However, Tramadol has kicked my butt. "Restless leg" doesn't even begin to describe what I've been going through at night. It's more like "restless body syndrome." I have to be in constant motion or I feel like I will lose my mind or crawl out of my skin...or both. I've also had nausea, chills, feeling feverish (although haven't checked my temp), and sleep is nonexistent. Last night, I just couldn't handle anymore of it so I took some Phenergan hoping I would at least get some sleep since it usually knocks me out. It calmed me down within 30 minutes, took away the restless body syndrome, gave me 4 hours of really good sleep. Since it is an antiemetic, it also stopped my nausea. If I had chills, I wasn't aware of it in my sleep!!! And that was all from 1/2 of a 25 mg Phenergan tab. I took 1/4 tab this afternoon and got a nice 2 hour nap and feel more relaxed. Not feeling perfect but absolutely better than I have in a week. I've already taken my 1/2 tab this evening and hope to be dosing off soon. I hope this will help someone who is suffering like I am without having to turn to other narcotics. FYI, I will never take another Tramadol after I am finished with this!
Ugh tramadol is nasty. I was on 100mg, then bumped up to 200mg at one point over six months. Realized it was not working at all at this point, not exactly sure why, but my pain level had returned to where it was previously. So I stop taking it and luckily had no withdrawal. Also realized the daily migraine I was getting had gone away, along with the panic attacks. Its a dirty drug...very nonspecific. I'm glad my rheumatologist didn't keep upping the dose, maybe I would've gotten addicted, or even more sick from it (seizures etc.).
Fast forward a few years...my health improved some, then deteriorated...in with a pain specialist who is very anti-opiates. She rx's ultram, which i tell her I've had bad experiences with, having tried it a couple of times since and experienced some other bad effects (panic attacks, severe naseau). She wants me to try ultracette, and tells me its completely different, "I think it will work much better for you". I try it. Its not. I don't see how it could be...its just ultram + APAP.
Not sure why some docs think this doesn't feel like an opiate...it definitely does. It should absolutely be scheduled...not doing so is hypocritical, and very puzzling. Maybe not enough people have OD'd and died yet for the DEA to care. I'm glad someone in healthcare is angry about this and willing to speak out about it.
Fast forward a few years...my health improved some, then deteriorated...in with a pain specialist who is very anti-opiates. She rx's ultram, which i tell her I've had bad experiences with, having tried it a couple of times since and experienced some other bad effects (panic attacks, severe naseau). She wants me to try ultracette, and tells me its completely different, "I think it will work much better for you". I try it. Its not. I don't see how it could be...its just ultram + APAP.
Not sure why some docs think this doesn't feel like an opiate...it definitely does. It should absolutely be scheduled...not doing so is hypocritical, and very puzzling. Maybe not enough people have OD'd and died yet for the DEA to care. I'm glad someone in healthcare is angry about this and willing to speak out about it.
I have been taking tramadol for about a year for pain in my back. I was told it wasn't habit forming well I took my last 2 Sunday Sept 4th and I will never take them again I have been through ****. I feel like one big panic attack I'm sleeping just have started eating. I called my doctor on tuesday he called me in Clonidine 0.1mg how much longer am I going to feel this way? I want to get back to normal.
Hello! This is my first post ever and I am greatful to have read all prior posts. Pain is no joking matter! I am 32 years old and have severe sciatic pain down my right leg and sometimes down my left on a bad day. I live in constant pain. This has been debilitating to me and i am not use to this, though it's been 5 months. I am an athletic woman, mother of two, and I just can't keep up like I once was able too.
I had an MRI which concluded my pain is the result of a cyst deep in my joint, which pushes on my sciatic nerve. I also have the beginning of arthritis which I hear is common for athletes. I am being treated by a pain management Doctor here in Dallas who has been giving me Epidural Steroid Injections. I have my 3rd and final treatment in a few days. They help but not like I need and I feel my best next option is surgery.
I have been taking Norco for 6 months to alieve pain. I am currently out and waiting in a refill to be authorized by my doctor and am severely sick. I am so sick I can see why people don't come off the medication. I took a tramadol as I am having severe withdrawals and in horrific pain. This is no way to live. If anyone has a suggestion to help me understand how to come off the Norco safely without having to try and alieve the pain with another medicine, please advise. I am at wits end and tired of living in pain. I can see how some people never make it through as everyday is a battle when dealing with chronic pain. :(
I had an MRI which concluded my pain is the result of a cyst deep in my joint, which pushes on my sciatic nerve. I also have the beginning of arthritis which I hear is common for athletes. I am being treated by a pain management Doctor here in Dallas who has been giving me Epidural Steroid Injections. I have my 3rd and final treatment in a few days. They help but not like I need and I feel my best next option is surgery.
I have been taking Norco for 6 months to alieve pain. I am currently out and waiting in a refill to be authorized by my doctor and am severely sick. I am so sick I can see why people don't come off the medication. I took a tramadol as I am having severe withdrawals and in horrific pain. This is no way to live. If anyone has a suggestion to help me understand how to come off the Norco safely without having to try and alieve the pain with another medicine, please advise. I am at wits end and tired of living in pain. I can see how some people never make it through as everyday is a battle when dealing with chronic pain. :(
From reading other posts I feel withrawl symptoms are very similar between Norco and Tramadol. So why is Tramadol deemed as "safe" from doctors is beyond me. Here are my withdrawal symptoms from my Norco. They include but are not limited to flu like symptoms, cold sweats mixed with hot flashes, lethargic to the point if I could place a catheter to keep me from having to get up to go to the bathroom I would. Nausea, vomiting, diahreah, fever, no appetite, tremors, sad and hopeless feelings. The list can go on and on. The sad part of this is that I need the medicine to deal with severe chronic pain I have. Do the pro''s really outweigh the con's?
I have serious concerns and this is absolutely no way to live.
I have serious concerns and this is absolutely no way to live.
Dear Doctor,
I am not sure,however, doesn't Tramadol break down to the same metabolite that was used in ecstasy
several years ago? On another note: it seems that people only talk about opiate withdrawal these
days and I can tell you by being in the mental health field,the worst detox is from the benzos. Opiates
get all the publicity and funding,but outside of the good ''doc" over in the U.K.,most doctors do not have a clue
about "benzo prolonged withdrawal syndrome". Alot of people wind up killing themselves because of the long
term pain they receive from never getting their inhibitory processes normal again. I mean opiate users die
from overdoses but their are so many tools to get them stabilized,that if they are motivated and have enough
support and entitlements, "it is a walk in the park" compared to benzo withdrawals(I am referring to the long-term
high dose benzo users.). Two final thoughts:"the hardest addiction and largest suicide rates are among compulsive
gamblers-I am glad that finally the folks drawing up the DSMV are making it a full blown disease and not a personality
disorder. Lastly, I find it ludicrous that many physicians and mental health experts are not buying into the "glia"
model of the brain;clearly glutamate's ubiquitous presence in the brain and the subsequent neuron death that its inflamatory properties create; it seems we might have been hoodwinked by all that "electrical action" we saw on those
functional MRIS. Moreover,doesn't that bode well for such supplements as Omega 3 and NAC as an adjunct in psycho pharmacological cocktails. p.s. I am new on here and I really enjoyed reading your posts and blogs
I am not sure,however, doesn't Tramadol break down to the same metabolite that was used in ecstasy
several years ago? On another note: it seems that people only talk about opiate withdrawal these
days and I can tell you by being in the mental health field,the worst detox is from the benzos. Opiates
get all the publicity and funding,but outside of the good ''doc" over in the U.K.,most doctors do not have a clue
about "benzo prolonged withdrawal syndrome". Alot of people wind up killing themselves because of the long
term pain they receive from never getting their inhibitory processes normal again. I mean opiate users die
from overdoses but their are so many tools to get them stabilized,that if they are motivated and have enough
support and entitlements, "it is a walk in the park" compared to benzo withdrawals(I am referring to the long-term
high dose benzo users.). Two final thoughts:"the hardest addiction and largest suicide rates are among compulsive
gamblers-I am glad that finally the folks drawing up the DSMV are making it a full blown disease and not a personality
disorder. Lastly, I find it ludicrous that many physicians and mental health experts are not buying into the "glia"
model of the brain;clearly glutamate's ubiquitous presence in the brain and the subsequent neuron death that its inflamatory properties create; it seems we might have been hoodwinked by all that "electrical action" we saw on those
functional MRIS. Moreover,doesn't that bode well for such supplements as Omega 3 and NAC as an adjunct in psycho pharmacological cocktails. p.s. I am new on here and I really enjoyed reading your posts and blogs
Geez....what a pitiful family we are here! LOL I was placed on tramadol 3 yrs ago after a RT cuff tear/shoulder injury and then for post -op care, then was diagnosed w/fibromyalgia and my rheumatologist put me on a maintenance dose of it. I began to figure out it gave me "good feelings of euphoria" and lots of energy....slowly but surely i became physically dependent on it before I knew what was happening. I figured out 2 hrs ago my system "needed it" to continue on in a normal fashion. I knew it had to end someday...soon....but there was never a "good time" to do it, right?? LOL I ran out 1.5 yrs ago and actually went cold turkey for 2 wks.....i was so ill and so miserable that i jumped at the chance and hopped right back on the "trammy bus" as soon as i found out my Rx was refillable. I came back w/a vengence and worked up to prob taking 20 or more a day until July of this past (2012) summer....my husband had suspected "something" and found 3 of those "little white pills" laying on the bathroom counter one day while i was gone & went to work playing detective on the internet and put it all together. When i got home, he confronted me and his evidence was mind-blowing, i had to choice but to come clean - ashamedly & honestly - for the 1st time since I started abusing it in 2009. He has been so super - so supportive, caring & considerate with me since. I am now in a "taper" that we worked out/agreed to together. I am in no "hurry" to be done bc my w/d's before when i went CT were so horrific and hell-ish that i can honestly say it was the worst 2 wks of my life....so I want to do it this time and be done - for good!!! My sweet hubby dispenses my pills to me nightly ( i wanted him to do this and he readily agreed) bc I think it is really important for me to have his support and understanding and for him to be in this w/me to hold me accountable to myself. We both want me to do this in a productive way and to then come out with a successful ending but yet w/the least amount of discomfort and w/d's as possible for me. I am currently @ 5 1/2 per day for another week (I am not sure i can say much more about my tapering without my post getting yanked - i've found they are funny abt that here! LOL) I have had some "icky" times since i started tapering - low energy, being "down" and depressed and just no motivation period. I know this is not over - but i am trying to keep telling myself that i am down from 20 a day to 5!! I guess that's something??? I have started taking a couple of supplements (a daily dose of B12 as well as St. John's wart) and i believe it is helping a bit.....my question is this: is there anything else i can be doing as i continue to "whittle down" on this awful little tablet? what about this "Withdrawal Ease" I have been reading about - is this helpful in your opinion while tapering, or not until you're completely off of them - or not at all? I know everyone is different and different things work for different ppl - but do you have an opinion personally on supplements to help lessen w/d symptoms??? thanks : )
oops - 4th sentence in my former/initial post should have read "I figured out 2 YEARS ago (not 2 hrs ago) that my system "needed it" to continue on in a normal fashion. sorry peeps!! :)
Good for you! I'm glad to hear you're finding your way off the evil tram.
Only thing I wanted to mention is that I don't think taking the St. John's Wort while you're still on the tramadol is entirely safe. I believe they treat SJW like an anti-depressant and therefore, that, combined with the tramadol, can be dangerous (serotonin symdrome). Double-check with your Dr. and/or pharmacist first just to be sure.
Good luck to you! And congrats for deciding to quit. :)
Only thing I wanted to mention is that I don't think taking the St. John's Wort while you're still on the tramadol is entirely safe. I believe they treat SJW like an anti-depressant and therefore, that, combined with the tramadol, can be dangerous (serotonin symdrome). Double-check with your Dr. and/or pharmacist first just to be sure.
Good luck to you! And congrats for deciding to quit. :)
That's crazy....that is EXACTLY how my surgeon described Tramadol to me when I requested something to help wean me off Hydrocodone, "a strong version of Tylenol."
Two years later, I'm still dependent on Hydrocodone and Tramadol.
Two years later, I'm still dependent on Hydrocodone and Tramadol.
My husband has End Stage Renal Disease and is on his second kidney transplant. He also has disintegrating disks in his back and has been on Tramadol 3 times a day for several years. Now he is itching and stinging all over to where he can't even sleep. Could the Tramadol be causing this?
You have to make sure that it is not due to the deterioration of his kidney function. Please chech with his nephrologist as soon as you can. Good luck.
Thank you Dr. Julia for this forum!
As of a few weeks ago, I became aware that my boyfriend of 1.5 years has been addicted to Tramadol for the past 10 years! He is diabetic, so various medications in his bag was no concern. His 6 month prescription was running out and it was stressing him, therefore he started to come clean about what he was actually doing. I felt absolutely sick, so I read EVERYTHING I possibly could about this drug and none of it was good! Clearly I would not be alright with this habit, so I really do give him credit for fessing up and making the decision to quit this poison. I feel like the doctors in his life have been irresponsible with allowing him to continue for so long with vague reasons from the patient, for staying on this horribly addictive drug.
Years ago I took Paxil for about 6 months, getting used to it was so awful that when it was time, I weaned off super slow in order to NOT feel any of that weird chemical withdrawal. That is all I have to go on with helping my boyfriend come off the Tramadol because his doctor has been no help!
When he contacted his doctor about wanting ONE month instead of 6 month refill to wean off slowly, she offered NO suggestions about safely coming off, just gave him 90 more pills! This make my blood boil! He still had 30 or so, 50mg tablets left so together we decided on a cut back schedule that he could tolerate. Luckily he's done a lot better than the last time he tried to come off and he is NOT refilling the 90 pills! Did I mention how proud I am of him?
All this is leading up to my question about dropping the dose...
His 10 yr. habit was 50mg 4-5 times per day.
Dropped to 25 mg 4 times per day for a week. (I had to give him an old Librium 5mg to get through the first night)
He needed Immodium for the next drop in dosage.
Fast forward another week and he is now on 25mg once a day for this whole week.
Pharmacist suggested 25mg every other day for an additional week.
I've been giving him half a Benedryl at night to help him sleep and now started giving him B-Compex to combat his extreme fatigue.
He wants to be DONE but I don't want to hurt him.....Is this slow enough for a long time user?
As of a few weeks ago, I became aware that my boyfriend of 1.5 years has been addicted to Tramadol for the past 10 years! He is diabetic, so various medications in his bag was no concern. His 6 month prescription was running out and it was stressing him, therefore he started to come clean about what he was actually doing. I felt absolutely sick, so I read EVERYTHING I possibly could about this drug and none of it was good! Clearly I would not be alright with this habit, so I really do give him credit for fessing up and making the decision to quit this poison. I feel like the doctors in his life have been irresponsible with allowing him to continue for so long with vague reasons from the patient, for staying on this horribly addictive drug.
Years ago I took Paxil for about 6 months, getting used to it was so awful that when it was time, I weaned off super slow in order to NOT feel any of that weird chemical withdrawal. That is all I have to go on with helping my boyfriend come off the Tramadol because his doctor has been no help!
When he contacted his doctor about wanting ONE month instead of 6 month refill to wean off slowly, she offered NO suggestions about safely coming off, just gave him 90 more pills! This make my blood boil! He still had 30 or so, 50mg tablets left so together we decided on a cut back schedule that he could tolerate. Luckily he's done a lot better than the last time he tried to come off and he is NOT refilling the 90 pills! Did I mention how proud I am of him?
All this is leading up to my question about dropping the dose...
His 10 yr. habit was 50mg 4-5 times per day.
Dropped to 25 mg 4 times per day for a week. (I had to give him an old Librium 5mg to get through the first night)
He needed Immodium for the next drop in dosage.
Fast forward another week and he is now on 25mg once a day for this whole week.
Pharmacist suggested 25mg every other day for an additional week.
I've been giving him half a Benedryl at night to help him sleep and now started giving him B-Compex to combat his extreme fatigue.
He wants to be DONE but I don't want to hurt him.....Is this slow enough for a long time user?
I took tramadol for years and did not abuse it. It was not the most uncomfotable coming off of but either was lexapro after 3 years. you take 10 or more yes you will have seizures and bad withdrawals. And like any drug anyone can have side effects at any level. Do I regret being on it for 4 years yes because it put me in a funk even at 4 a day after 3 years. It was my decision to take they did not make me. Any blame goes to me not anyone else.
dr.julia, i have a surgery on my back coming up and am on suboxone. have had chronic pain for years and cannot get any pain meds at all. doctors are very unfeeling up here in ma. i was told by a doc that i might have to go out and by some meds myself. also my doc wants to give me some antidepressant (nortryptaline) and lamictal for pain which is used for bipolar. he must think im stupid . if i buy drugs off the street i guarantee the doctor is going down for it. and i also do not believe in any of these spin dry get you off opiates etc... clinics in the united states or any other country. if your on it must be a reason. stay on until you need to borrow money. you wont get help from any docs.thanks to the dea and scared to death to lose license doctors that like the idea of you being in pain just because they dont do any physical labor except picking up a keyboard and start typing so much **** that they really didn't do. best to all and hope you start saving thousands of dollars, you know you are on you're own, sorry to say.
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