The abuse and dependence issues in Tramadol was very strong. In 2014, Drug Enforcement Administration, DEA moved this opioid analgesic drug into Controlled Substance schedule IV. In addition, Tramadol withdrawal symptoms can occur. It is because the drug has a strong contribution to the brain performance. In the brain, the drug binds to the opioid receptors. Therefore, it can increase the dopamine level. In fact, dopamine is the messengers in the brain that works to control emotions and moods.
What happened if you take Tramadol regularly? It can disrupt the neurotransmitters, the part of the brain. When Tramadol is not active in your bloodstream, the brain will regulate itself. Here, it leads to the withdrawal symptoms. Even though you take Tramadol for medical reasons and you got it from your doctor. The dependence will build up.
However, the dependence will be faster if you use it improperly. Hence, we can say that the dependence of Tramadol still has a connection with its withdrawal. In another word, the more you cannot live without it, the longer Tramadol withdrawal symptoms you will get.
Factors Determine The Length Of Tramadol Withdrawal Symptoms
In fact, there are some factors can contribute to the duration and the withdrawal side effects as below:
- Environmental factor, ex: trauma, stress
- Generic reasons, ex: personal or family history of dependence
- Biological aspects, ex: age, ethnicity, gender, and others related to metabolism and dependence level
- The amount of Tramadol you take each dose and the length of using it. The more doses and longer duration of using Tramadol or abuse will increase the dependence level
- The way you use or abuse Tramadol, ex: chew Tramadol, crush, snort, smoke, and inject it will increase the dependence level)
- Use other medications, drugs, and alcohol-related to Tramadol
- Mental or medical disorders
What Are Tramadol Withdrawal Symptoms
Commonly, Tramadol withdrawal symptoms will begin with agitation, followed by irritability, insomnia, and sweating. After that, you can experience other symptoms like anxiety, tearing of the eyes, muscle aches, and runny nose. These symptoms may happen at the beginning of few days. With two to three days of Tramadol detox, you may experience the symptoms are at the peak with other following symptoms:
- Abdominal cramps
- Drug cravings
- Dilated pupils
These symptoms can decrease after the peak and begin to go away in the next few days. However, drug cravings, mood, and sleep disturbances will standstill for the following weeks.
The withdrawal is very hard because it can be too intense. Too intense withdrawal makes you feel like you must use take the drug to relieve the symptoms. In addition, it can be a serious problem if you have an opioid overdose. In the U.S.A., Centers for Disease Control and Prevention (CDC) explains there were six of 10 patients drug overdosed. This problem happened in 2014. There were 50,000 people used the opioid drug. Tramadol withdrawal symptoms can be dangerous if Tramadol complications lead to opioid overdose.
Tramadol Medical Detox Treatment
Detox means your body will remove the toxins of Tramadol naturally out of the body system. Meanwhile, withdrawal means the range of side effects that you experience after your body formed drug dependence. You can accomplish the withdrawal by inpatient or outpatient programs in a treatment center. On the other hands, detox programs take five to seven days for Tramadol.
Medical detox is one of the most effective detox forms. In this way, you will get the best level of security and care to deal with Tramadol withdrawal symptoms. In medical detox, the professional treatment providers are ready to help you during the medical detox. They will supervise the important signs. In addition, their duty is to make sure that the signs are normal, nothing serious. Even medical detox treatment comes with mental health professionals to support you. Hence, you have granted personal safety. Besides, no relapse happens. Moreover, the detox program supports you to decrease Tramadol withdrawal symptoms. Therefore, it makes the withdrawal timeline is shorter than other treatments.
It is important to note that Tramadol is opioid so you should not stop using it in a sudden. If you want to stop using it, the best way is to do tapering. Tapering means that you are reducing the dosage of tramadol slowly day by day. So, the withdrawal symptoms will not severe. In fact, tapering is useful for detox treatment.
Besides, there is also some longer-acting opioid medicines such as methadone and buprenorphine. We use it to replace Tramadol during the detox treatment. The goal is to minimize the dosage less often. Yet, it keeps the brain receptors with opioids to reduce the withdrawal signs.
Still, there are some useful medications to manage the withdrawal symptoms during detox such as mood-stabilizing drugs.
Tramadol Withdrawal Symptoms: Inpatient Vs. Outpatient Treatment
Asides of medical detox treatment, you can deal with Tramadol withdrawal symptoms through inpatient and outpatient treatment. These options are available with the help of a physician.
1. Inpatient Treatment
There are many programs available for inpatient treatment. It is a great choice for those who have no much time to concern about their treatment. It is because they have round-the-clock care. Here, the physician can help control the withdrawal symptoms.
2. Outpatient Treatment
You can take it as the alternatives. You know that not all people can afford the first option. In addition, the outpatient treatment is great if you have time issues. Here, you will get counseling, physician assistants to deal with the withdrawal, and group support group. Other than that, they also provide family/friend support groups.
The treatments are available in many options because it depends on the level of dependence or addiction. It also depends on the severity of the withdrawal.
Tramadol withdrawal symptoms: Tapering Guide
There are two primary components in Tramadol that can cause the withdrawal syndromes, which Opioid-like half and the antidepressant-like half. To stop using Tramadol, you should taper off the opioid and the antidepressant at the same time. In addition, tapering Tramadol is available in two options. We call it as the opiate tapering and antidepressant tapering. Here, we try to explain as clear as possible to you.
1. Opiate Tapering Guidelines
Canadian Guidelines help you have safe and effective Opiate usage when you want to taper off an opioid. Here is the following information:
- It is okay to drop 10% per day. Alternatively, reduce slowly by 5% per two weeks.
- If you anxious about Tramadol withdrawal symptoms, or the addiction issues, you should slow the rate of tapering.
- Once you are reaching the third of the starting dose, slow the taper rate for a half.
- If you get bad withdrawal symptoms, your body is not ready. Therefore, hold on the dose until you feel nothing bad when you reduce it in the next days.
We believe that the guidelines above can be too fast if you depend your life on this drug. In addition, this guideline is not the ideal choice if you have outpatient self-directed taper treatment. It is because fast tapers can lead to the higher risk of failure or non-completion. The drug’s antidepressant substances can make Tramadol tapers are complicated.
2. Antidepressant Tapering Guidelines
The Royal College of Physiatrists in the UK provides the guideline for SSRI or SNRI antidepressant tapering as below:
- Start slow
- If you have been taking for less than eight weeks, taper down for more than one to two weeks.
- If you have been using for more than six months, taper down for more than a six or eight week period.
- For you who have been using for chronic health issues, do not reduce it more than 25 percent for every four to six weeks.
Please note that the guidelines above are not specifically for Tramadol. Instead, it is for people with depression treatment and takes straight medications in SSRI or SNRI drugs.
The Medications During Detox Treatment
The following medication comes with different properties that are helpful during Tramadol detox and the treatment in different ways. Here are the options:
- Methadone: It comes with the longest period of action with the average half-life for 30 hours as published by the National Highway Traffic Safety Administration (NHTSA). Therefore, it is a good option to keep the withdrawal symptoms at the low level. However, you should take it with caution.
- Buprenorphine: It is one of the opioid receptors can stay longer in your body system than Tramadol. However, it stays inside your body as a partial opioid. In another word, it does not activate the receptors as similar to Tramadol. It is a helpful way to minimize Tramadol withdrawal symptoms yet it does not create any “high” sensation. Nevertheless, you should not take it more than the recommended dose.
- Naltrexone: It is ideal to use it after the initial Tramadol withdrawal symptoms. There are some Naltrexone brands such as Vivitrol, Depade, and ReVia as reported by National Institute on Drug Abuse (NIDA). They block the opioid receptors so that the opioid drugs cannot activate them.
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