Tramadol Addiction and Abuse

Despite its classification as a prescription drug in the UK, tramadol is addictive. People are becoming addicted in increasingly large numbers because, as an opioid, tramadol shares many of the same effects as heroin and produces cravings and withdrawal symptoms after long-term usage.

A common practice among people with opioid use disorder is to mix tramadol with alcohol to increase the potency of the ‘high’ – an action with serious risk of overdose, respiratory depression and in extreme cases, death. Anthony Mcpartlin checked himself into rehab in 2017 after admitting he was addicted to tramadol and was mixing it with alcohol.

He and many others around the UK were prescribed the medicine for severe pain, but soon found themselves addicted to the opiate. When the pain stops, users often can’t quit, and take more tramadol to ward off withdrawal symptoms and feel the euphoric high associated with opioids.

What is Tramadol?

Tramadol is a narcotic pain reliever, developed by German scientists in the early ‘60s as a non-addictive medicine that relieves moderate to severe pain in adults. The immediate release pill is prescribed for patients who are experiencing chronic pain including pain from an accident; the extended release form is often given to cancer patients, who require round-the-clock pain relief.

The black box warning for tramadol informs patients and doctors alike about the risk of accidental ingestion in children, drug abuse and addiction, neonatal withdrawal and interactions with benzos and other addictive pills.

Tramadol works by stimulating the opioid receptors in the brain to change how your body perceives pain. Recreational users abuse tramadol because it floods the brain with serotonin to produce feelings of relaxation, calmness, warmth, euphoria and sleepiness. Over-stimulating the brain with serotonin is dangerous. Serotonin syndrome leads to rapid pulse, muscle twitches, tremors, shivering, confusion and agitation.

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Tramadol Addiction and Abuse: What is it?

Any alteration to the original prescription (such as crushing the pill to snort, smoke or ingest)
is considered abuse. Many patients abuse tramadol by taking higher doses, using it more frequently than was prescribed and taking the drug with alcohol and other addictive substances.

Abusing tramadol releases the drug at a faster, more potent rate into your body. This allows you to experience a more intense ‘high’ when tramadol binds to opioid receptors in the brain. Over time, with increased dosage of opioid analgesic, you’ll need higher doses, because the original dose won’t induce the same effect after you’ve built up a tolerance to the drug. At this point, you should notify your doctor to prevent addiction; however, many patients who’ve become used to the ‘high’ and are afraid of withdrawal symptoms simply keep using.

After tolerance, dependence sets in quickly. You might notice you’ve also built up psychological dependence if you’re taking higher doses to overcome tolerance and limit withdrawal symptoms. When you build physical dependence to tramadol, the brain (which has become used to high levels of dopamine and serotonin) fights back with painful side effects of serotonin syndrome. They include hallucinations, diarrhoea, accelerated heart rate, lack of coordination, vomiting, high blood pressure and coma.

What Causes Tramadol Addiction and Abuse?

Doctors prescribe tramadol because it has low abuse potential when compared to other opioid analgesics. Sadly, many patients still develop tramadol addiction. Most who don’t experience physical dependence still feel the psychological need to keep using the drug, long after they quit.

Tramadol addiction starts by triggering the reward centre of your brain.

Legitimate users who take tramadol for chronic pain want to feel pain relief 24/7, and in a bid to maintain or increase the level, they take higher doses than needed. Once you take higher doses, you quickly build up tolerance and soon move to the stage of dependence and addiction.

Scientists have conducted extensive research over decades trying to understand why some people who follow their doctor’s prescription for pain medication still develop physical and psychological dependence on prescription meds. Findings have led them to deduce that family genetics play a crucial role. The inherited behaviour from parents can easily make children think that taking drugs is acceptable behaviour.

How Tramadol Addiction and Abuse Affect the Brain and Body

Tramadol has a low potential for abuse, so you’ll have to consistently take large doses for long periods to become addicted. Long-term tramadol usage alters chemicals in the brain circuits and system. The brain adjusts to the constant flow of tramadol by slowing down some processes and accelerating others.

When you quit tramadol, the brain (which has adjusted to a large influx of the drug) goes into overdrive and produces withdrawal symptoms in the fight for control. When tramadol affects the brain, physical symptoms follow. They include pain relief, drowsiness, loss of concentration, vomiting, shallow breathing, drowsiness, impaired coordination, dizziness, slowed heart rate and vomiting.

Who Becomes Addicted to Tramadol?

People who have a history of drug abuse are likely to become addicted to tramadol. That’s why it’s critical to inform your doctor of all your addiction risk factors before they prescribe a medication that only worsens your situation.

As a habit-forming drug, long-term users are at risk of tramadol addiction. Take the medicine according to the doctor’s guidelines. When you notice you’ve built a tolerance, consult your doctor and don’t increase the dose. However, some who stringently follow a doctor’s orders still develop physical dependence on tramadol.

There are also those with opiate use disorder who take tramadol to chase the reward of the ‘high’. They often don’t take the drug orally, because the effect isn’t the same as snorting, injecting or smoking the drug, which is their preferred method of consumption.

Short-Term Effects of Tramadol on the Body

Many people who are given tramadol believe it’s a safer, non-addictive painkiller compared to narcotic opioids. As a medication acting on the central nervous system, some of the short-term effects of tramadol include:

  • Elated mood caused by norepinephrine and serotonin in your brain. This feeling of euphoria is the primary reason why people abuse tramadol.
  • You experience less pain or complete lack of pain when you take the drug
  • Tramadol works through norepinephrine and serotonin signals the brain to reduce obsessive and depressive symptoms in patients.

Long-Term Effects of Using Tramadol

The first and most common long-term effect of using tramadol is building tolerance for the opioid. This is dangerous, because many adjust the dosage without consulting their doctor, which leads them to becoming chemically dependent on tramadol. Your body adapts to tramadol and sees it as a natural presence in the brain’s chemistry. You’ll need larger doses to feel the original pain-relieving effect of the medication.

Physical dependence (where you need tramadol in your body to feel like yourself or function at a basic level) follows shortly after tolerance. When you attempt to quit, you’ll experience withdrawal symptoms. You’ll also notice that you’re slower, forgetting simple details and finding it hard to perform complex tasks.

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Physical Signs and Symptoms of Tramadol Abuse and Addiction

Physical signs of tramadol abuse include:

  • Dizziness
  • Fever
  • Constipation
  • Difficulty concentrating
  • Muscle aches
  • Sweating
  • Nausea and vomiting
  • Loss of appetite
  • Fever

Severe physical signs of serotonin syndrome include confusion, tremors, coma, seizures, jerky muscles, agitation and rigid muscles.

Psychological Signs and Symptoms of Tramadol Abuse and Addiction

Psychological signs of tramadol abuse are mostly long-term. They include cravings: long-term uses who’ve become dependent on tramadol to function will experience strong cravings during withdrawal that sometimes leads to relapse.

Other psychological signs of abuse include:

  • Tolerance
  • Dependence
  • Hallucinations
  • Insomnia
  • Anxiety
  • Depression
  • Mood swings
  • Paranoia

Signs of Tramadol Withdrawal and Overdose

Withdrawal symptoms manifest when a person who has developed opiate dependence tries to quit tramadol. As an opiate painkiller, withdrawal symptoms mirror those of other opioid painkillers, such as hydrocodone and oxycodone. It affects areas of the brain where antidepressants work, so those going through withdrawal might experience antidepressant symptoms alongside opioid withdrawal symptoms.

Withdrawal symptoms include: gastrointestinal pain, diarrhoea, hallucinations, confusion, numbness, agitation, depression, ringing in the ears, blurred vision, irritability, loss of appetite, restlessness, nightmares, anxiety and tremors.

Signs of tramadol overdose include: slowed heartbeat, narrowed pupils, shallow breathing, respiratory depression, seizures, clammy skin, extreme weakness, narrow pupils and loss of consciousness.

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Dangerous Effects of Tramadol Abuse and Addiction

People who abuse tramadol risk experiencing side effects of serotonin syndrome, which happens when you overwhelm the brain with an influx of serotonin. Side effects include: high body temperature, agitation, coma, unusually strong reflexes, vomiting, hallucinations, fast heart rate and diarrhoea.

A study of 57 tramadol addicts revealed that at the end of a three-year period, 54.4% of participants experienced tonic-clonic seizures, 55% had several seizures and 45% only had one seizure in three years. There’s also the risk of death from an overdose and the danger of developing polydrug usage, which occurs when abusing tramadol and other substances simultaneously.

Physical, Psychological, Emotional, Behavioural and Mental Effects of Tramadol Abuse and Addiction

Everyone wants to loved, accepted and wanted. For some people, drugs are the answer to the feeling of loneliness. When you think no one wants, loves or cares for you, it’s common to turn to drugs to build confidence and self-esteem. Drugs influence positive emotions and those things which you loved doing – such as watching a football game, walking your dog in the park, going for a run or hanging out on Saturday nights with friends – won’t hold the same appeal.

Drug addiction affects how you feel about yourself, especially when you come down from the ‘high’. The realisation that you have no control over your drug use and that you need drugs to feel confident or loved causes depression and induces the onset of other mental health issues.

The Social Impacts of Tramadol

The family suffers most when you have an opioid use disorder. You can lose your job, say hurtful things and might eventually steal from loved ones to feed your drug habit. For those who are married, the stress is passed on to children and spouses who bear the brunt of your anger and sometimes physical abuse. There’s also the risk your children might grow up thinking substance abuse is acceptable behaviour.

You’ll also lose friendships and stop enjoying activities you loved in favour of drug usage. Everything in your life takes a backseat to drugs until your circle is limited to just drug users and dealers.

Coping with Withdrawal

Medication-assisted treatment (MAT) is used to help patients cope with withdrawal symptoms during medical detoxification. Some medications used include:

  • Naloxone: to block opiates and prevent opiate overdose
  • Suboxone: prevents withdrawal and blocks relapse
  • Naltrexone: prevents you from feeling the euphoric effects of opiates

How to Treat Tramadol Withdrawal

You experience withdrawal symptoms when your body becomes chemically dependent on tramadol. This could happen over a lengthy period of continuous use or after just a few weeks. Withdrawal symptoms manifest a few hours after you stop using tramadol and could last up to two weeks, depending on the length and frequency of use, as well as any polydrug use problems or co-occurring disorders.

The safest way to treat tramadol addiction is to undergo treatment at a medically-supervised detox facility. During the first three days of treatment, the focus is on helping you taper off, until you completely quit tramadol. Withdrawal symptoms will be treated as they appear and medications include:

  • Loperamide for diarrhoea
  • Methadone and buprenorphine for withdrawal discomfort and cravings
  • Valium for insomnia and anxiety
  • Clonidine for sweating
  • Acetaminophen for muscle pain
  • Metoclopramide for vomiting and nausea

Therapy, Treatment and Rehab for Tramadol Abuse and Addiction

There are two treatment options for addressing the problem of tramadol abuse and addiction.

Inpatient Treatment

Inpatient treatment centres are structured rehab facilities that provide 24/7 support and care for patients. As a resident, you’ll disconnect from the distractions of the world and fully concentrate on your recovery journey. Therapy is the core treatment technique used to identify the real reasons why you started abusing drugs. Individual counselling, group therapy, family therapy and alternative therapy models help you replace negative behaviour with positive attitude, emotions and thoughts that encourage sober living.

Outpatient Programmes

Outpatient programmes have the same therapy techniques as inpatient facilities. The difference is that you will commute from home and won’t have access to 24/7 care and support. It’s designed to integrate with your home and work life if you can’t take time off to enrol as a full-time resident.

Staying off Tramadol

The risk of relapse for most drug users appears most prominent in the first month after treatment when cravings and temptations are very hard to overcome. The first thing you should do is attend meetings. Don’t miss a single meeting – even when you feel like you’re coping just fine. Narcotics Anonymous (NA) or community-based programmes help you stay motivated, focus on recovery and stay sober.

Exercise to clear your head, relieve stress and release endorphins. Eat healthy food and watch out for signs of relapse, such as negative habits you engaged in while you abused drugs. Create an aftercare plan that will guide your actions and prepare you for triggers, at least for the first few months after treatment.

Individual Counselling

Individual counselling is a therapy approach used to address problems faced by a drug user. It examines emotions, thoughts, behaviour and actions that led to drug use and teaches the individual how to develop positive behaviour that encourages sobriety.

Support Groups

If you want to maintain sobriety long after rehab, you’ll need to join a community-based support group. Narcotic Anonymous or SMART Recovery are suitable for tramadol addicts. The 12-step programme guides you on your abstinence journey using a similar philosophy to Alcoholics Anonymous. The goal is to help you become more self-confident, manage cravings and triggers, as well as reach milestones on your recovery journey.

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Family Therapy

Family therapy can be applied to group or individual therapy. It is an effective addiction treatment that addresses financial issues, parenting skills and problems within the family that encouraged your drug habits. Techniques such as multidimensional family therapy and solution-focused therapy are used to teach young people positive skills that enable sobriety, help parents learn not to be controlling, as well as suggest things they can do to improve communication with their teenager and help them on their recovery journey.


FAQs

What Is Tramadol?

Tramadol is an opioid analgesic medication prescribed for patients experiencing moderate to severe pain. Compared to other opioid medication, it’s a painkiller with minor addictive properties.

Does it Have any Side Effects when Used Appropriately?

Yes. Most medications have side effects that affect some patients. You might experience headaches, vomiting, anorexia, somnolence, sweating, constipation, dizziness, nausea, asthenia, insomnia and dry mouth.

How Does it Work?

Tramadol targets opioid receptors in the brain and changes how the pain sensations are sent to the brain, numbing any painful effects on the body.

Can it Improve Sexual Functioning?

No. In fact, long-term use of tramadol reduces sexual function in men.

How Long does it Take to get Addicted to Tramadol?

Addiction is different for everyone. Some people become dependent within a few weeks and others take a longer time to get there. Factors determining the risk of addiction, method of use and polydrug use problem also accelerate addiction.

What is the Annual Fatalities rate?

In 2013, tramadol was cited in 12% of drug overdose deaths in England and Wales. In 2014, there were 240 tramadol deaths in the UK.

Who Becomes Addicted to Tramadol?

People who have chronic or acute pain might become addicted to tramadol after long-term usage. Recreational users take tramadol for the euphoric ‘high’ it produces.

What are Tramadol Withdrawal Symptoms?

Withdrawal symptoms of tramadol include extreme numbness, depression, diarrhoea, paranoia, confusion, agitation and gastrointestinal pain.

What are the Effects of Tramadol Abuse and Addiction?

Effects of abusing tramadol include insomnia, convulsions, physical and psychological substance dependence, loss of consciousness, irregular heartbeat, seizure and clammy skin.

Is there a Normal Level of Tramadol usage?

When you take tramadol exactly as the doctor prescribed, you use it appropriately. When used legitimately, tramadol reduces pain in patients who have cancer and those experiencing acute post-surgery pain.

Can Tramadol be Abused?

Tramadol is abused when you take it any form not recommended by your doctor or when it’s used for recreational purposes. When abused, tramadol is taken at higher doses, used more frequently, and snorted, injected, smoked and chewed.

Tramadol Addiction Symptoms: Can they be Treated?

Addiction symptoms will be treated as they appear at a tramadol rehab facility. Medically supervised detox is used to treat physical symptoms and wean you off tramadol, while therapy and counselling treat the psychological symptoms.

Do Controlling Parents Increase Children’s Risk of Addiction?

Yes. Some kids rebel and use tramadol when situations at home aren’t ideal. Many who are aged 12 and above admitted to using tramadol at least once.

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