Tramadol Withdrawal and Detox

Tramadol (and its branded versions such as Ultram) is prescribed by doctors as a narcotic painkiller for treating mild to severe pain. It is an addictive drug, and like most painkillers, tramadol is prone to causing physical and psychological dependence.

People who attempt to quit tramadol without medical supervision often experience severe withdrawal symptoms and complications. The physical and psychological discomfort associated with withdrawal during detox can often lead to relapse.

If you want to detox from tramadol, it is best to see an addiction specialist. The doctor will advise you to undergo a supervised opioid detox as part of an exclusive tramadol addiction treatment programme. This will help to relieve the difficulty of withdrawal symptoms and guide you through recovery and support.

Withdrawal and Detox

Tramadol is easily abused, because it is perceived to produce feelings of relaxation and calm. People who want to remain in this state use more of the drug than is healthy for them. If you take tramadol frequently, you’ll quickly develop a tolerance to the drug’s effects. This means the regular dosage will no longer have the desired effect, causing you to take more for it to be effective.

This is known as drug tolerance, which is common with most substance abuse cases. A dependency is created when alterations in the brain are fixed, so that it can no longer function ‘normally’ without the presence of tramadol.

Drug dependency can occur even when you follow a doctor’s prescription, but its effect is more rapid when the drug is abused. It is advisable to see a doctor regularly for advice about the use of prescription drugs.

For recreational users of tramadol, dependence produces withdrawal symptoms that prevent them from quitting, even when they try to do so. The signs are easy to recognise in a loved one or close friend. It’s advisable to call for professional help if you observe withdrawal symptoms. A guided detox process is the best way to attempt withdrawal from opioids.

What is Tramadol Withdrawal?

Tramadol works by targeting the centres of the brain that signal pain in the body and suppresses them. When the receptors are suppressed, the pain is relieved. However, abusers take large doses of tramadol to feel good. This inhibits the reuptake of neurotransmitters such as serotonin and norepinephrine, whilst activating opioid receptors in the central nervous system (CNS).

When abusers repeatedly take the drug, the brain builds a tolerance that demands a larger dose for the drug to be effective. Over time, tolerance escalates into dependence. A brain that is dependent on tramadol cannot function ‘normally’ if the drug is absent. It therefore reacts by causing the abuser to feel extreme physical and psychological distress. This distress manifests in symptoms of withdrawal.

Tramadol withdrawal usually occurs in physical and psychological phases. The physical side effects of withdrawal appear to mirror the symptoms of flu. They normally peak within a few days before tapering off, while the psychological side effects tend to stay a little longer.

Withdrawal is experienced differently by each user. Certain factors such as the history of drug usage and the user’s overall health status, determine the length and severity of withdrawal symptoms.

One major contributor to the duration of and severity of withdrawal symptoms is the abuser’s level of dependency. This is because a brain that is heavily dependent on tramadol will require more time to recover and ‘rewire’ its natural functions that have been altered by long-term drug abuse.

Your mode of administration is also a key factor in how dependent you might be. People who take tramadol orally (as a pill) are less likely to be as dependent as those who inject, snort or smoke the drug.

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Risks of Withdrawal

Acute withdrawal symptoms can cause a myriad of physical health complications, ranging from minor flu-like symptoms to severe seizures. Prolonged withdrawal symptoms can lead to mental health problems, including depression and anxiety. Therefore, it is best to detox in a controlled facility with medical professionals present.

Acute withdrawal is the initial appearance of symptoms after abruptly discontinuing substance usage. The symptoms are usually the opposite of effects of the substance. For example, tramadol often makes people numb to pain, but during withdrawal, they tend to feel muscular aches and pain.

During acute withdrawal, patients are given medication to help relieve the feelings of discomfort, although this is not always the case. Withdrawal risks are higher for cases of severe addiction. The brain and body will often trigger intense reactions to make you resume the drug. The chance of relapsing is higher when you try to detox on your own, especially for opioids like tramadol.

Tramadol Withdrawal Symptoms: What to Expect

The following symptoms are experienced during withdrawal:

Physical symptoms

  • Headaches
  • Nausea
  • General discomfort
  • Tremors and chills
  • Flu-like symptoms
  • Sleeplessness
  • Vivid nightmares

Psychological symptoms

  • Paranoia
  • Agitation
  • Anxiety
  • Mood swings
  • Aggressive outbursts
  • Depression
  • Deliriums

The severity and length of addiction to tramadol can directly affect the intensity, presence and duration of the listed symptoms.

Timeline of Tramadol Withdrawal Symptoms

People often like to know how long the symptoms may last. The length varies with each individual, but it’s helpful to have a timeline in mind to help you prepare adequately.

Most tramadol dependent users experience three withdrawal phases during detox. In phase one (also known as acute withdrawal), the physical symptoms begin 12 hours after the last tramadol intake (though this could be shorter for more dependent users). The symptoms peak by the third day before tapering down. Overall, acute withdrawal lasts approximately five days.

Phase two lasts about two weeks. As the body works to purge all traces of the substance, it also seeks to reorder the balance of endorphin levels which were reduced during opiate dependence. The symptoms associated with this period are chills, dilated pupils and leg cramps.

In the final phase, the symptoms are more psychological than physical. Patients often experience restlessness, insomnia and anxiety. You may be advised to exercise (walk 30 to 60 minutes daily, practice yoga or use the gym), eat healthily, drink plenty of water and sleep more.

Factors Influencing Withdrawal and Detox

We are all unique in the way we think and feel. It is therefore natural that we differ in the way we respond to various stimuli. The difficult aspect of treatment for most substance abusers is the withdrawal symptoms.

Nobody can say for sure how severe their symptoms will be, but the following factors influence withdrawal and detox:

  • Age. Older users tend to experience more unpleasant symptoms than younger ones. Doctors usually take this into consideration.
  • Longer usage history. A prolonged history of drug abuse is a significant factor during withdrawal, because the brain (and body) will have changed its structure in the long-term.
  • Co-occurring disorders. Mental health disorders such as bipolar and anxiety disorders often arise because of drug abuse. During detox, a physician will consider treating the psychological symptoms, as well as the physical ones.
  • Poor support system. Detoxing without a good support system could exacerbate the experience for the patient. It’s therefore important to know that your family and friends are there for you.
  • Negative attitude. People who go into detox with a negative attitude find it difficult to persevere. Without a strong mental foundation, withdrawal can subdue a person’s resolve to quit.

Detoxing in a safe, reliable environment takes all these factors into account and ensures you prevail and live a clean, sober life, free of tramadol addiction.

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Tramadol: the Detox Process

Treatment options for people addicted to tramadol will vary, but it’s best to go for a rehab option that includes a detox programme for patients. There are often two stages of a comprehensive treatment programme:

  • Detoxification from physical dependence on tramadol
  • Education and therapy to correct psychological dependence

Detoxification includes a period where you slowly cease using the drug until it is completely washed from your system. You will also learn how the drug hurts you and interferes with your life. Rehab also provides support and therapy that builds you mentally to function without needing the drug.

Throughout this period, you’ll experience withdrawal symptoms, but the medical team and counsellors will provide medication and care to help you pull through it successfully.

How to Safely Detox from Tramadol

Detoxification is not necessarily a form of treatment, but it is a critical first step towards recovery. If it’s not done properly, you could end up relapsing or experiencing other health complications.

A detoxification strategy should be created and executed to safely transition you from dependence. Never attempt to detox without first weaning off the drug, as it could make withdrawal dangerous. Doctors always advise against abrupt discontinuation.

Weaning or tapering is the gradual cessation of drug usage over a period of time. During detox, a physician will ensure you are carefully weaned off tramadol. The resulting effects are treated with medication to help you bear the discomfort.

Make sure you are in a facility with access to medical attention 24 hours a day during the course of treatment. Prior to actual detox, the doctor will ask questions about your drug usage history, the frequency and quantity consumed and other relevant information. This should allow them to gauge the severity of withdrawal and prepare adequately.

It’s important that the environment is safe and secure to prevent self-harm or relapse if need be.

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Home Detox?

While it is risky, there are people who have successfully detoxed at home. If you must, it’s advisable to do so under the supervision of an addiction physician.

This is complicated, because full detox requires 24-hour medical attention and unless you can afford to have a doctor (or nurse) on call, problems could arise. In addition, people who detox at home tend to self-medicate and may use the wrong medicines. Conversely, using just any painkiller when you are detoxing from tramadol can jeopardise the whole treatment.

There is also the problem of psychological withdrawal symptoms. Unless you can contact an addiction psychologist at home, you could be at risk when going through certain mental disturbances unsupervised. Only a qualified doctor can prescribe the right antidepressants.

Therefore, while it is not uncommon, the cons of detoxing at home greatly outweigh the pros. Please see an expert before proceeding with this decision.

Medically Supervised Tramadol Withdrawal Detox

There are various ways to treat tramadol dependence, but medical supervision is the most recommended. This is performed in a hospital or rehab facility with a detox clinic and medical personnel available in case of complications.

While tramadol dependence is not as dangerous as opiates such as heroin or morphine, a patient can develop severe symptoms at any time. A hospital provides a controlled environment with suitable resources to handle a withdrawal crisis. There is also easy access to proper medication for pain, headaches and psychological disturbances. Unlike people who detox at home, there is limited (or no) access to tramadol. Therefore, the chances of relapsing are almost non-existent.

Medically supervised tramadol withdrawal detox is offered by many inpatient rehab centres in the UK.

Medications Used During Tramadol Detox

Medications for opiates such as tramadol are used to alleviate cravings and withdrawal symptoms. The medicines are often administered daily in tablet form. While some people experience withdrawal for weeks, others suffer the symptoms for a lot longer. Long-term replacement medications can prevent cravings and post-acute withdrawal syndrome (PAWS).

Some addiction medications for tramadol and other painkillers include:

  • Methadone. Methadone is used for moderate to extreme opiate addictions. As an opiate, methadone binds to the same receptors in the brain as tramadol, but it doesn’t produce the ‘euphoric’ effects. The medicine suppresses cravings and tempers withdrawal effects.
  • Buprenorphine (Suboxone). Like methadone, buprenorphine binds the same opioid receptors in the brain and its potential for addiction is very low. People who use this drug can take it home with them, instead of reporting to the clinic every day.
  • Naltrexone. Although naltrexone is a common anti-alcoholism medication, it also works for opiate addiction. It blocks the receptors in the brain that produce pleasurable sensations, thus subduing the urge to use tramadol. It has mild side effects (nausea and headaches) and is administered as an injection once a month.

Rapid Detoxification Programmes

Traditional detox programmes usually last for 7 to 14 days to completely remove all traces of the chemicals left from drug dependence. Here, under the supervision of a doctor, you will be treated for withdrawal symptoms and any other issues that may arise.

For people who would like to hasten the detox process, a rapid detox programme is a system carried out in a clinical setting. Instead of waiting for the body to eliminate the remnants of tramadol, you will be placed under an anaesthetic and a rapid elimination process is performed within four to six hours. After that, you’ll remain in the hospital for another 24 to 48 hours.

During this process, you’ll be placed under general anaesthetic and medications will be given intravenously to hasten withdrawal. There will be qualified doctors present to make sure there are no complications. When you wake up, another drug (Naltrexone) will be administered regularly for several months after detox.

There is a debate about the potency of rapid detox programme (RPD); while there are little or no withdrawal symptoms, RPD is very expensive and going under general anaesthesia could pose its own risks.

Treatment for Withdrawal

Tramadol is an opiate with mild to severe withdrawal pains during detox. To help patients bear the discomfort, doctors usually administer various medications. While some target physical pain, others are aimed at relieving psychological discomfort.

Serotonin syndrome is one of the major problems of tramadol withdrawal. It happens when the brain is unable to regulate the quantity of serotonin, leading to bouts of extreme depression and anxiety. Many clinics resolve this by giving the patient antidepressants or SSRI medication.

Other forms of treatment include naltrexone to mimic opiate use and therapies for building mental resolve during the detox process.

Guided Tramadol Therapy

Most doctors believe that drug addiction also stems from psychological influences. For this reason, an addiction counsellor helps patients identify the underlying cause behind their addictive behaviour.

Therapies may also be used to educate you on how to change your orientation towards tramadol consumption, as well as beat any cravings you encounter.

Popular therapeutic solutions include:

  • Behavioural therapy
  • Motivation therapy
  • SMART therapy
  • Cognitive behavioural therapy (CBT)
  • Twelve-step programmes

Before choosing a rehab centre for recovery, ensure you understand and agree with the type of treatment programme they offer.

Live a Sober Life Again

Addiction prevents you from doing the things you love and living a life of happiness and fulfilment. If you are dependent on tramadol or any drug, it can make you feel trapped and less motivated to continue. Fortunately, it is not late to change course and take control of your life. With the right guidance, treatment and support, you can live a sober life again.

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Preventing Relapse

Some rehabilitation centres provide a post-rehab aftercare programme that helps former abusers build their strength and resist the urge to relapse. It usually involves building a strong support system and maintaining contact with narcotics anonymous groups. You also get to discuss your challenges with others and learn different ways to abstain and maintain sobriety each day. During this time, you can continue to see a therapist if you wish.

Find a Treatment Centre

The quality and type of treatment centre you choose is critical to the success of your recovery. When making a choice, ensure you look for things that matter in a clinic or rehab centre.

It is important to verify that a hospital is accredited for rehabilitation treatment. Another key factor is the type of treatment programme employed. Do you prefer traditional or alternative therapy? Sometimes, your preferences can affect the way you respond to certain procedures.


Does Tramadol have Codeine or Opiates in it?

Tramadol is a ‘synthetic analogue’ of codeine. While it doesn’t contain codeine, it was synthesised to act like codeine. However, it is an opiate and binds in the same receptors in the brain as other opiates, like morphine.

What is Tramadol Withdrawal?

Tramadol is a painkiller that acts by suppressing the actions of the brain receptors responsible for pain signals. It affects the serotonin-norepinephrine reuptake inhibitors, causing the nucleus accumbens to be flooded with these pleasure hormones.

People tend to abuse tramadol to continue feeling this sensation. They soon develop dependence when the brain gets fixated on the drug. An addiction is formed when the brain cannot function normally without tramadol. The negative reaction is known as ‘withdrawal’.

Is Tramadol Withdrawal Dangerous?

It may not be as dangerous as heroin or morphine withdrawal, but it can lead to severe complications if a qualified doctor isn’t on hand to supervise.

How long does Tramadol Withdrawal last?

Withdrawal varies with each individual. Generally, the acute withdrawal phase lasts between 24 to 72 hours, but the psychological symptoms can linger for weeks. People with heavy dependence on tramadol will usually have longer withdrawal periods. The severity of the symptoms will also vary.

Why are Withdrawals so Tough?

When undergoing withdrawal, your brain is essentially reacting to what it believes is the absence of a ‘normal’ part of its function. Therefore, it requires a new orientation to function without tramadol in the system. The longer the abuse period, the more dependent the user will be, and the tougher it is to overcome withdrawal.

How is Tramadol Prescribed?

Doctors prescribe tramadol to treat minor and severe pain in adults. Tramadol comes in tablet form, as an extended release medication or a capsule for round-the-clock relief from pain. Physicians may start a patient on 25mg and proceed to 50mg-100mg doses four times a day.

Are there Remedies to Deal with It Naturally?

Some rehab centres use alternative methods to treat tramadol dependence with some measure of success. However, long-term addictions can present very severe withdrawal symptoms that require medication to control. Regardless of the type of remedy you use, it is always important to have a qualified physician present.

What Causes Insomnia During Post-Acute Withdrawal?

During post-acute withdrawal, patients are unable to sleep, often because they usually experience vivid nightmares. The stress of detoxing is also a major factor. Insomnia may last from 24 to 48 hours and is often followed by fatigue. Some people may experience sleeplessness post-rehab as well.

What Recovery Programme is Right for Me?

There are two major types of recovery programmes; inpatient and outpatient. Your doctor will decide which is suitable for you after determining your level of dependence to tramadol. Most heavily dependent users are referred to the inpatient programme, as it offers a more comprehensive treatment solution.

When does it get Better?

It usually gets worse before it gets better. The first few days of withdrawal are the most unpleasant. However, after the first phase, things start to get a lot easier. If you have been using tramadol for a prolonged period, the discomfort tends to last longer though. Fortunately, there are medications that make withdrawal more bearable.

What is the Purpose of a Tramadol Addiction Detox Facility?

A specialised detox facility is designed to cater to tramadol addiction only. This makes it better equipped to handle withdrawal and any complications that may arise. Even post-detox, some people visit a tramadol addiction detox facility for regular injections to help them overcome cravings.

Does Tramadol Help with Opiate Withdrawal?

Despite its addictive property, some physicians find tramadol to be an effective painkiller for withdrawal caused by dependence to more potent opiates. Although it may sound unusual, tramadol at this stage presents a less dangerous drug with analgesic properties. However, it is used under strict supervision to avoid substituting one addiction for another.

How Long does it Take to Detox from Tramadol?

The duration of detox is determined by the length of withdrawal. The longer your withdrawal period, the longer you will likely remain in a detox facility. Since the level of dependence influences the severity and length of withdrawal, detox varies for different people. Many clinics cap their minimum detox stay to 14 days, but a doctor may recommend a longer stay to monitor recovery.

Can you Die from Tramadol Withdrawal?

Although it’s very rare, some uncontrolled withdrawal symptoms can lead to fatal consequences. People with untreated mental health disorders may end up hurting themselves if there is no proper supervision.

Can Medications Help?

Yes. Medically supervised tramadol withdrawal detox aims to help abusers go through withdrawal with alleviated physical and mental discomfort. The doctors administer treatment that targets certain parts of the brain and body to reduce pain. Some medications like methadone and naltrexone mimic the actions of tramadol by blocking the opiate receptors in the brain. Methadone is not addictive, so it is safe for treatment purposes.

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