What is tramadol?
Tramadol is a medication that is used to treat acute pain and chronic pain. It is available in immediate-release and extended-release preparations. Some brand names include Ultram and Ultracet. While tramadol is an opioid, it was, until recently, the only prescription opioid in the US that was not controlled. Now, this is no longer the case. Tramadol is a controlled medication with a higher level of restriction than it previously had.
Why is tramadol addiction a concern?
Unfortunately, when tramadol was not controlled, many doctors were lulled into a false sense of security in prescribing it to patients. When a drug is controlled, it is recognized to have a certain level of abuse potential. This implies that non-controlled prescription drugs do not carry the risk of abuse and addiction. Tramadol is certainly milder than many other opioids, but patients are at risk of becoming addicted and there is the potential for drug abusers to misuse it. Additionally, even when taken as directed, tramadol is known to stimulate opioid cravings in patients who have been addicted to opioids in the past.
What kind of addiction treatment is appropriate for tramadol addiction?
There are several treatment options for treating tramadol addiction. Outpatient rehab, around-the-clock inpatient treatment, medical detox, and medically-supervised treatment with detox medications are all possible tramadol addiction treatments. For patients with co-occurring mental health issues or multiple substance abuse problems, a residential rehab treatment center with inpatient detox may be ideal. Otherwise, tramadol addiction may be treated as an outpatient, even in a private doctor’s office.
What about medication-assisted treatment (MAT)? Can this work for tramadol abuse?
Is it appropriate to use medications such as methadone, buprenorphine, or naltrexone to treat tramadol addiction? In nearly all cases, methadone will probably not be necessary as a treatment option if tramadol is the only opioid that the patient is using. Suboxone, an addiction treatment medication that contains buprenorphine, may help some patients to overcome tramadol-related substance abuse by preventing ongoing withdrawal symptoms and cravings. If a patient has been detoxed off of tramadol and they are able to remain opioid-free, naltrexone, an opioid receptor blocker, may help them long-term to have fewer cravings for opioids.
How common is tramadol dependence?
While tramadol withdrawal from ongoing tramadol dependence is possible, it is not very common. This is due to several factors. One issue is that tramadol use at high dosages can lead to dangerous side effects, such as seizures. Many opioid users are aware of this risk, so they avoid tramadol use. Additionally, because tramadol is a mild opioid compared to other opioids that are commonly abused, it is often skipped over in favor of other opioids, such as heroin, fentanyl, oxycodone, hydromorphone, morphine, and others. However, treatment centers are seeing an increase in tramadol addiction simply because tramadol is a more accessible opioid. Tramadol withdrawal is essentially the same as opioid withdrawal with any other opioid. With the shorter-acting form of the drug, withdrawal may start within 24 hours of quitting and can last for days. Some users, in order to avoid flu-like withdrawal symptoms, will switch to other opioids if tramadol is not available.
Can tramadol be used to treat opioid withdrawal and opioid addiction?
The US government only allows two opioids to be used to treat opioid use disorder, methadone, and buprenorphine. Most opioids cannot be used for any purpose besides treating moderate to severe pain. While I cannot confirm this, I have been told that tramadol has been used by treatment programs for opioid addiction treatment in the past. Was this possible because tramadol was not controlled at that time? Either way, tramadol is now a controlled opioid, so if it was ever used in us treatment programs as part of a detox plan, it cannot be used in this way anymore. In other countries, such as Canada and Switzerland, other opioids, including heroin, are being used in medical addiction treatment programs successfully.
Is tramadol addiction a life-threatening condition?
While not as immediately deadly as the use of street opioids, such as heroin and fentanyl, tramadol can still be quite dangerous if abused. For example, as mentioned earlier, taking too much tramadol can lead to seizures. Respiratory depression may also be a risk with excess tramadol, especially if it is combined with other sedating drugs. Additionally, there is the risk that a person who is experiencing tramadol withdrawal may turn to other, more dangerous opioids.
Besides medical treatment, what can I do if I am addicted to tramadol?
There are support groups to help develop a network of friends in recovery. 12-step groups and non-12-step groups have meetings in most regions that you can attend in person. There are also online recovery meetings for people who are ready to quit drug use. Many people find these meetings helpful and they are able to make new friends and find new activities that support their recovery. Also, it is important to see a mental health specialist, such as a psychiatrist or psychologist, for ongoing one-on-one therapy. Identifying that you have a problem with opioid addiction is the first step to getting help to overcome your addiction.