tramadol for opiate withdrawal: does it work?

Can you use Tramadol to treat opiate withdrawal?

tramadol medicine

Some people believe that medication-assisted therapy is only substituting one addiction for another. However, some medications can be effective at reducing the symptoms of detox, making it easier for you to pass through withdrawal and into recovery. Tramadol is one such drug.

What is Tramadol?

Tramadol is a narcotic drug used for moderate to severe pain relief, especially after surgery. There is also an extended release version that can be used for chronic pain.

The term ‘narcotic’ refers to drugs that are either made from opium or compounds that resemble opium. These drugs have strong analgesic effects, but they can also alter your mood and behavior, sometimes resulting in dependency. This word is often applied to both opiates (drugs made from opium) and opioids (all drugs that act on opiate receptors, whether they’re natural, synthetic, or semi-synthetic).

Tramadol is a Schedule IV drug, meaning that it has an accepted medical use and a low potential for both abuse and dependence.

What are the symptoms of opiate withdrawal?

Opiate withdrawal symptoms come in stages. The early stages include:

  • Agitation.
  • Anxiety.
  • Insomnia.
  • Muscle aches.
  • Runny nose.
  • Sweating.

These usually start within 12-30 hours of the last dose of opiates. Later symptoms include:

  • Abdominal cramps.
  • Diarrhea.
  • Goosebumps.
  • Nausea and vomiting.

How can Tramadol be used for opiate withdrawal?

Tramadol acts as a weak opioid agonist, meaning that it activates the opioid receptors in the brain, but on a much smaller level than other opioids.

Comparison studies have shown that people using Tramadol for opiate withdrawal had fewer withdrawal symptoms than people using buprenorphine and side effects were comparable. Individuals who are moderately opioid-dependent find greater success rates with Tramadol when it comes to detox and preventing relapse.

Overall, it seems like Tramadol is the best medication-assisted treatment for withdrawal and detox. After this phase is over, other more intensive medications can be used for maintenance.

What are the side effects of Tramadol?

Some side effects of Tramadol include:

  • Abdominal pain.
  • Constipation.
  • Coughing.
  • Diarrhea.
  • Dizziness.
  • Dry mouth.
  • Fainting.
  • Fever.
  • Headache.
  • Heartburn.
  • Irritability.
  • Itching.
  • Joint pain.
  • Lightheadedness.
  • Loss of appetite.
  • Nervousness.
  • Runny nose.
  • Shivering.
  • Sore throat.
  • Trouble concentrating.
  • Upset stomach.
  • Weakness.

These are all fairly common.

The dangers of Tramadol

There are dangerous side effects of Tramadol that you should be aware of. They include:

  • Blisters under the skin.
  • Blood in the urine.
  • Chest pain.
  • Fast or irregular heartbeat.
  • High blood pressure.
  • Seizures.

If you experience any of these symptoms, contact your doctor immediately.

Pregnant women should use caution when taking Tramadol. It is a FDA pregnancy category C medication, meaning that it should only be used if the benefits outweigh the risks. Tramadol has been classified as category C due to risks shown in animal studies. There have not been human studies done because of these risks, but Tramadol is known to be excreted in breast milk and can be passed on to nursing infants.

Alternate medications for opiate withdrawal

If you’d rather not take use Tramadol, there are other medications available for opiate withdrawal:

  • Buprenorphine can be used for withdrawal and maintenance therapy. You can take it daily or three times a week. Common side effects include respiratory depression, headache, and constipation.
  • Clonidine can help suppress the “fight or flight” response triggered by your body producing excess norepinephrine, but it doesn’t help to manage cravings and malaise. However, it doesn’t induce dependence. Some side-effects include kidney dysfunction, heart disorders, and hypotension. It must be taken every six hours.
  • Methadone, like buprenorphine, can be used on a daily basis for maintenance as well as for withdrawal. It combats cravings for opiates by acting on the same receptors in the brain without causing the same side-effects. However, it does cause other side-effects, such as constipation, respiratory depression, dizziness, nausea, and sedation.
  • Naltrexone can help with withdrawal symptoms such as sedation, respiratory depression, and dependence, but it does come with side-effects such as anxiety, nausea, and muscle pain. Like buprenorphine, it can be taken daily or three times a week.
  • Vitamins can play an important part in dealing with various parts of opiate withdrawal. Multivitamins can help combat poor nutrition that often goes along with regular opiate use. Vitamin C can support your immune system and help with cognitive functioning. Vitamin E can repair damage to the skin that comes from abscesses and picking at your skin as a result of using opiates. Vitamin B helps to reduce the fatigue of withdrawal, and calcium and magnesium can relieve muscle aches.

Alternate treatments for opiate withdrawal

Non-pharmacological treatments for opiate withdrawal include:

  • Aversion therapy, which attaches negative consequences to opiate use.
  • Cognitive-behavioral therapy, which focuses on relapse prevention.
  • Contingency management, which exchanges vouchers or prize incentives for negative drug tests.
  • Group therapy to combat the stigma attached to substance use.
  • Inpatient treatment.
  • Intensive outpatient treatment/day hospitalization.
  • Long term inpatient rehab.
  • Outpatient counseling.
  • Support groups like Narcotics Anonymous and SMART Recovery.

While Tramadol has quite a bit of evidence backing it up as a viable resource for withdrawal, there are many ways to treat opiate dependence and abuse. Making it through detox and withdrawal in the first place is more important than the method you use to do it, so take all methods into account and speak with a doctor to help you make the best possible choice.

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Can you use Tramadol to treat opiate withdrawal?
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