Some medications can be effective at reducing the severity of opioid withdrawal symptoms during opioid withdrawal, making it easier for people to transition into recovery. Tramadol is one such drug.
Table of Contents
What Is Tramadol?
Tramadol is an opioid 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 opioid 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 mood and behavior, sometimes resulting in opioid addiction. The term opioid is often applied to both opiates (naturally occurring drugs derived from opium) and man-made or synthetic opioids.
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 Opioid Withdrawal?
Opioid withdrawal symptoms come in stages. The early stages may include:
- Muscle aches
- Runny nose
These symptoms usually start within 12-30 hours of the last dose of opioids. Later symptoms include:
- Abdominal cramps
- Nausea and vomiting
How Can Tramadol Be Used for Opioid Withdrawal?
Tramadol acts as a weak opioid agonist, meaning that it activates the opioid receptors in the brain, but on a much less intense level than other opioids.
Currently, tramadol has no FDA-approved indication for medication-assisted opioid addiction treatment. Drugs that are approved for this use include methadone, buprenorphine and naltrexone. Although tramadol has been studied in small clinical trials and may be useful in situations where buprenorphine isn’t available, it is not generally considered a treatment for opioid withdrawal.
What Are the Side Effects of Tramadol?
Some side effects of Tramadol may include:
- Abdominal pain
- Dry mouth
- Joint pain
- Loss of appetite
- Runny nose
- Sore throat
- Trouble concentrating
- Upset stomach
The Dangers of Tramadol
There are dangerous side effects of tramadol that people should understand. They include:
- Blisters under the skin
- Blood in the urine
- Chest pain
- Fast or irregular heartbeat
- High blood pressure
If you experience any of these symptoms, contact your doctor immediately.
Pregnant women should use caution when taking tramadol. The prescribing information for tramadol clearly states that prolonged use of opioid analgesics during pregnancy may lead to neonatal abstinence syndrome. For pregnant women, tramadol should only be used if the benefits outweigh the risks. Additionally, tramadol may be excreted in breast milk and can be passed on to nursing infants.
Alternate Medications for Opioid Withdrawal
If a person would rather not use tramadol, there are other medications available for opioid withdrawal:
- Buprenorphine can be used for withdrawal and maintenance therapy. A person 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 the body producing excess norepinephrine, but it doesn’t help manage cravings and malaise. However, clonidine doesn’t induce dependence. Some side effects include kidney dysfunction, heart disorders and hypotension. Clonidine may be taken every six hours.
- Methadone, like buprenorphine, can be used on a daily basis for maintenance as well as for withdrawal symptoms. Methadone reduces cravings for opioids by acting on the same receptors in the brain without causing the same side effects. However, it may cause other side effects, such as constipation, respiratory depression, dizziness, nausea and sedation.
- Naltrexone can help with withdrawal symptoms, but it does come with side effects such as anxiety, nausea and muscle pain. Like buprenorphine, naltrexone can be taken daily or three times a week.
- Vitamins can play an important part in dealing with various parts of opioid withdrawal. Multivitamins can supplement nutrition, for example. Vitamin C can support the immune system and help with cognitive functioning. Vitamin E can repair damage to the skin that comes from abscesses and picking at the skin as a result of using opioids. Vitamin B helps to reduce the fatigue of withdrawal, and calcium and magnesium can relieve muscle aches.
Alternative Treatments for Opioid Withdrawal
Non-pharmacological treatments for opioid withdrawal include:
- Aversion therapy, which attaches negative consequences to opioid use
- Cognitive-behavioral therapy, which focuses on relapse prevention
- Contingency management, which exchanges vouchers or prize incentives for negative drug tests
- Group therapy to reduce the stigma surrounding addiction
- Inpatient treatment
- Intensive outpatient treatment or daytime hospitalization
- Long-term inpatient rehab
- Outpatient counseling
- Support groups like Narcotics Anonymous and SMART Recovery
While tramadol may be a viable resource for opioid withdrawal, there are many ways to treat opioid dependence and abuse. Research and take all methods into account and speak with a doctor to help you make the best possible choice to treat opioid withdrawal symptoms.
National Institute on Drug Addiction. “Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine).” December 2012. Accessed 11 January 2017.
The United States Drug Enforcement Administration. “Drug Scheduling.” (n.d.) Accessed 11 January 2017.
DailyMed. “LABEL: TRAMADOL HYDROCHLORIDE- tramadol hydrochloride capsule, extended release.” Updated September 3, 2018. Accessed February 2019.
MedlinePlus. “Opiate and opioid withdrawal.” (n.d.) Accessed 11 January 2017.
St. John, Tina. “Vitamins for Opiate Withdrawal.” Livestrong, 19 February 2014. Accessed 11 January 2017.
Nicholls, Pharm. D., et. al. “Opioid Dependence Treatment and Guidelines.” Supplement to Journal of Managed Care Pharmacy. Academy of Managed Care Pharmacy, February 2010. Accessed 11 January 2017.
Pahwa, Mehak, et. al. “Tramadol vs. Buprenorphine for the Treatment of Opioid Dependence: A Comparative Study.” Journal of Addiction Research & Therapy, 12 August 2015. Accessed 11 January 2017.
Preda, M.D., Adrian, et. al. “Opioid Abuse Treatment & Management.” Medscape, 7 June 2016. Accessed 11 January 2017.
Sarkar, Siddharth and Mattoo, Surendra K. “Newer approaches to opioid detoxification.” Industrial Psychiatry Journal. National Databases of India Medical Journals, December 2012. Accessed 11 January 2017.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.