Tramadol Withdrawal and Detox

Tramadol is prescribed by physicians as a painkiller for treating moderate to severe pain. Tramadol, like other opioids, acts on opioid receptors, monoamine reuptake systems, and the central nervous system to alleviate pain sensations and enhance feelings of calmness and relaxation. A person taking tramadol regularly may become tolerant to its effects and more will need to be taken in order for the drug  to remain effective.

The DEA reports that 3.2 million Americans used tramadol for nonmedical purposes at some time in their lives. The potential for becoming dependent on tramadol may be higher for individuals misusing it, or for individuals with a history of substance misuse or a use disorder. However,  tramadol can induce substance dependence when taken for long periods of time, even with a legitimate prescription, according to the World Health Organization.

Like other opioids, tramadol may cause both emotional and physical dependence. Attempting to abruptly discontinue consuming tramadol is often tied to serious withdrawal symptoms and complications. The psychological and physical pain associated with withdrawal symptoms during opioid detox often leads to setbacks in recovery.

If an individual is looking to detox from tramadol, a doctor may recommend that they undergo supervised tramadol detox as part of an individualized tramadol addiction treatment program. This can help mitigate tramadol withdrawal symptoms and maximize recovery.

Tramadol Withdrawal

Traditional opioids like oxycodone and hydrocodone increase sensations of pleasure and can produce a high when taken in larger doses than what was originally prescribed. Tramadol works a little differently by not only activating opioid receptors in the brain but also by blocking neurotransmitters, like serotonin and norepinephrine, from being reabsorbed back into the system. For that reason, tramadol withdrawal may actually take two different forms: traditional opioid withdrawal syndrome or atypical opioid withdrawal syndrome.

If a client is dependent on tramadol, it’s important to safely detox. This includes assistance from a medical professional, either as part of a prescription plan or in a supervised detoxification setting. In general, tramadol withdrawal symptoms occur within a few hours after tramadol effects wear off. In fact, people who forget to take their tramadol have reported feeling tramadol withdrawal symptoms only a few hours after their last dose. The length of time until withdrawal stops can vary from weeks to months later.

Tramadol Withdrawal Symptoms

Tramadol is habit-forming and as a result, dependence can occur over time. Severity and length of tramadol addiction can directly impact the presence, intensity, and duration of the withdrawal.

Opioid withdrawal generally has two main phases: early and late withdrawal. Early withdrawal starts when the substance leaves the bloodstream, and late withdrawal occurs a little later. Signs of opioid withdrawal vary according to the stage.

Early Opioid Withdrawal:

  • Runny nose
  • Sweating
  • Tearing up
  • Muscle and body aches
  • Trouble sleeping or insomnia
  • Anxiety
  • Restlessness
  • Agitation
  • Racing heart rate
  • Hypertension
  • Fast breathing

Late Opioid Withdrawal:

  • Chills and goosebumps
  • Stomach pain and cramping
  • Diarrhea
  • Vomiting
  • Loss of appetite
  • Pupil dilation
  • Difficulties concentrating or thinking clearly
  • Irritability
  • Drug cravings
  • Depression
  • Depersonalization

Atypical Withdrawal Symptoms 

Tramadol is unlike other opioid painkillers like oxycodone, in that it relieves pain by way of two different mechanisms: 1) by stimulating opioid receptors and 2) inhibiting serotonin and norepinephrine reuptake. Due to the fact that it is atypical in this way, some users will actually experience a whole set of symptoms not normally seen in opioid withdrawal. This atypical withdrawal syndrome include a range of psychological symptoms marked by:

  • Hallucinations
  • Intense paranoia
  • High anxiety and panic
  • Confusion and disorientation
  • Depersonalization
  • Unusual sensory experiences including numbness and prickling in the extremities.

These tramadol withdrawal symptoms might not be dangerous by themselves, but they can lead to dangerous situations. People that experience visual or auditory hallucinations, paranoia, and delusions can make poor choices, which can put themselves and others around them at risk.

Physical Complications from Tramadol Withdrawal

Post-acute withdrawal syndrome (PAWS) is a rare complication that can occur if a person has taken tramadol for a long time in large doses. PAWS involves long-term tramadol withdrawal side effects, which are typically psychological, but can manifest in physical ways. The individual could feel weak or fatigued for weeks after detoxing from the substance. They could also experience intense cravings, anxiety, depression, insomnia, or an increased sensitivity to pain. Working with a doctor to taper the dose of tramadol can help to prevent PAWS.

PAWS symptoms include:

  • Mood swings
  • Depression
  • Cognitive problems (memory loss)
  • Sleep problems
  • Agitation
  • Anxiety
  • Sensitivity to stress

Because tramadol also influences serotonin in the brain, abruptly discontinuing taking the substance can, in some instances, produce psychosis. Tramadol-induced psychosis typically ends after a few days.  

Withdrawal Timeline 

Days 1-3

Onset of general withdrawal symptoms, including feelings of pins and needles, sweating, nervousness, nausea, anxiety, palpitations, insomnia and drug cravings.

Days 4-7

Substance cravings persist, along with insomnia, disorientation and confusion, and blurred vision.

Days 8-14

Symptoms should be fairly mild by this point. Depression, anxiety and irrational thoughts may persist.

The physical tramadol withdrawal symptoms may be similar to symptoms of the flu. They are likely to peak within a few days and taper off while the psychological withdrawal side effects may linger a little longer. Everyone experiences tramadol withdrawal differently, and certain factors may influence how long it will last and the potential severity of the symptoms.

The level of dependency to tramadol is a major contributor to the duration and severity of the withdrawal from tramadol as a brain that is significantly dependent on tramadol may need extra time to bounce back and repair what may have been damaged by long-term and chronic substance misuse. Therefore, individuals taking tramadol for a long time, and especially those taking large doses, may be more heavily dependent on the substance.

The way in which an individual takes tramadol is a factor in withdrawal from tramadol and substance dependence as well. If a person is taking tramadol as directed, they are less likely to become dependent as an individual who is injecting, snorting, or smoking it.

An individual’s personal physiology, genetics, and biology plays a role in substance dependence, and one person may become dependent more easily than another. Underlying medical or mental health conditions may impact drug dependence as well. Someone with a family history of substance misuse and addiction may be more prone to becoming dependent on tramadol than someone without this risk factor.

Trauma, neglect, chronic stress and misuse can contribute to the onset of a substance use disorder, as can the age at which an individual first begins using or misusing substances. Adolescent brains are not fully formed, and regions responsible for sound decision-making controlling impulses, learning, and memory may be damaged by substance misuse during the teenage years. The National Survey on Drug Use and Health (NSDUH) of 2013 reported that individuals misusing substances before the age of 14 were more likely to suffer from a substance use disorder as an adult than those who waited until after age 18 to initiate substance misuse.

How Long Does Tramadol Withdrawal Last?

Tramadol detox symptoms typically show up within a day of stopping the medication. Especially if you are experiencing withdrawal, you may be wondering: just how long do tramadol withdrawal symptoms last?

The duration of tramadol detox is unique to each person, but can range from 10 days to several weeks. A client’s personal timeline depends on their dosage, tolerance, physiology, and how long they’ve been battling the tramadol use disorder.

Physicians may choose to taper tramadol itself to ease the person off physical dependence. This means the experience of withdrawal from tramadol may be milder, but the timeline will be longer, often taking weeks or months to fully overcome the body’s dependence on the substance.

Tramadol Detox

If a person decides to stop taking tramadol after establishing a physical dependence, they are likely to experience withdrawal symptoms from tramadol. This occurs because the brain has grown accustomed to the substance, and has even adapted many of its processes to accommodate the presence of tramadol. When there is a sudden absence of the substance of the drug, the brain has such difficulty adjusting that it triggers tramadol withdrawal symptoms. The primary goal of detoxification is to minimize the harm caused by the substance. Detoxification is accomplished through:


  • Evaluation — In this stage, medical, psychological and social factors are evaluated to determine the best course of action.
  • StabilizationDuring this stage, the individual receives medical supervision and psychological support to achieve a substance-free state.
  • Encouraging further treatmentBecause tramadol detox is not a complete treatment for substance misuse, further treatment is recommended for sustained recovery.
To safely detox from tramadol, clients must remain under close medical supervision until their body expels the substance. Choosing to detox at home can expose an individual to many withdrawal-based dangers and severe detox side effects, including:

  • Hallucinations
  • Psychosis
  • Depression
  • Anxiety
  • Sleeplessness
  • Extreme sweating
  • Vertigo
  • Serotonin discontinuation syndrome

Instead of detoxing at home, a client should consider these options:

Inpatient Treatment  With 24-hour supervision, doctors and nurses can closely monitor tramadol detox symptoms and help make clients as comfortable as possible during their stay. This method may produce higher success rates than at-home or outpatient programs.

Intensive Outpatient Treatment  While maintaining other life obligations like family, work, and school, outpatient detox allows clients to attend treatment sessions when they’re available during the day.

Typically, withdrawal symptoms associated with tramadol are unpleasant but not fatal. However, if a person has another health condition, they may have a higher risk of more dangerous withdrawal symptoms and complications.

If a person finds that they are unable to stop misusing tramadol , they likely need treatment. Quitting tramadol may not be easy, but long-term health outweighs the temporary discomforts of tramadol withdrawal. With the help of medical professionals, detoxing from tramadol can be done safely and effectively.

A focus of tramadol detox will be to connect the individual to follow-up treatment to maintain sobriety. Like detoxification, continuing treatment occurs in an inpatient, residential, or outpatient setting at a tramadol rehab.

Beginning the recovery journey can be a life-saving decision for you or your loved one. However, navigating available tramadol addiction treatment services can be difficult.

Choosing a detoxification center is an important part of the recovery process. With the assistance of a reputable program, recovery from tramadol use disorder is possible. At The Recovery Village, clients experience a full continuum of care to help them start the process of lasting recovery. A healthy, substance-free life is  attainable by making one simple telephone call.

Locations of Tramadol Treatment Centers

The Recovery Village facilities serve communities from Florida to Washington, and specialize in a range of substance use disorder recovery services.

The Recovery Village Umatilla Umatilla, FL

Residence opportunities at this location include inpatient, outpatient, intensive outpatient, and partial hospitalization programs.

Orlando Recovery Center Orlando, FL

This client-centered substance and eating disorder treatment facility in Orlando, Florida, features inpatient rehab services for adults.

The Recovery Village Ridgefield Ridgefield, WA

The Ridgefield, Washington, location assists people struggling with substance use disorders, substance misuse, and co-occurring mental disorders.  

The Recovery Village Palmer Lake Palmer Lake, CO

The Colorado location offers a full continuum of care including medical detox, residential treatment, partial hospitalization programs, and intensive outpatient programs.

The Recovery Village Columbus Columbus, OH

The Recovery Village Columbus provides full-service substance use disorder therapy and counseling including medical detox, inpatient and outpatient treatment, aftercare and more.

Next Generation Village Sebring, FL

With a focus on adolescent recovery care, Next Generation Village provides customized treatment for substance dependence in Central Florida.

IAFF Center of Excellence Upper Marlboro, MD

IAFF Center of Excellence is a one-of-a-kind substance use disorder treatment facility specializing in PTSD for IAFF members who are struggling to receive the help that they need.

Next Step Village Maitland, FL

With facilities in Maitland and Eustis, Next Step Village provides transitional living and aftercare services for individuals seeking recovery.

Drug Scheduling.” DEA. Accessed 11 Jan. 2017.

Tramadol: MedlinePlus Drug Information.” MedlinePlus – Health Information from the National Library of Medicine, 15 Sept. 2016. Accessed 11 Jan. 2017.

Harvard Women’s Health Watch. “Going off Antidepressants.” Harvard Health, Harvard University, 27 Oct. 2015. Accessed 11 Jan. 2017.

Opiate and Opioid Withdrawal: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 20 Apr. 2016, Accessed 11 Jan. 2017.

Rajabizadeh, Ghodratolah, et al. “Psychosis Following Tramadol Withdrawal.” PubMed Central (PMC), National Institutes of Health, 2009. Accessed 11 Jan. 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.


Share on Social Media: