Tramadol Addiction, Treatment, and Prevention

You might be familiar with tramadol – a narcotic painkiller that is prescribed by doctors. Tramadol, known by its brand names as Ultracet or Ultram, is typically prescribed for moderate pain – for example, following dental surgery or other types of surgeries and for arthritis pain. The drug is in the same category as other opiate agonists – and as such, it can be highly addictive. While most tramadol users take the pain medication with no incident, a small percentage of users may become addicted to tramadol.

Tramadol addiction could affect anyone. Even those who were prescribed the drug for treatment of pain. With prolonged use, tramadol users need a higher dose of the drug to experience the intended effects. Therefore, even individuals who are using tramadol legitimately, as prescribed by their doctor, can become addicted to the painkiller if they use it for an extended period of time. Recent statistics indicate that within a given year, 1.5 million people start abusing tramadol. Over 60% of individuals who abuse tramadol get the drug from friends or family. An even scarier statistic is that 84% of people who are severe tramadol abusers (such that they ingest the drug in very high doses) experience seizures within 24 hours of first abusing the drug. It goes without saying that tramadol can have very serious effects on your health if taken improperly.

Known on the street as trammies, chill pills, and ultras, tramadol is a Schedule IV substance under the United States Controlled Substances Act. Many people don’t consider it an addictive drug because of its low potency and use with low to moderate pain. But, most people who become addicted to tramadol do so without really knowing. The Substance Abuse and Mental Health Services Administration has cited a 250% increase in emergency room visits due to tramadol abuse from 2005 to 2011. Prior to this time, the Food and Drug Administration only had record of 700 cases of tramadol abuse between 1995 and 2004. Tramadol is an opioid painkiller – and is included in the United States’ opioid epidemic. Based on those statistics alone, there’s no question we are under an epidemic. Recent statistics show us that in 2015, 12.5 million people have misused prescription painkillers in the United States at an economic cost of $78.5 billion.

Tramadol works by changing the way the brain responds to pain – making the body less sensitive to it. The way users might become addicted to tramadol without even knowing is that they get nervous or anxious at the thought of not being able to take the drug in response to pain. This addiction oftentimes occurs long after the need for the drug. That is, long after the pain of the surgery or other medical condition is no longer an issue.

The individuals most likely to suffer from tramadol abuse include those who suffer from chronic pain (such that they need tramadol as an ongoing prescription) and those who have a history of a substance abuse problem (either drugs or alcohol). When taken every day, tramadol users develop a tolerance to the drug and require more of the drug to continue to relieve pain. As such, an addiction is born.

What does tramadol addiction look like? When taken properly, some of the side effects of tramadol ingestion include nausea and vomiting, constipation, and headaches. Though unpleasant, the benefits of using the drug outweigh these side effects if it means the user is relieved from acute or chronic pain.

When tramadol addiction settles in, the most common symptoms include:

• Pinpoint pupils (very small pupils)
• Appetite changes (not eating properly)
• Nausea
• Vomiting
• Constipation
• Drowsiness
• Seizures (with no prior history)
• Slurred speech
• Headaches
• Coordination/balance problems
• Dizziness
• Muscle aches
• Depression
• Sweating
• Concentration problems
• Fever

You might be thinking that these do not seem like “pleasant” symptoms to have (i.e., there is not a very strong euphoric “high” as associated with other drugs). That’s how tramadol can be so dangerous. Users can be misusing the drug without necessarily being addicted to it in the true sense of street drug addiction. While tramadol abusers do experience a mood-altering state when taking higher doses of the drug, the intensity of this high is not as strong as other illicit street drugs like crystal meth or heroin.

But, similarly to other drugs, when tramadol runs out or the body does not receive a dose, withdrawal symptoms may kick in. Tramadol withdrawal symptoms include:

• Depression
• Diarrhea
• Gastrointestinal upset
• Agitation
• Numbness
• Ringing in the ears
• Hallucinations
• Paranoia
• Confusion

Tramadol addiction can often be spotted when users are taking the drug improperly, seem obsessed with taking the drug/take higher doses than prescribed, participate in “doctor hopping” to get multiple prescriptions, and/or request their friends or family to get prescriptions for them.

If you suspect a tramadol addiction, drug abusers will get the most benefit out of rehabilitation treatment and recovery programs. Though, it may be necessary to stage an intervention with the tramadol user prior to this occurring. As stated above, this is often because many abusers of the drug may not be aware of their addiction since the pills were prescribed medically and they have been taking them over a long course of time.

Rehabilitation from tramadol is a two-step process. The first step being detoxification of the drug from the body’s system and the second step is the counseling/treatment needed to learn to live a life drug-free. Medical supervision should be given during the detox phase of treatment – with this phase normally lasting 5 to 7 days. While a week is not long in the grand scheme of things, tramadol detox is anything but pleasant and may seem like eternity to those in the treatment and recovery program. The reason detox should be done under medical supervision is because sometimes other medications are provided to ease detox symptoms and to prohibit the ability from those undergoing treatment to get their hands on tramadol to ease the withdrawal symptoms.

After detox is complete, tramadol abusers can enter either inpatient or outpatient rehab treatment and recovery facilities and attend peer-recovery organizations.

Inpatient treatment facilities for tramadol addiction include round-the-clock supervision and treatment within a recovery or rehabilitation facility. This is to provide focused attention to tramadol treatment and recovery, removed from the stressors and reminders of everyday life/home. Tramadol addicts may stay within an inpatient treatment facility for about a month to undergo a fully focused and beneficial treatment program.

Outpatient treatment programs for tramadol addicts allow the drug abusers to stay within the comfort of their own home, while attending counseling and therapy sessions at a treatment and recovery center multiple times per week. Outpatient treatment and recovery programs are often best for those individuals who do not have a very severe addiction to the drug and can handle being outside of a 24/7 rehab facility.

Peer-recovery organizations are traditional 12-step programs for drug addicts and include group programs for addicts to share their stories and receive support from individuals going through the same thing.

Treatment approaches in both inpatient and outpatient facilities focus on counseling and showing users how to re-shape their beliefs to live a drug free life. These types of rehab programs focus on life skills training to recognize poor choices and options for making better choices in the future.

It goes without saying that tramadol treatment and recovery programs are a necessity for those that abuse the drug. But, because rehab and treatment centers can be incredibly expensive, some don’t seek the help they need because of money. It’s clear that many friends and families have gone bankrupt seeking treatment for their loved ones who are undergoing an addiction problem.

In response to the opioid epidemic, the Food and Drug Administration, along with other government agencies are researching and taking important steps to tackle this debilitating problem. New medications are being developed, Health IT solutions are being initiated, and rehab financing and Medicaid coverage options are being re-evaluated.

It’s important to know that recovery is a life-long process and any setbacks or relapses are not indicative of failure. Rather, they are indicative that a new approach to treatment may be necessary. Just as addiction did not occur overnight, recovery will not be an overnight process as well. However, with repeated exposure to treatment and rehabilitation, tramadol abusers have a positive trajectory toward lifelong recovery.