If you, or someone you know, has been taking tramadol and wants to stop, an important consideration is how long tramadol withdrawal lasts. Tramadol is an opioid analgesic used to treat pain, and has seen a wide use for this purpose since it’s introduction in the United States in 1995. Like other opioids, tramadol will result in physical and psychological effects once its use is stopped. These withdrawal symptoms can serve as a barrier for individuals looking to quit using tramadol. Getting a better understanding of what tramadol is, what the withdrawal symptoms that result from quitting tramadol are, and how long those symptoms last can help individuals make an informed decision about the level of care they will need to transition off of the drug.
What is Tramadol?
Tramadol is an opioid analgesic used to treat moderate to severe pain. Tramadol is the generic name for this medication, but it may be sold under a variety of different brand names including Ultram, ConZip, and Rybix. A combination pill of acetaminophen and tramadol is also marked under the brand name Ultracet. Tramadol is distinct from many other drugs in the same class because it interacts with both opioid and serotonin receptors in the body. While this can increase its efficacy for treating certain types of pain, it can also present complications during tramadol withdrawal.
Tramadol is generally viewed as a relatively mild opiate analgesic, yet as with all opiates there is a risk of chemical dependency with tramadol. This risk was recognized by the Drug Enforcement Administration (DEA), which rescheduled tramadol as a Schedule IV controlled substance in light of its potential for abuse. In part, the rationale for rescheduling tramadol was due to the fact that very few individuals who were taking or prescribing tramadol recognized its potential for abuse. Up until tramadol was rescheduled by the DEA, it was the only uncontrolled opiate on the market.
Do You Have Withdrawal With Tramadol?
Many people mistakenly believe that tramadol has little or relatively minor withdrawal effects when compared with other opiates. It is true that opiates such as heroin or morphine interact with the body in a much more powerful way than tramadol. Tramadol is typically found in pill-form, with both normal and extended-release varieties available. While the interaction of tramadol in the body is not as pronounced as heroin or morphine, it is still present. Over time, this interaction can lead to a chemical dependency which will result in withdrawal symptoms once you stop taking tramadol. It is important to note that withdrawal symptoms can arise even when tramadol has been taken as prescribed. The key is that a chemical dependence on the drug has been cultivated. Once you have stopped taking tramadol, withdrawal symptoms will begin to manifest in a short period of time.
Symptoms of Tramadol Withdrawal
Withdrawal symptoms from tramadol are both similar and distinct from other opiate analgesics. This is due to the fact that while tramadol interacts with opioid receptors, it also interacts with an individual’s serotonin receptors. In a way, it functions like a selective serotonin reuptake inhibitor (SSRI). As with SSRI’s, abruptly stopping usage can result in a number of different negative reactions. Put another way, nearly all users who have developed a dependence on tramadol will experience typical opioid withdrawal symptoms. A portion of people will also experience withdrawal symptoms that aren’t typically seen with opiate withdrawal. These symptoms are especially important to be mindful of during the withdrawal process.
Common Withdrawal Symptoms
Some of the most common withdrawal symptoms associated with tramadol are also present with other opiates. Symptoms associated with opioid withdrawal are most commonly described as “flu-like”. Although these symptoms can be extremely uncomfortable for the individual experience them, they aren’t typically life-threatening. However, medical supervision when you stop taking tramadol is beneficial to avoid any complications associated with these symptoms such as dehydration.
- Excessive sweating
- Runny nose
- Excessive tear production
- Abdominal cramps
- Dilated pupils
Uncommon Withdrawal Symptoms
Some withdrawal symptoms are uniquely associated with tramadol in contrast with other opiates. These symptoms don’t manifest in all users going through tramadol withdrawal. A study done in the years following the introduction of tramadol on the market found that roughly 1 in 8 individuals would develop atypical withdrawal symptoms after quitting tramadol. However, the severity of these atypical symptoms of tramadol withdrawal highlights the importance of undergoing tramadol withdrawal under medical supervision.
- Extreme anxiety
- Panic attacks
- Numbness or tingling in one or more extremities
How Long do Tramadol Withdrawal Symptoms Last?
Withdrawal from tramadol is slightly different than from other commonly abused opiates such as heroin. Heroin is an opiate that interacts with the body quickly and powerfully. The resulting withdrawal effects come on suddenly as well, as the body reacts to the strong chemical dependency heroin creates. In contrast to this, tramadol is typically used as a medication to treat moderate or severe pain over time. As such, tramadol has a much more moderate interaction with the body than heroin. Often, tramadol is taken as an extended release tablet that slowly releases tramadol into the bloodstream throughout the day to deal with chronic pain.
While users coming off of tramadol will experience withdrawal effects similar to other opiates, this is usually the case when tramadol is stopped abruptly. In some situations, tramadol has been used to aid individuals detoxing off of fast-acting opiates like heroin as a way to minimize the withdrawal process. In these situations, tramadol is used in drug replacement therapy and then tapered off over time. Although the use of tramadol in drug replacement therapy is not as common as other drugs, such as methadone, it does highlight something important that can have an impact on the timeline for tramadol withdrawal. Most individuals who are prescribed tramadol will be slowly tapered off of the drug over a period of weeks or months. This tapering process is important to not only minimize the opioid withdrawal symptoms, but also to avoid any of the atypical withdrawal symptoms associated with tramadol.
In total, tramadol withdrawal typically takes around two weeks. Assuming that an individual stops taking tramadol abruptly, the initial onset of symptoms will begin within hours of the drug being broken down completely in the body. Depending on if the drug is an extended release capsule or not, this will be anywhere from four to twenty-four hours after the last dose. The initial symptoms will be similar to withdrawal from other opiates, with the onset of flu-like symptoms ranging in severity from moderate to severe. In most cases, these flu-like symptoms will begin to subside in 2-3 days. After this point, individuals detoxing from tramadol may continue to experience insomnia, restlessness, and anxiety that diminishes by the end of the second week.
The Importance of a Detox Program
There are some risks associated with tramadol withdrawal that make it necessary to be under medical supervision throughout the process. The atypical withdrawal symptoms associated with tramadol withdrawal can place the individual going through withdrawal in dangerous situations. Individuals going through withdrawal may have hallucinations and paranoia that accompany the already uncomfortable flu-like symptoms of opioid withdrawal. People suffering from these atypical symptoms may suffer from paranoid thoughts, and experience panic attacks and anxiety in the weeks that follow cessation. This can not only place the individual in potentially dangerous situations, but can also encourage users to return to tramadol use in order to stave off the most intense side effects of withdrawal.
Tramadol withdrawal should be done in a safe and compassionate setting. Not only must individuals going through tramadol withdrawal deal with the sometimes severe flu-like symptoms, but they must also sometimes deal with the psychological side effects associated with tramadol’s interaction with the body’s serotonin regulation. Undergoing tramadol withdrawal under medical supervision is essential to ensure that it is done safely and in a way that will minimize any atypical side effects you might experience. Additionally, undergoing the cessation of tramadol usage in a detox program will allow medical professionals to minimize the severity of the flu-like symptoms associated with opioid withdrawal. Individuals sometimes overlook the risks that these flu-like symptoms can pose, including dangerous levels of dehydration from persistent vomiting or diarrhea.
A final reason to pursue a medically supervised detox from tramadol is to reduce the risk of relapse. Although tramadol does not pose the same level of danger for a relapse that heroin does, it should still be avoided. Detoxing off of long-term tramadol usage in a medically controlled setting substantially reduces the risk of relapsing. Through medical management of the withdrawal symptoms associated with tramadol, individuals will be much more comfortable throughout the withdrawal process. In some cases, withdrawal symptoms for tramadol might be avoided entirely through a tapering process over a period of days or weeks.
While tramadol withdrawal may be uncomfortable, it is not considered life-threatening. Tramadol remains in wide use as an opiate analgesic to treat long-term or chronic pain. As such, cessation of tramadol has been well-documented. Still, there are risks associated with tramadol withdrawal. Typically, withdrawal symptoms subside after three days, but can persist for up to two weeks. In some situations individuals will develop atypical withdrawal symptoms that include powerful panic attacks, anxiety, hallucinations, and paranoia. Many of the more powerful side-effects of tramadol withdrawal are the result of an individual suddenly stopping the medication. For this reason, it is important to undergo tramadol withdrawal under medical supervision. This way, medical staff and therapists can monitor you to ensure that any withdrawal symptoms are promptly recognized and minimized to the extent they can be.Find hope. Find recovery. Begin a commitment to lifelong recovery today – for yourself, your friend, or for your loved one.
 Edward C Senay et al., “Physical Dependence on Ultram® (Tramadol Hydrochloride): Both Opioid-like and Atypical Withdrawal Symptoms Occur,” Drug and Alcohol Dependence 69, no. 3 (April 1, 2003): 233–41.