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Tramadol Abuse Signs, Symptoms and Addiction Treatment

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Tramadol is most often prescribed to patients with moderate or severe pain. As an opiate analgesic, tramadol affects the way the brain responds to pain in order to manage pain in patients. However, if used incorrectly, it can become habit-forming. Like most opiate medications, tramadol has a risk of abuse from those who are looking for a euphoric high. If a person abuses or becomes addicted to tramadol, he or she will need treatment to stop taking the drug.

Understanding Tramadol
prescription drug abuseTramadol is an opiate painkiller that can lead to addiction, overdose and other consequences when abused.

There are several different types of brand medications that contain Tramadol. According to the NLM, "tramadol extended-release tablets and capsules are only used by people who are expected to need medication to relieve pain around-the-clock."

Brand name medications that contain tramadol include: Ultram, Ultram ER, Ryzolt, Rybix ODT and Conzip

Tramadol is an opiate analgesic, which means that most of the rules of opiate-based medications apply to it.

However, tramadol is very strong as it is used to treat strong pain. People who take tramadol should be very careful with their doses and must not deviate from what their doctors have prescribed. The DOJ states that "retailers dispensed 43.8 million tramadol prescriptions in the U.S. in 2013."

"Tramadol is a synthetic 4-phenyl-piperidine analogue of codeine" (NCBI). It is part of the opioid family but does not come directly from the poppy plant. While tramadol is beneficial to those in severe pain, there are many important facts to know about the drug.

Signs and Symptoms of Tramadol Use

As tramadol is an opiate analgesic, it will make a person feel very relaxed after taking it. The use of tramadol can cause other side effects as well, such as:

  • Dizziness
  • Weakness
  • Headache
  • Insomnia
  • "Uncontrollable shaking of a part of the body" (NLM)
  • Mood swings
  • Heartburn
  • Nausea
  • Constipation
According to the NIDA Teen, "opioids attach to specific proteins called opioid receptors which are found in the brain, spinal cord, gastrointestinal tract, and other organs." This is why a person's stomach and other organs aside from just the brain might be affected by the drug. Even so, these reactions are not especially problematic, and your doctor can merely lower your dosage if you begin to feel them.

More Severe Effects Caused by Tramadol Include:

  • Fever
  • Seizures
  • Swelling in the face, hands, eyes, face, throat, and/or mouth
  • Agitation
  • Quickened heartbeat

Any of these side effects are a sign that something is wrong. You should get to the hospital or seek treatment immediately if you begin to experience them.

You Can Often Tell If a Person is Using Tramadol If He or She:

  • Is drowsy while being euphoric
  • Has difficulty concentrating
  • Is apathetic
  • Is weak or dizzy

It is important to remember that, like all other drugs, tramadol can sometimes have strong side effects and risks.

Risks Caused by Tramadol Use
There are inherent risks with taking tramadol, as with any drug. With tramadol, there is a high risk for "patients with previous histories of emotional disturbances or suicidal ideation or attempts" (FDA).
"Tramadol-related deaths have occurred" in patients with these medical histories. Because of this, your doctor must be very careful and ask questions about your past history with these issues. If you have battled with depression or suicide, your doctor will likely find a medication that will be better for you.

Other Risks Caused by Tramadol Use Are:

  • Serotonin Syndrome - This occurs when the body has too much serotonin. It often is caused by "high doses of tramadol" in combination with other drugs. Symptoms include "convulsions, hyperthermia, muscle rigidity and pain" (DOJ).
  • Seizures are rare when the medication is taken at the recommended dosage, but they can still occur.
  • Dependence
  • Tolerance
Tramadol Dependence
Because tramadol is an opiate, a person taking it risks issues with dependence. If someone becomes dependent on a drug, it means that he or she will experience physical and/or psychological symptoms when attempting to stop using it. This period is called withdrawal. Tramadol dependence can occur whether or not the person is abusing the drug.

The Symptoms of Tramadol Withdrawal Are:

  • Flu-like symptoms
  • Cravings
  • Restlessness
  • Nausea
  • Vomiting
  • Diarrhea
  • Muscle and bone pain

The DOJ states that "this type of withdrawal syndrome is encountered in about 90 percent of cases" and is more typical of other types of opiate withdrawal. However, "another withdrawal syndrome (encountered in about 10 percent for cases of tramadol withdrawal) is atypical of opioids."

This Type of Withdrawal is Characterized by These Symptoms:

  • Hallucinations
  • Paranoia
  • "Numbness and tingling in the extremities"
  • Confusion
  • Uncontrollable anxiety
  • Panic attacks
Tramadol Tolerance

According to the NCBI, "tolerance is defined as a decrease in pharmacologic response following repeated or prolonged drug administration." When someone takes tramadol for an extended amount of time, he or she will begin to feel that the same dosage of the drug does not produce the same effects. Because of this, many people will begin to up their dosages, taking more tramadol to feel the effects they want. If you are increasing your dosage of tramadol without the advice of a doctor, this is already a form of abuse.

Tramadol Abuse
People who abuse tramadol may do it for many different reasons. Someone might build up a tolerance to the effects and start taking more of the drug. Or the abuser might not be taking it from the advice of a doctor at all and could just be attempting to feel the strong euphoric high tramadol can give users. For whatever reason, tramadol is abused by many people and this abuse can have serious consequences.
Someone who takes tramadol with alcohol is also abusing the drug, as mixing the two can be very dangerous. Alcohol dependence or addiction is another condition doctors should check for before prescribing tramadol.
According to the FDA, it should be remembered that "abuse of Ultram [and other tramadol medications] can occur in the absence of true addiction and is characterized by misuse for non-medical purposes, often in combination with other psychoactive substances." However, abuse can often lead to addiction.
Tramadol Addiction

Tramadol is a habit-forming medication. While many people believe that they can abuse the drug without issue, there are many instances where individuals have become addicted to tramadol and other opiates. After taking the drug for a while, abusers begin to crave the euphoric feeling it gives them and will continue seeking out more of the drug no matter what the consequences.

If you are wondering whether or not you may be suffering from tramadol addiction, ask yourself these questions:

  • Has my use of tramadol caused me several problems at work, school, or home over the past year?
  • Even when tramadol is causing issues in my life, do I feel unable to stop taking it?
  • Do I become irritable when someone asks me about my tramadol use?
  • Do I use tramadol to feel happy or even normal when I used to find my life satisfaction in other ways?
  • Have I experienced severe symptoms when I've tried to stop taking tramadol?
  • Do I crave tramadol?
  • Do I feel like I need tramadol to get out of bed in the morning?
  • Am I beginning to feel apathetic about other aspects of my life that do not include tramadol?

If you answered yes to any of these questions, you may already be addicted to the drug. Tramadol addiction is very serious and does require treatment.

Tramadol Overdose

The FDA states that tramadol does have a risk of overdose with "serious potential consequences." Those consequences are:

  • Respiratory Depression
  • CNS Depression
  • Death
  • Coma

If you are unsure of whether or not someone has overdosed on tramadol, call 911 immediately and stay with the individual until help arrives. Usually the best way to tell if someone has overdosed on an opioid drug is to check the pupils. They will be decreased, almost to the size of a pinpoint (pinpoint pupils).

Other Symptoms That Indicate Tramadol Overdose Are:

  • Clammy Skin
  • Unconsciousness
  • Slowing of the Heartbeat
  • Weakening of the Muscles
  • Breathing Problems
  • Drowsiness
Prevalence of Tramadol Abuse

Tramadol is often abused by those looking to get high from the effects. Many people do begin to abuse the drug after starting out with the instructions of their doctors, but "tramadol is most commonly abused by narcotic addicts, chronic pain patients, and health professionals" (DOJ).

Tramadol abuse causes problems for not only the abusers but their loved ones as well. Tramadol is listed as a Schedule IV drug which means that it does have some potential for abuse but that it still has been found to be of medical use.

Other Statistics Concerning the Prevalence of Tramadol Abuse Are:

  • "An estimated 16,251 emergency department visits were related to tramadol nonmedical use in 2010 and an estimated 20,000 related nonmedical visits in 2011" (DOJ).
  • "3.2 million people in the U.S. aged 12 or older" were reported to have used tramadol "for nonmedical purposes in their lifetime" by a study in 2012.
  • There were 13,067 tramadol exposures reported in 2012 according to the American Association of Poison Control Centers.
Treatment for Tramadol Abuse and Addiction

Someone who has been chronically abusing tramadol will need treatment in order to get better. Tramadol abuse and addiction can cause many issues in a person's life and, according to the NIDA, ideal addiction treatment should:

  • "Help the individual stop using drugs"
  • Set them on the path towards a "drug-free lifestyle"
  • Allow them to "achieve productive functioning in the family, at work, and in society

After the issues that drug addiction causes, individuals may be jobless, homeless, and/or alienated from their friends and family. It is important for treatment plans to help patients by incorporating "many components, each directed to a particular aspect of the illness and its consequences."

Tramadol Detox
As stated by the NIDA Teen, tramadol addicts should first undergo "medically supervised detoxification to help reduce withdrawal symptoms." This does not cure the addiction, but it is an important part of addiction treatment as individuals are able to focus on their recoveries instead of on their withdrawals.
Because of the risk for intense withdrawal symptoms that are atypical of other opioid drugs, those detoxing from tramadol may want to consider inpatient detox. There will be a 24-hour medical staff to watch over these patients who will likely need extra care. Medication will also be given to help curb the patients' symptoms.

Some of the General Types of Opioid Medications Used in Detox Are:

  • Methadone- a synthetic medication often used for heroin addiction but can be used for other types of opioid addictions as well
  • Naltrexone- a medication that "only someone who has already stopped using opioids can take," as it causes severe withdrawal symptoms when a person continues to abuse opioid drugs
  • Buprenorphine- a medication that can be prescribed by a physician but is also used in detox clinics.
What Does Tramadol Addiction Treatment Entail?

A person who is addicted to tramadol will need further treatment after detox. Depending on the person's needs, he or she may decide to attend inpatient treatment or outpatient treatment. Patients should choose the type of facility that best fits all of their needs (not just the ones associated with drug abuse); however, "for residential or outpatient treatment, participation for [fewer] than 90 days is of limited effectiveness" (NIDA). Generally, it has been found that "treatment lasting significantly longer is recommended for maintaining positive outcomes."

Someone who is addicted to tramadol, in addition to medication, will need therapy as treatment. Many addiction treatment facilities continue with medication after detox in order to help patients focus on their therapy and control cravings. Therapy is important because it helps patients change the way they think about their abuse of tramadol.

Tramadol is a highly effective drug for the treatment of severe pain. Many patients are able to use it with the guidance of their doctors and are weaned off the medication successfully when they need to be with little effort. However, there are cases where abuse, addiction, and the general risks of taking medication can make the use of the drug problematic and dangerous.


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