Tramadol Withdrawal and Detox
By The Recovery Village Ridgefield
Editor Jonathan Strum | Medically Reviewed By Dr. Deep Shukla, PhD, MS
Last Updated: May 30, 2023
Editorial Policy | Research Policy
Because of its low potential for misuse and milder side effects, Tramadol is often used as an alternative to opioids for the treatment of chronic pain. Tramadol binds to opioid receptors like morphine and other opioids to produce its pain-relieving effects, but it is less potent. Its relatively weak effects on opioid receptors are responsible for its low addiction potential. To produce its pain-relieving effects, tramadol also reduces the reabsorption of serotonin and norepinephrine neurotransmitters.
Tramadol misuse may result in the development of physical dependence on the drug. When someone has a physical dependence, ending use or even lowering the dosage can result in adverse withdrawal symptoms. This is because the neurons in the brain adapt to the intake of the drug, and ending use results in negative feedback in the form of withdrawal symptoms. The symptoms of tramadol withdrawal can be very unpleasant, and treatment at a detox center may be necessary to relieve symptoms.
Symptoms of Tramadol Withdrawal
In most cases, tramadol withdrawal symptoms are similar to withdrawal symptoms from other opioids. These symptoms are generally very unpleasant but not life-threatening. Some of the physical side-effects of tramadol withdrawal include:
- Nausea and vomiting
- Abdominal cramps
- Muscle and bone pains
- Excessive sweating
- Watery discharge from eyes and nose
Some of the psychological and behavioral symptoms of tramadol withdrawal include:
- Anxiety and restlessness
Ending tramadol use can also cause atypical withdrawal symptoms that are unlike those observed with opioids. These symptoms are presumed to be caused by other properties of tramadol, such as its inhibition of neurotransmitters. Atypical symptoms include:
- Visual and auditory hallucinations
- Extreme anxiety
- Panic attacks
- Psychosis involving paranoia, delusions, depersonalization, derealization and confusion
- Unusual sensory experiences involving numbness and tingling
Tramadol Withdrawal Timeline
There are no scientific studies that have examined the exact duration of tramadol withdrawal symptoms. Most of the information that exists is based on case reports involving a single patient.
In most cases, tramadol withdrawal symptoms last between 3–10 days, like many opioids. These symptoms generally appear within the first 12–48 hours after ending tramadol use. In many cases, the withdrawal symptoms are relatively mild and resolve themselves within 3–4 days without any medication. However, more severe symptoms may occur, especially when long-term use is suddenly ended. These symptoms generally subside within 7–10 days and medication may be used to help throughout withdrawal. In cases involving atypical symptoms, hallucinations and delusions may persist beyond this initial period of one week.
Dangers of Tramadol Withdrawal
In almost 90% of cases, individuals develop typical symptoms during tramadol withdrawal. These symptoms are generally not life-threatening but are very unpleasant, resembling symptoms of severe flu.
In the remaining 10% of cases that exhibit atypical symptoms, there is a potential for self-harm or harm to others. These severe symptoms are likely to arise when quitting tramadol cold-turkey. People should consider treatment at a detox facility to help cope with these unpleasant and sometimes life-threatening withdrawal symptoms.
Tramadol Detox Process
Detoxification from tramadol involves eliminating the drug from the body, and the process can lead to unpleasant and severe withdrawal symptoms. This may lead to relapse, but treatment at a detox facility can help reduce the risk. Detoxification at a detox facility usually takes around 7–10 days.
Treatment generally involves tapering the dose of tramadol while treating withdrawal symptoms as they arise. Opioid substitution has also been used to relieve withdrawal symptoms. Opioid substitution involves the temporary use of other opioids, such as buprenorphine, to reduce the severity of withdrawal symptoms. Since tramadol produces its effects by inhibiting neurotransmitters, however, opioid substitution may not always be effective. In these cases, treatment involves gradually reducing the dosage of tramadol.
Medically Assisted Detox
Medically assisted detox may be done at an outpatient or an inpatient detox center. Inpatient detox should be done at a center that allows for 24/7 supervision by medical staff. Treatment at a detox facility uses medications and behavioral approaches to help the individual cope with withdrawal symptoms. Detoxification often involves tapering the dose of tramadol and managing symptoms as they emerge. The intensive care provided at an inpatient detox allows for the careful monitoring of these symptoms and the administration of drugs.
Ending tramadol use, especially long-term use, may result in severe withdrawal symptoms. Gradually tapering the dose of tramadol before stopping use can help reduce the severity of withdrawal symptoms. Tapering involves following a schedule that reduces the administration of the drug (by 10–25%) at regular intervals (1–5 days). Although a slow taper may not relieve withdrawal symptoms entirely, it is likely to make the symptoms more manageable.
The taper schedule may depend on the severity of tramadol dependence and the physiological characteristics of the patient. Physiological characteristics are influenced by a variety of factors, including genetics, age and lifestyle.
Finding a Tramadol Detox Center in Washington or Oregon
Choosing a detox center can be difficult since many facilities provide similar services. Because withdrawal symptoms can vary from person to person, it is necessary to find a treatment center that provides individualized care. The treatment center must also provide evidence-based treatments that are delivered by well-trained and experienced medical professionals.
The Recovery Village Ridgefield Detox Center
5114 NE 94th Ave Vancouver, WA 98662
If you or a loved one is concerned with tramadol misuse or co-occurring mental health issues, The Recovery Village Ridgefield can help. We have a medical detox facility located a short drive from the Portland, Oregon metro area. Contact us today to learn more about detox programs and treatment options that can work well for your situation.
Our Recovery Advocates are ready to answer your questions about addiction treatment and help you start your recovery.
Senay, Edward C.; et al. “Physical dependence on Ultram® (tramadol hydrochloride): both opioid-like and atypical withdrawal symptoms occur.” Drug and alcohol dependence, April 2003. Accessed August 28, 2019.
Drug Enforcement Administration. “Tramadol.” October 2018. Accessed August 28, 2019.