For people living with a painful medical condition that disrupts their daily life, tramadol may seem like a life-saving medication, one that allows them to resume normal function. But tramadol is also considered an opioid analgesic, which means that there are several risks inherent in taking this drug, especially when it’s used improperly. Tramadol uses and side effects need to be well understood by anyone taking this medication in order to avoid any serious issues as well as the potential for abuse and addiction.
Tramadol is the generic name for this medication; the most common brand name is Ultram®. Tramadol is usually prescribed for patients who have moderate to severe pain caused by a medical condition such as osteoarthritis. Depending on the severity and duration of the pain, tramadol can be taken along with other opioid medications or pain relievers such as ibuprofen and acetaminophen. In 2016, there were 43.6 million tramadol prescriptions in the United States, with a slight decrease to 41 million the following year.
Available in both fast-acting and extended-release tablets, tramadol is typically prescribed at low doses when a patient first begins taking the medication, and the doctor can gradually increase it depending on how the patient responds to treatment. Generally, patients should take a maximum of 400 mg per day, or 300 mg for people older than 75. Tramadol is most effective when used at the first signs of pain and it can lose its efficacy if taken over a long period of time.
Tramadol works by changing the brain’s response to pain. Like other opioid analgesics, the drug affects the brain’s opioid receptors to reduce the sensation of pain. Tramadol also is thought to reduce pain by inhibiting the brain’s neurotransmitters for serotonin and norepinephrine. The overall effect relaxes the brain and body while creating a heightened state of pleasure that boosts a patient’s emotional state.
It’s that potential for an opioid high that changed how tramadol is used and prescribed. When tramadol hit the market in 1995, it was an uncontrolled substance and was not even categorized as an opiate. But abuse of the drug due to its opioid effects prompted the U.S. Food and Drug Administration (FDA) to develop stricter usage guidelines and add warning labels to the packaging. In 2014, the FDA changed tramadol’s designation to a Schedule IV controlled substance. That means there is a recognized potential for abuse, although not as high as drugs with higher classifications such as illicit substances such as heroin or cocaine, or other medications such as oxycodone. That doesn’t mean, however, that you should underestimate the potential for short-term and long-term side effects of tramadol, especially if the drug is being abused.
Tramadol Side Effects
Because it has such potency, there are several tramadol side effects to watch out for when taking this pain medication. Some of the common side effects that may be experienced:
- Nausea or vomiting
- Dizziness (or vertigo in advanced cases)
- Abdominal pain
- Dry mouth
- Diarrhea (older adults may experience constipation)
- Feelings of agitation or anxiety
- Lack of appetite
There are other side effects that, while rare, can be more serious. These include decreased breathing rate, seizures, suicidal thoughts or attempts, sleep apnea, low blood pressure, gastrointestinal problems, heart arrhythmia, and severe allergic reactions. Patients may also experience negative side effects if they take tramadol with benzodiazepines, alcohol, or illicit drugs that have a sedating effect. When taken at high dosages, tramadol combined with monoamine oxidase (MAO) inhibitors or selective serotonin reuptake inhibitors (SSRIs) can trigger muscle stiffness, hyperthermia, or convulsions. Recent studies indicate there could be links between tramadol use and increased risk of hip fracture, myocardial infarction, and mortality, although researchers caution that much more data needs to be collected and studied to prove causation, especially with regards to increased mortality risk.
Specific tramadol side effects in women focus on females who are pregnant or nursing. There is the potential for opioid withdrawal in infants whose mothers used tramadol during pregnancy, and the drug can also be passed through breast milk. For those reasons, women in these circumstances must talk with their doctors about the risks and benefits of using tramadol. Some males use tramadol off-label for premature ejaculation, but tramadol side effects for men in these cases can include a higher risk of sexual dysfunction, such as erectile disorder or decreased satisfaction.
Finally, as with other opioids, long-term side effects of tramadol can include a higher risk of abuse, which can lead to drug tolerance and dependency, and, in the worst-case scenario, addiction. In cases of abuse or addiction, tramadol withdrawal treatment is highly recommended in order to clear the drug from the body and begin the steps towards recovery.
Abuse, Addiction, and Tramadol Withdrawal Treatment
In 2016, 1.6 million Americans age 12 and older abused tramadol, according to the National Survey on Drug Use and Health. Like other opioids, it presents an inherent risk of abuse and addiction, especially for people who already struggle with a substance use disorder with alcohol or illegal drugs.
It’s critical that anyone abusing tramadol not try to quit cold turkey on their own, as that can trigger withdrawal symptoms. Similar to other opioids, people in withdrawal may experience fever and sweating, runny nose, nausea, aching muscles, drug cravings, and restlessness. Unlike other opioids, tramadol withdrawal may also lead to hallucinations, panic attacks, anxiety, paranoia, suicidal ideation, and numbness/tingling in the arms and legs.
Because of the nature and severity of these symptoms, tramadol withdrawal treatment should be undertaken at a facility where experienced medical professionals can carefully monitor each patient’s progress. Clear Sky Recovery offers safe, comfortable detoxification from tramadol and other substances with the use a medically based and clinically sound ibogaine treatment plan. Contact us to learn more about our individualized treatment program.
Dr. Sola is one of the world’s leading experts in medically-based ibogaine treatment; he has more clinical experience with safe and effective ibogaine administration than any other M.D. in the world today.