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How to Cope With The Symptoms of Tramadol Withdrawal

Medically reviewed by Dr. Po-Chang HsuFebruary 10, 2025
Written by
On February 10, 2025

Table of Contents

Key Points

  • Tramadol withdrawal involves both opioid withdrawal symptoms and unique effects related to serotonin, typically beginning within 24 hours of the last dose.
  • Professional help improves outcomes: Medical supervision provides safer withdrawal through proper tapering schedules and symptom management medications.
  • Various coping strategies exist: Managing withdrawal involves multiple approaches, including proper hydration, nutrition, gentle exercise, and stress reduction techniques.
  • Recovery support is crucial: Whether through outpatient care, counseling, or support groups, having proper assistance helps ensure successful withdrawal and reduces relapse risk.

Managing Tramadol withdrawal requires understanding, preparation, and support. When someone stops taking Tramadol, they may experience physical and emotional changes as their body adjusts to functioning without the medication. While withdrawal symptoms can feel overwhelming, many people have successfully moved through this challenge with the proper addiction/medical guidance and self-care techniques.

What is Tramadol?

Tramadol is a prescription opioid medication used to treat moderate to severe pain.[1] This medication works by changing how the brain and nervous system respond to pain signals while also affecting serotonin and norepinephrine levels in the brain. Unlike some stronger opioids, Tramadol offers a dual mechanism of action that makes it unique among pain medications.

Originally developed in Germany in the 1970s, Tramadol was introduced to the United States in 1995 under the brand Ultram.[2] While initially considered to have a lower risk of dependence compared to other opioids, experience and research have shown that physical dependence and addiction can develop, particularly with prolonged use or higher doses. The medication comes in several forms, including immediate-release and extended-release tablets.

Prescribers and healthcare teams often prescribe Tramadol for both acute and chronic pain conditions, ranging from post-surgical pain to ongoing back problems. Like other opioid medications, Tramadol requires careful monitoring and should be taken exactly as prescribed. The medication’s effects typically begin within an hour or two. They can last four to six hours for immediate-release formulations, while extended-release versions relieve longer-lasting pain.[3]

Is Tramadol Abused?

Yes, Tramadol abuse does happen, with people taking higher doses than prescribed, using it more frequently than directed, or taking it without a prescription. Some crush and snort the tablets or combine them with other substances to intensify the effects. The medication’s ability to create feelings of euphoria and relaxation, particularly at higher doses, contributes to its potential for misuse.

The Drug Enforcement Administration classified Tramadol as a Schedule IV controlled substance in 2014 due to growing concerns about its abuse potential.[4] Certain populations may be at higher risk for Tramadol abuse, including those with a history of substance use disorders, chronic pain conditions, or mental health challenges.

Can You Overdose on Tramadol?

Yes, Tramadol overdose can be a serious and potentially life-threatening emergency that requires immediate medical attention.[5] An overdose can occur when someone takes too much of the medication at once, combines it with other substances, or has an adverse reaction even at prescribed doses. The risk increases significantly when Tramadol is taken with other central nervous system depressants like alcohol, benzodiazepines, or other opioids. Signs of overdose include severe drowsiness, difficulty breathing, pinpoint pupils, seizures, loss of consciousness, and, in severe cases, respiratory failure or cardiac arrest.

Due to Tramadol’s unique mechanism of action affecting both opioid receptors and serotonin levels, it can also cause serotonin syndrome. This dangerous condition may occur even without taking doses high enough to cause traditional opioid overdose symptoms.[6]

What Are the Signs of Tramadol Withdrawal?

The sudden discontinuation of Tramadol can lead to various withdrawal symptoms, even when taken as prescribed. Withdrawal symptoms typically begin within 24 to 48 hours:[7]

  • Physical discomfort and pain: Muscle aches, joint pain, and overall body discomfort often emerge as the medication leaves the system. Many people describe feeling like they have a severe case of the flu during this period.
  • Sleep disturbances: Changes in sleep patterns commonly occur, including insomnia, vivid dreams, and night sweats. These disruptions can affect energy levels and mood throughout the withdrawal process.
  • Gastrointestinal symptoms: Nausea, vomiting, diarrhea, and loss of appetite frequently appear during withdrawal. These symptoms can lead to dehydration if not properly managed.
  • Mood changes: Anxiety, irritability, depression, and mood swings are common emotional responses. These feelings can be intense but typically improve as the body adjusts.
  • Cognitive effects: Difficulty concentrating, confusion, and memory issues may occur. Some people report feeling mentally foggy or disconnected during this time.
  • Physical reactions: Sweating, tremors, goosebumps, and temperature fluctuations are typical responses as the body works to reestablish balance without the medication.

Managing Withdrawal Discomfort

While going through Tramadol withdrawal, several strategies can help minimize physical and emotional discomfort. Working with a doctor to create a tapering plan often provides the safest approach, allowing the body to adjust gradually rather than stopping abruptly. Staying well-hydrated, maintaining good nutrition, and getting adequate rest create the foundation for managing withdrawal symptoms effectively.

  • Movement and light exercise: Taking short walks or doing gentle stretches can help reduce muscle aches and improve mood. Even simple activities like light yoga or tai chi may ease physical tension.
  • Comfort measures: Warm baths, heating pads, and comfortable clothing can help with muscle aches and chills. Creating a calm environment with minimal stimulation often helps with anxiety and restlessness.
  • Sleep hygiene: Establishing a consistent bedtime routine, keeping the bedroom cool and dark, and avoiding screens before bed can help improve sleep quality during withdrawal.
  • Nutrition support: Eating small, frequent meals with easily digestible foods helps manage nausea. Foods rich in nutrients support the body’s healing process.
  • Stress management: Practicing relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation can help manage anxiety and emotional symptoms.
  • Support system: Connecting with trusted friends, family members, or support groups provides emotional comfort and practical assistance during challenging moments.

 

Remember that withdrawal symptoms are temporary, though they may feel intense. Working closely with healthcare providers ensures access to appropriate medical support and medications to help manage specific symptoms if needed.

Does Tramadol Withdrawal Require Professional Help?

Professional assistance during Tramadol withdrawal often provides the safest and most effective path to recovery. A doctor can assess individual circumstances, create a personalized tapering schedule, and monitor progress throughout the withdrawal process. Without proper medical supervision, some people may experience severe or prolonged withdrawal symptoms that could lead to complications.

Several factors influence whether someone needs professional help, including the time on Tramadol, typical dosage, overall health status, and co-existing conditions. Those taking high doses or who have been using Tramadol for extended periods typically benefit most from medical supervision. A doctor may prescribe supportive medications to manage specific withdrawal symptoms and ensure safety throughout the process.

Treatment options range from outpatient care with regular check-ins to intensive inpatient programs. Medical professionals can help determine the most appropriate level of care based on individual needs and risk factors. Some people may benefit from counseling or therapy during this time to address any underlying pain management needs or develop new coping strategies. The key is finding the right balance of support to ensure a safe and successful transition off the medication.

Don’t Struggle Alone With Tramadol Addiction and Withdrawal

Recovery from Tramadol addiction and withdrawal becomes more manageable with proper support and guidance. Many doctors, counselors, and support groups understand the challenges of opioid withdrawal and can help you create a personalized recovery plan. Taking the first step toward getting help might feel daunting, but reaching out can provide relief, professional guidance, and connection with others who have successfully navigated similar challenges. Help is available 24 hours a day through addiction helplines, where compassionate specialists can connect you with appropriate local resources and treatment options.

Medical Content Writer

Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.

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Frequently Asked Questions About Tramadol Withdrawal

The withdrawal timeline varies for each person experiencing Tramadol withdrawal symptoms. Most experience acute opioid withdrawal symptoms for five to seven days, with physical and mental health symptoms peaking between days three and five. Serotonin and norepinephrine imbalances can cause mood swings and flu-like symptoms to persist. Some people develop post-acute withdrawal syndrome (PAWS), where symptoms return periodically over several months, though with decreasing intensity.

Yes, abruptly stopping this painkiller can be life-threatening. Medical professionals recommend tapering to prevent severe withdrawal symptoms, including seizures and panic attacks. Physical dependence on Tramadol affects both opioid receptors and neurotransmitters. Treatment options may include medications like buprenorphine or clonidine to manage detox symptoms. The risk of tramadol addiction and relapse increases without proper medical detox support.

Anxiety and body aches are the most frequently reported symptoms of tramadol withdrawal. People often experience muscle aches, runny nose, and flu-like symptoms as opioid withdrawal syndrome develops. These physical and psychological side effects reflect the medication’s impact on both traditional opioid and serotonin reuptake systems. The intensity varies based on the length of use and the last dose amount.

Yes, PAWS symptoms can resurface even after initial detoxification. These episodes often involve mood swings, cravings, and chronic pain. Healthcare providers may recommend outpatient treatment programs, support groups, or addiction treatment to manage recurring symptoms. While PAWS episodes typically become less frequent over time, they may persist for months during tramadol dependence recovery.

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[1] Tramadol (Oral Route) Description and Brand Names – Mayo Clinic. (n.d.). Www.mayoclinic.org. https://www.mayoclinic.org/drugs-supplements/tramadol-oral-route/description/drg-20068050 on January 27, 2025

[2] Yusef Progler. (2025). Drug addiction in Gaza and the illicit trafficking of tramadol. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 15(3), 185. https://pmc.ncbi.nlm.nih.gov/articles/PMC3082799/ on January 27, 2025

[3] How long does it take for tramadol to start working? (n.d.). Drugs.com. https://www.drugs.com/medical-answers/long-tramadol-start-working-3553891/ on January 27, 2025

[4] Federal Register :: Request Access. (n.d.). Unblock.federalregister.gov. https://www.federalregister.gov/documents/2014/07/02/2014-15548/schedules-of-controlled-substances-placement-of-tramadol-into-schedule-iv on January 27, 2025

[5] Aliasghar Manouchehri, Zahra Nekoukar, Abdollah Malakian, & Zakaria Zakariaei. (2023). Tramadol poisoning and its management and complications: a scoping review. Annals of Medicine and Surgery, 85(8), 3982–3989. https://pmc.ncbi.nlm.nih.gov/articles/PMC10406095/ on January 27, 2025

[6] Takeshita, J., & Litzinger, M. H. (2009). Serotonin Syndrome Associated With Tramadol. The Primary Care Companion to the Journal of Clinical Psychiatry, 11(5), 273. https://pmc.ncbi.nlm.nih.gov/articles/PMC2781045/ on January 27, 2025

[7] Sidana, A., Domun, I., & Arora, P. (2019). Tramadol withdrawal psychosis. Indian Journal of Psychiatry, 61(6), 655. https://pmc.ncbi.nlm.nih.gov/articles/PMC6862981/ on January 27, 2025

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