Tramadol is often regarded as a relatively weak and safe opioid with a low potential for abuse and addiction. For this reason, some people only realize that they’ve become dependent on it once they experience uncomfortable tramadol withdrawal symptoms when trying to quit their medication.
Contrary to popular belief, tramadol isn’t as innocent as it seems. Due to its dual-acting mechanism, this drug sometimes causes symptoms that aren’t typical for opioid withdrawal. This can make tramadol detox even more challenging than that of traditional opioids.
What Is Tramadol and How Does it Work?
Tramadol is a synthetic opioid used to treat moderate to severe pain that cannot be relieved by non-opioid painkillers, such as aspirin. Most commonly, it is sold under the following brand names:
- Ultram®
- ConZip®
- QDOLO®
- Ryzolt®
Like buprenorphine and tapentadol, tramadol is considered an atypical opioid. It differs from conventional opioids because it is also a serotonin and norepinephrine reuptake inhibitor (SNRI).
Not only does tramadol interact with opioid receptors to interrupt the transmission of pain signals between the body and the brain, but it also prevents serotonin and norepinephrine reuptake. In other words, it acts as both an analgesic and an antidepressant.
Tramadol is classified as a Schedule IV controlled substance, meaning it has a relatively low potential for abuse and dependence compared to most other opioids. As one of the weakest opioids, it is often regarded as a safe medication.
However, tramadol can still induce euphoria and lead to tolerance, dependence, and addiction, much like any other opioid. Although anyone who uses it can develop an addiction to tramadol, taking it precisely as prescribed can minimize these risks.
Risks and Dangers of Taking Tramadol
Although many people see tramadol as a safer alternative to traditional opioids due to its lower potential for abuse and addiction, the greatest risk is tramadol addiction.
In 2021, it was the fourth most commonly misused prescription pain reliever among Americans, and it’s no news that opioid abuse increases the risk of opioid addiction.
Tramadol can also cause life-threatening breathing problems. However, as a dual-acting opioid, it can also lead to serotonin syndrome, which can be fatal if left untreated. Because of this, you should never take it with other drugs containing serotonin, such as antidepressants.
Moreover, long-term use of tramadol is associated with seizures, as well as Parkinson’s and Alzheimer’s disease, among other neurological disorders.
Most Common Tramadol Side Effects
Like any medication, tramadol can also cause various side effects, ranging from mild to severe and potentially lethal.
The most common tramadol side effects include:
- Constipation
- Dizziness
- Dry mouth
- Sweating
- Fatigue
- Nausea
- Vomiting
- Appetite loss
- Itching
- Stomach ache
Tramadol Withdrawal Symptoms
Tramadol withdrawal symptoms occur when people dependent on this drug quit or reduce tramadol use.
If you take tramadol regularly, your body will eventually become accustomed to it, leading you to build up tolerance to the medication. Tolerance occurs because tramadol stimulates the production of opioid receptors. Over time, your usual tramadol dose may no longer be sufficient, and you may not feel the drug’s effects without increasing it.
Tolerance is a sign of a physical dependence on the medication. If you suddenly stop taking tramadol or take a lower dose than usual after becoming dependent on it, you’ll experience physical and psychological tramadol withdrawal symptoms.
Tramadol withdrawal differs from usual opioid withdrawal in that it can produce two types of symptoms—typical and atypical—due to the drug’s dual mechanism of action.
Typical Tramadol Withdrawal Symptoms
The most common symptoms include:
- Appetite loss
- Body aches
- Chills
- Cravings
- Diarrhea
- Goosebumps
- Insomnia
- Mood swings
- Muscle pain
- Nausea
- Restlessness
- Stomach pain
- Sweating
- Vomiting
Atypical Withdrawal Symptoms
While 90% of tramadol users experience typical withdrawal symptoms after abruptly quitting the drug, 10% of people going through tramadol withdrawal suffer from atypical withdrawal symptoms, including:
- Confusion
- Hallucinations
- Intense anxiety
- Panic attacks
- Depersonalization
- Derealization
- Paranoia
- Numbness and tingling in hands and feet
In very rare cases, tramadol withdrawal can also induce psychosis.
Since tramadol withdrawal can be hard to bear and may lead to relapse and a potentially fatal overdose, you should never attempt to quit this medication on your own.
Tramadol Withdrawal Timeline
The tramadol withdrawal timeline varies from one person to another, as it largely depends on various factors, including but not limited to:
- Tramadol use duration
- Method of tramadol use (pill, injection, etc.)
- Frequency of tramadol use
- Tramadol dose
Nonetheless, for most people, the tramadol withdrawal timeline looks something like this:
Days 1–3
Tramadol withdrawal symptoms usually begin within the first 24 hours after the last dose.
During this time, you can expect to start experiencing nausea, sweating, and other physical symptoms that indicate that your body is detoxing from tramadol. As your body eliminates the drug, you may also begin to experience intense tramadol cravings.
Usually, tramadol withdrawal symptoms peak around day 3.
Days 4–8
After reaching their peak, tramadol withdrawal symptoms begin to subside and usually fade within 5–8 days after the last dose.
Still, you may experience strong cravings for tramadol, sleep problems, confusion, anxiety, and other psychological withdrawal symptoms.
Days 9+
In most cases, physical withdrawal symptoms disappear within the first week after quitting tramadol.
However, psychological tramadol withdrawal symptoms, such as depression, cravings, and anxiety, may persist or become even more intense, increasing the risk of relapse.
How Long Do Tramadol Withdrawal Symptoms Last?
Typical tramadol withdrawal symptoms usually last 5–8 days.
However, the duration of these symptoms may vary based on how long, at what doses, and how frequently you’ve been using tramadol. Individual factors, such as your liver health, metabolism, age, and overall health, may also affect this. The healthier your body is and the faster it breaks down substances, the quicker your tramadol withdrawal symptoms should pass.
How long these symptoms last also depends on whether you’re receiving any treatment for tramadol withdrawal.
Tramadol Post-Acute Withdrawal Syndrome (PAWS)
| Overview | |
| Occurrence | Affects ~90% of long-term opioid users |
| Duration | Symptoms may last 1–2 years or longer depending on individual factors |
| Highest Relapse Risk | During the first 12 months of abstinence |
| Common Symptoms | Anxiety, depression, cravings, insomnia, mood swings, cognitive fog |
| Symptom Pattern | Unpredictable “waves” that can re-emerge without warning |
Around 90% of recovering opioid addicts experience some level of post-acute withdrawal syndrome (PAWS), and tramadol PAWS is characterized by persistent withdrawal symptoms.
While these symptoms subside for most people in more or less a week, some experience them for weeks, months, and even years after quitting tramadol.
Post-acute withdrawal syndrome can have severe effects on mental illnesses such as depression, anxiety, and bipolar disorder. Besides the effects on mental health, PAWS can also cause:
- Attention deficit
- Interruptions to sleeping patterns
- Indifference
- Lethargy
- Loss of appetite
- Mood swings
By negatively affecting your mental and physical well-being, PAWS can significantly increase the risk of relapse.
How to Manage Tramadol Withdrawal Symptoms
The most effective way to manage tramadol withdrawal symptoms is to seek medical help.
While certain over-the-counter medications can help you cope with withdrawal symptoms, you should never attempt withdrawal from tramadol without medical supervision. Otherwise, you may be at increased risk of relapse. It’s not uncommon for people to resume opioid use to soothe the pain associated with withdrawal symptoms.
Since abstinence from drugs reduces your tolerance to them, relapse is extremely dangerous and could lead to a potentially fatal opioid overdose. Because of this, it’s in your best interest to seek professional tramadol withdrawal treatment.
More often than not, your doctor will suggest tapering off tramadol to reduce the severity of tramadol withdrawal symptoms. Once you’re ready to quit tramadol, they will create a tapering schedule based on your needs, the extent of tramadol use, and your health condition. It may take several weeks to several months to safely get off tramadol.
How to Detox From Tramadol
To detox from tramadol safely and effectively, you should do so in a medical setting. Quitting tramadol at home—especially “cold turkey”—can intensify the severity of tramadol withdrawal symptoms.
Simply put, tramadol detox is the process of clearing out the drug from your body. As your body tries to cope with the absence of the drug after becoming dependent on it, you will experience tramadol withdrawal symptoms.
Rapid detox is a medical treatment that involves administering opioid antagonist drugs to quickly eliminate tramadol from the body while the patient is sedated. However, this treatment does not guarantee full recovery from tramadol addiction
Accelerated Neuro-Regulation (ANR) is an opioid addiction treatment that doesn’t simply clear opioids out of the system but restores balance in the endorphin-receptor system.
Tramadol Rapid Detox vs. ANR Treatment
The main difference between tramadol rapid detox and the ANR treatment is that tramadol rapid detox can alleviate withdrawal symptoms, but it doesn’t treat the root cause of tramadol dependency—the chemical changes in the brain caused by opioid use. Unlike ANR, it doesn’t eliminate the risk of relapse.
While its inability to actually treat dependency is arguably the biggest disadvantage of rapid detox, it isn’t the only one: it can also lead to various side effects, such as renal failure.
Meanwhile, ANR is a safe and comprehensive opioid addiction treatment that doesn’t stop at tramadol detox.
Unlike rapid detox, it tackles the underlying causes of dependency and restores your brain to its pre-addiction state by re-regulating the endorphin-receptor system. By addressing the underlying cause of tramadol addiction, ANR negates the risk of relapse and persistent withdrawal symptoms.
Here are other differences between ANR and rapid tramadol detox:
Key Takeaways
If you or someone you love is looking to detox from tramadol safely and effectively, remember that the best thing to do is seek professional help for tramadol withdrawal and detox.
Now, let’s go over the key points we covered:
- Tramadol is a synthetic opioid and SNRI that is less potent than most typical opioids but can still lead to abuse and addiction.
- Tramadol withdrawal symptoms can be typical (e.g., muscle pain, sweating, nausea, etc.) or atypical (confusion, hallucinations, paranoia, etc.).
- Although tramadol withdrawal symptoms usually fade away within about a week, some people experience persistent symptoms for several weeks or months. This is known as post-acute withdrawal syndrome (PAWS).
Tramadol Withdrawal and Detox FAQ
The most common withdrawal symptoms of coming off tramadol are nausea, mood swings, insomnia, diarrhea, muscle aches, and tramadol cravings. Tramadol withdrawal can also manifest in atypical symptoms, such as hallucinations, extreme anxiety, panic attacks, and paranoia.
In most cases, you should taper off tramadol. It can increase your chances of successfully detoxing from tramadol by reducing the severity and duration of tramadol withdrawal symptoms.
Quitting tramadol cold turkey is unsafe. It can cause severe withdrawal symptoms, such as nausea, insomnia, anxiety, and even hallucinations. Furthermore, it greatly increases the risk of relapse and overdose due to lost tolerance. Instead, a medically supervised taper or treatments like ANR are safer, easing withdrawal and improving recovery outcomes.
Although it is a relatively weak opioid, tramadol can be lethal—especially when taken at very high doses or mixed with alcohol, sedatives, or other substances. Relapse is particularly dangerous, as you may accidentally take a lethal dose of tramadol due to decreased tolerance to the drug.
Tramadol stays in your system for up to 35 hours on average after your last use. However, saliva, urine, and hair tests can detect it long after that – for up to 2, 4, and 90 days after the last dose, respectively.
Yes, you can most certainly fully detox from tramadol. Most people detox from tramadol within a week, though some withdrawal symptoms may linger. If you want to achieve a full tramadol detox and quit opioids for good, consider undergoing Accelerated Neuro-Regulation (ANR).
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