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Treatment for Tramadol Addiction | Boca Recovery Center

Treatment for tramadol addiction, and addiction to any other opioid, is generally a combination of medication-assisted treatment (MAT) with drugs like methadone or buprenorphine and therapy. Behavioral therapy, such as cognitive behavioral therapy, is commonly used.

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Tramadol addiction is a complex and chronic condition characterized by uncontrollable tramadol misuse despite negative consequences, such as psychological or physical issues, withdrawal symptoms, missing work, or failing to meet other responsibilities.

Tramadol addiction treatment can occur in several settings, including inpatient rehab, partial hospitalization, intensive outpatient, and standard outpatient rehab. Medical detox is often the first step before comprehensive care. Medication-assisted treatment (MAT) is often considered the gold standard of treatment for an addiction to opioids like tramadol. It involves a combination of medication like methadone, buprenorphine, or Suboxone and behavioral therapy.

If you are looking for a quality and evidence-based treatment program, contact us at Boca Recovery Center. We are in the top 10% of rehabs and provide compassionate and individualized care to people from all over the country.

Tramadol Addiction Treatment Options and Settings

For opioid use disorder (OUD) or tramadol addiction treatment, there are many different treatment settings and options available.

Medical Detox

People may associate quitting opioids with medical detox. This refers to the process of stopping opioid use and undergoing withdrawal with some level of medical supervision. Since tramadol withdrawal symptoms can be intense and severe, medical supervision is recommended. 

During medical detox, patients may receive:

  • Opioid withdrawal medications like methadone or buprenorphine
  • Supportive care like IV fluids
  • Mental health support and counseling
  • Nutritional therapy
  • Case management

With medical detox, people will usually spend the acute withdrawal phase, which is the phase of withdrawal that generally has the worst symptoms, at a specialized treatment facility. They will then go through withdrawal in a safe environment and without easy access to tramadol and other opioids, reducing the risk of a relapse. Once they are medically stable and substance-free, they’re ready to transition into comprehensive rehab.

Since tramadol withdrawal symptoms can be intense and severe, medical detox treatment is recommended to ensure comfort and safety.

Medication-Assisted Treatment

Medication-assisted treatment is a common and effective form of care for tramadol addiction or opioid use disorder.

Medications used for this purpose include the following: [4]

  • Methadone: Full opioid agonist that binds to opioid receptors in the brain, relieving withdrawal symptoms and cravings
  • Buprenorphine: Partial opioid agonist that binds to opioid receptors and alleviates cravings and tramadol withdrawal symptoms
  • Suboxone: Combination medication comprised of buprenorphine and naloxone, an opioid antagonist that deters misuse
  • Naltrexone: An opioid antagonist that binds to opioid receptors and blocks the pleasurable effects of tramadol

At present, methadone can only be obtained at specialty methadone clinics, making abuse of it less likely. 

Buprenorphine can be taken home, but its risk of abuse is lower because it is an opioid receptor partial agonist. This means it is less potent than most opioids associated with abuse. Because buprenorphine is usually combined with naloxone, such as in the drug Suboxone, it is not easily abused. Naltrexone can also be obtained through a doctor or provider and taken at home.

Inpatient Rehab

Inpatient tramadol addiction treatment involves living at the facility for the duration of the treatment program—which typically lasts for 30 to 90 days, depending on the person’s needs.

Inpatient rehab is the most intensive and structured option that can help individuals focus solely on their sobriety early on in recovery. Individualized treatment plans involve a combination of treatment modalities, such as:

  • Individual therapy like cognitive behavioral therapy
  • Group counseling
  • Family therapy
  • Support groups
  • MAT
  • Drug education or psychoeducation classes
  • Experiential therapies
  • Aftercare planning

Inpatient rehab is the most intensive treatment option that provides a highly-structured environment and routine in a peaceful environment, away from triggers for tramadol misuse.

Partial Hospitalization Programs (PHPs)

The most intensive outpatient option, patients live at home while attending up to 30 hours of addiction treatment per week at a hospital or clinic. 

Partial hospitalization programs are a great option for those with a moderate or severe tramadol addiction for whom inpatient rehab isn’t an option. It is also commonly used as a form of “step-down care” for those who have completed an inpatient program and need additional support.

Intensive Outpatient Programs (IOPs)

A step down in intensiveness from PHPs, intensive outpatient programs involve living at home and attending therapy for between 9 and 20 hours per week, depending on the program.

This is a good option for someone with a mild to moderate opioid use disorder or as step-down care for someone who completed an inpatient or PHP.

Standard Outpatient Programs

The least intensive and most flexible rehab option, standard outpatient treatment involves living at home and attending therapy for a few hours per week. Because it offers so much flexibility, many people choose this so they can continue working or attending school while in recovery.

However, it has a higher risk of relapse than inpatient programs so it’s important to have a strong support system while attending outpatient care. It’s also essential to have other forms of support like a 12-step group or non-12-step group.

Therapies Used for Tramadol Addiction

Depending on the treatment center, the treatment team will likely create an individualized treatment plan consisting of many different therapies, including:

  • Group counseling: A mental health professional facilitates a group therapy meeting in which you may practice new coping skills, learn sober social skills, and engage in role-play. 
  • Family therapy: A psychologist or therapist facilitates a family therapy meeting that involves healing from relationship fractures, improving conflict resolution skills, and improving communication strategies.
  • Cognitive-behavioral therapy (CBT): A therapist examines the connection between thoughts, feelings, and behaviors to reduce the risk of relapse and develop healthy coping skills.
  • Contingency management: The treatment team provides rewards like vouchers for abstinent behaviors, such as substance-free urine tests.
  • Motivational enhancement therapy: The therapist works with individuals to improve motivation and resolve ambivalence related to quitting tramadol.
  • Dialectical behavior therapy (DBT): Individuals work with a therapist and attend group sessions to learn new skills like mindfulness, emotional regulation, distress tolerance, and interpersonal skills.
  • Person-centered therapy: The therapist uses a loving, affirming, and encouraging approach to therapy that focuses on the person as opposed to their tramadol misuse.
  • Eye Movement Desensitization and Reprocessing (EMDR): For people who have experienced trauma or who have PTSD, EMDR can help reduce the distress associated with trauma-related stimuli.
  • 12-step facilitation therapy: A therapist works with a patient to encourage them to join a 12-step program such as Narcotics Anonymous (NA). 
  • Experiential therapies: In conjunction with evidence-based practices, the treatment team may recommend experiential therapies to help with expression like music therapy, art therapy, role-play, and beyond.

The tramadol addiction treatment team will create an individualized treatment plan consisting of many different therapies, such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), motivational enhancement therapy, and more.

Aftercare & Ongoing Support

Due to the chronic nature of addiction, aftercare is essential to prevent relapse. Some form of aftercare will be lifelong, but as a person gains a stronger footing in recovery, the nature of aftercare and support will likely change.

For example, weekly therapy sessions (or even more frequent sessions) might be needed after completing a formal addiction treatment program. As years pass, the frequency of therapy might decline to twice a month or even monthly.

Many people in recovery from tramadol addiction attend regular peer support meetings, such as Narcotics Anonymous or SMART Recovery meetings. These meetings can serve as the framework of a support network in recovery, allowing group members to learn from and encourage each other through the ups and downs of lifelong recovery.

Ultimately, an aftercare plan is highly individualized and can change just like a treatment plan can. Aftercare options may include:

  • Sober living homes
  • Step-down care at a PHP or IOP
  • 12-Step programs like NA
  • Non-12-Step programs like SMART Recovery
  • Ongoing individual therapy
  • Ongoing group or family counseling
  • Psychoeducation or relapse prevention classes
  • Case management or wraparound services
  • Ongoing MAT (can be indefinite)

How Tramadol Works & Can Lead to Abuse

Tramadol is an opioid, which means it acts on opioid receptors in the brain, changing how the brain and nervous system interpret pain signals and reducing the amount of pain a person feels significantly. When used as intended, tramadol can relieve moderate to moderately severe levels of pain. Extended-release tramadol tablets and capsules are generally only prescribed when a patient needs around-the-clock pain relief. [1]

The issue with most opioids, including tramadol, is that they have significant abuse and addiction potential, which is why doctors have grown increasingly careful about prescribing them. Opioids can cause a euphoric high and sedating calm that causes many people to abuse them. 

Fast Facts on Tramadol Abuse 

These facts are based on an analysis of data from 2002 to 2017 from the National Surgery of Drug Use and Health: [2]

  • Injecting tramadol appears rare. There were too few reports of injecting tramadol to draw significant conclusions on prevalence.
  • From 2015 to 2017, about 4% of oral tramadol prescriptions were reportedly misused in some way
  • This misuse number represents an increase from 2002 to 2014, where the rate of abuse remained 1.5% or less for oral tramadol prescriptions

Diagnosing Tramadol Addiction

The following elements could signal an addiction to tramadol or other opioids:[3]

  • Experiencing withdrawal when stopping tramadol or using a lower dose
  • Needing to increase your dose of tramadol to achieve the same effects
  • A strong desire to engage in tramadol misuse and spending significant time acquiring the drug
  • Wanting to cut down on the amount of tramadol you are taking but finding yourself unable to succeed 
  • Continuing to use tramadol or other opioids despite seeing the negative consequences of that use
  • Using tramadol in physically dangerous situations, including sharing needles, committing crimes to get the drug, or exchanging sex for drugs
  • Reducing the time spent on important or once enjoyable activities due to tramadol or other types of opioid use

The presence of these signs indicates that addiction treatment is needed.

Updated September 25, 2023
  1. Tramadol. (January 2022). National Library of Medicine.
  2. Misuse of Tramadol in the United States: An Analysis of the National Survey of Drug Use and Health 2002-2017. (June 2020). Substance Abuse: Research and Treatment.
  3. Opioid Addiction. (September 2022). StatPearls.
  4. Prescription Opioids. (June 2021). National Institute on Drug Abuse.
  5. Tramadol Misuse in Treatment-Seeking Adolescents and Young Adults With Problematic Substance Use – Prediction of Treatment Retention. (December 2022). Addictive Behavior Reports.
  6. A Systematic Review of Laboratory Evidence for the Abuse Potential of Tramadol in Humans. (September 2019). Frontiers in Psychiatry.
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