Tramadol isn’t typically considered as addictive as other commonly abused opioids, but it has a risk for abuse and addiction. With repeated use, the body can become dependent on the drug, which can make quitting more difficult.
After dependence has formed, the body will need time to adjust to the drug’s absence. While withdrawal can be uncomfortable, it can be managed with medications and treatments.
Key Facts
Key Facts
- Tramadol is a full agonist opioid, binding to and activating opioid receptors in the brain and spine.[1]
- The body adapts to repeated tramadol use, causing physical dependence.
- People who have a tramadol addiction are physically dependent on the drug and will go through withdrawal when use stops.
- Tramadol withdrawal can be managed with medication-assisted treatment (MAT), a combination of medication and therapy.[2]
- Buprenorphine (Suboxone) is often the preferred medication, but methadone and naltrexone are also commonly used.[3]
What Is Tramadol Withdrawal?
Tramadol withdrawal is a collection of undesirable symptoms that can occur as a result of trying to quit tramadol after your body has become dependent on the opioid. It’s better thought of as opioid withdrawal, as opioids all affect the brain in very similar ways, although the intensity of their effects differs. The body becomes dependent on opioids if one is repeatedly used, not a specific opioid.[1]
If a person struggles with a tramadol addiction, they have developed a dependence on opioids and will experience this kind of withdrawal if they try to quit misusing tramadol. This dependence develops because repeated opioid use rewires the brain and hijacks the reward system.[4] The brain begins to view the state while high on opioids as its default, which causes problems when tramadol use stops. The body and brain need time to adjust to their sober state, and withdrawal symptoms occur during this adjustment process.[5]
Opioid withdrawal can be life-threatening in specific circumstances.[5] It’s important that a person going through opioid withdrawal stay hydrated and supplied with essential nutrients, as they can lose significant amounts of water through heavy sweating, vomiting, and diarrhea. This is why medical supervision is essential for opioid withdrawal.
Medical detox also prevents relapse during withdrawal, which can result in tramadol overdose.
Tramadol Withdrawal Symptoms
Opioid withdrawal varies in severity, but you can typically expect it to be an uncomfortable process that lasts at least a few days. Common symptoms associated with opioid withdrawal, including withdrawal from tramadol, include the following:[2]
- Anxiety
- Diarrhea
- Hot and cold flushes
- Insomnia
- Muscle cramps
- Nausea and vomiting
- Perspiration
- Watery discharge from eyes and nose
What to Expect from Tramadol Withdrawal
Each person’s specific experience with opioid withdrawal can vary.
Withdrawal from short-acting opioids like tramadol typically begins eight to 24 hours after a person’s last use. The acute withdrawal phase (when withdrawal is most severe) typically lasts between four and 10 days. This is followed by the protracted withdrawal phase (a much less severe kind of withdrawal), which can last several months.[2]
The following table illustrates the basics of what to expect from tramadol withdrawal:[2]
| Time Since Last Use of Tramadol | What to Expect |
| 8-24 hours | Withdrawal symptoms begin. Hydration is essential to remain safe and comfortable. Avoid situations where opioids are accessible. |
| 1-2 days | Symptoms worsen and resemble a bad flu. |
| 3-4 days | Symptoms peak in intensity. |
| 4-10 days | Symptoms lessen in intensity after their peak until they subside completely. |
| Up to 6 Months | Protracted withdrawal may occur for some, which involves feeling generally unwell and experiencing ongoing tramadol cravings. |
As a general rule, the longer a person misuses tramadol, and the higher doses they take when engaging in use, the more severe their withdrawal process will be. If a person only took tramadol as prescribed and then stopped using it, withdrawal won’t usually be especially severe or long-lasting. If a person regularly abuses significant amounts of tramadol, detox may be a longer, more difficult experience.
Other individual factors can influence the withdrawal process. For example, people with co-occurring health issues, such as kidney or liver problems, may withdraw at a slower rate and have a more complicated withdrawal experience.[6]
Detox for Tramadol Withdrawal
While some people can detox from opioids like tramadol on their own, there is little benefit to doing so. It just makes the process more dangerous, and it makes it more likely that they will relapse into opioid misuse when their withdrawal symptoms become intense.
Evidence-based treatment involves talking to an addiction treatment specialist and entering a medical detox program to quit misuse of any type of opioid, including tramadol.[2] You can get a treatment plan tailored to your needs, including the use of MAT as appropriate.
Depending on your situation, you may wish to stay at a rehab program as you detox. This can allow you to go through withdrawal in relative comfort and with doctors around who know how to keep you safe and identify any problems that may occur during the withdrawal process.
If you’re detoxing from tramadol, MAT may be used. These medications may be used for opioid withdrawal and ongoing OUD maintenance:[3,7]
- Methadone
- Buprenorphine (Suboxone)
- Naltrexone
- Clonidine
Importance of Comprehensive Treatment
Importantly, detox doesn’t “cure” addiction; there is no cure for addiction. Detox is simply part of the recovery journey. Tramadol addiction treatment is needed following detox to address the issues that led to opioid abuse.
Treatment may involve medications, but therapy will be the backbone of care. In sessions, clients will learn to identify triggers that lead to substance abuse and how to manage them long-term. They’ll gain tools to better deal with life’s stresses, so they are less likely to relapse when things get hard.
Medical Detox for Tramadol Abuse at Boca Recovery Center
Recovery from tramadol addiction is possible. The best way to regain control of your life and stop abusing tramadol is with professional help. At Boca Recovery Center, we can design a recovery plan tailored to the severity of your addiction and your specific needs, maximizing your chances of long-term recovery.
If you struggle with tramadol or other types of opioids, reach out to us. We offer medical detox, inpatient treatment, outpatient care, MAT, and evidence-based therapy. Our team of empathetic and professional addiction treatment experts is ready to help.
Check out the locations of our addiction treatment facilities in Florida, New Jersey, and Indiana. Whether you live locally or are traveling for treatment, we can get you set up today.
Frequently Asked Questions
These are some frequently asked questions about tramadol withdrawal and detox:
Repeatedly using tramadol or other opioids causes the brain to adapt to their presence. Then, in the absence of opioids, the brain needs time to adjust back to its sober state, causing withdrawal. Typically, the more heavily one misuses opioids and the more often, the stronger a person’s dependence and the more intense the withdrawal symptoms they experience when quitting.
Quitting opioids like tramadol is difficult, and relapse is likely without professional help. In a medical detox program, professionals make sure you stay safe, hydrated, and supported, so you can make it through detox and withdrawal comfortably.
Quitting any opioid “cold turkey” is seldom the recommended approach. Cold-turkey approaches are associated with more issues and severe symptoms that can be dangerous and very painful.[8] A tapered approach to withdrawal or use of MAT is recommended instead.[9]
- Tramadol. U.S. National Library of Medicine. Published May 2023. Accessed March 9, 2024.
- Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. World Health Organization. Published 2009. Accessed March 9, 2024.
- The effectiveness of medication-based treatment for opioid use disorder. Mancher M, Leshner AI. National Academies Press (US); 2019.
- Alterations in brain structure and functional connectivity in prescription opioid-dependent patients. Upadhyay J, Maleki N, Potter J, et al. Brain. 2010;133(7):2098-2114.
- Opioid Withdrawal. Mansi Shah, Huecker MR. StatPearls. Published June 4, 2019.
- Opioid metabolism. Smith HS. Mayo Clinic Proceedings. 2009;84(7):613-624.
- Moxonidine for tramadol withdrawal symptoms during detoxification: Table 1. Talih F, Ghossoub E. BMJ Case Reports. Published July 8, 2015:bcr2015210444.
- Opioid withdrawal symptoms, a consequence of chronic opioid use and opioid use disorder: Current understanding and approaches to management. Pergolizzi JV, Raffa RB, Rosenblatt MH. Journal of Clinical Pharmacy and Therapeutics. 2020;45(5).
- Buprenorphine treatment for opioid use disorder: An overview. Shulman M, Wai JM, Nunes EV. CNS drugs. 2019;33(6):567-580.
