Chronic tramadol abuse or use can lead to physiological dependence, which means you need to keep taking this opioid to stave off withdrawal symptoms. If you suddenly stop taking the drug, you’ll experience distressing tramadol withdrawal symptoms, such as nausea, vomiting, diarrhea, and fever. 
The tramadol withdrawal timeline depends on whether you’ve been taking a short-acting or long-acting formulation of the drug—using the short-acting version will result in a rapid onset of withdrawal symptoms and a shorter timeline than the long-acting formulation.
As is true of all opioids, detoxing from tramadol, especially if you have an addiction, is best done in a medical detox setting where you can receive 24/7 care, supervision, and monitoring.
Tramadol Withdrawal Symptoms
Withdrawal from tramadol can cause a range of physical and psychological symptoms. Some of the most common tramadol withdrawal symptoms include:,
Seeking professional treatment is essential for long-term recovery
- Nausea and vomiting
- Muscle aches and pains
- Restless legs
- Dilated pupils
The severity of these symptoms will vary depending on several factors, described above, including the individual level of dependence, the amount and frequency of tramadol use, and the duration of use. Additionally, those who abruptly stop taking tramadol may experience more severe withdrawal symptoms than those who gradually taper off the medication.
How Long Does Tramadol Withdrawal Last?
The timeline for tramadol withdrawal can also vary depending on many factors, including:
- Individual physiology
- Tramadol dose taken
- Length of tramadol use
- Previous withdrawal experience
- Liver and kidney functioning
- Method of administration (oral, snorting, or injecting)
- Whether the person mixes tramadol with other drugs or not
- Whether they are taking a short-acting or long-acting formulation
Long-acting and extended-release tramadol formulations have a longer tramadol withdrawal timeline than short-acting versions, and the onset of symptoms may be delayed.
Those who stop taking tramadol abruptly (also known as cold-turkey detox) may experience more intense symptoms that can last for several weeks—conversely, tapering off tramadol can reduce withdrawal intensity.
Tramadol Withdrawal Timeline: Short-Acting
Short-acting tramadol withdrawal symptoms may appear within 6-12 hours after last use and may last up to 7 days.,
|Time Since Last Use||Withdrawal Intensity|
|6-12 hours||Tramadol withdrawal symptoms emerge|
|2-3 days||Symptoms peak in severity|
|5-7 days||Symptoms improve and dissipiate|
Tramadol Withdrawal Timeline: Long-Acting
Long-acting tramadol withdrawal symptoms may appear within 2-4 days after stopping use and last for up to 20 days.[3,]
|Time Since Last Use||Withdrawal Intensity|
|2-4 days||Tramadol withdrawal symptoms appear|
|1 week||Symptoms peak in intensity|
|10-20 days||Symptoms begin to improve and resolve|
Regardless of the formulation, protracted withdrawal can last for months or even years after a person has gone through acute tramadol withdrawal.
Cold-Turkey Detox vs. Medical detox
For those who are seeking to quit tramadol, there are two primary methods of withdrawal: cold-turkey detox and medical detox.
Cold-turkey withdrawal involves abruptly stopping tramadol use without any additional medication or support. While this method may work for some individuals, it can be very difficult and uncomfortable due to the severity of withdrawal symptoms. Most people who attempt to quit opioids cold turkey end up relapsing.
Medical detox involves using medications, such as buprenorphine or methadone, to manage withdrawal symptoms and cravings in a professional detox setting, such as a hospital. Medical detox can be very effective for reducing the severity of withdrawal symptoms and improving the chances of successful long-term recovery.
When the option of medical detox is available, it should generally be taken over the cold-turkey detoxing approach. Because it eliminates or greatly reduces the likelihood of withdrawal symptoms, it can allow individuals to focus on the work they are doing in therapy. It also controls cravings, which can greatly improve the chances of long-term recovery.
Why Is Treatment Important During Tramadol Withdrawal?
Withdrawal from tramadol can be a challenging and uncomfortable process, which is why seeking professional treatment is essential for long-term recovery. There are several reasons why treatment is important during tramadol withdrawal, including these:
- Relapse prevention: Those who attempt to quit tramadol on their own are at a higher risk of relapse. Professional treatment can help individuals develop coping strategies to manage cravings and avoid relapse.
- Psychological support: Tramadol withdrawal can trigger a range of psychological symptoms, such as anxiety and depression. Professional treatment can provide individuals with the psychological support they need to manage these symptoms and improve their overall mental health.
- Long-term recovery: Perhaps the most important reason to receive treatment during tramadol withdrawal is to increase your chances of long-term recovery. Withdrawal doesn’t “cure” addiction; it only reduces a person’s physical drug dependence. Treatment helps people build skills and get the support needed to better maintain drug abstinence. Without treatment, it’s unlikely that recovery from tramadol abuse will be sustained.
Frequently Asked Questions About Tramadol Withdrawal
Physical dependence on tramadol can develop when the body becomes accustomed to the presence of the drug and requires it to function normally. As such, dependence on tramadol can develop in individuals who have been prescribed the medication for pain management over an extended period of time. It can also develop in individuals who abuse tramadol, with heavy abuse generally leading to more severe dependence than prescribed use. 
If you are dependent on tramadol and suddenly stop taking it, withdrawal symptoms can occur. These can be uncomfortable and even dangerous (generally due to the risk of severe dehydration and asphyxiation). Withdrawal symptoms typically begin relatively soon after the last dose of tramadol. The severity of the symptoms will vary, depending on the level of physical dependence, including how long the drug was taken, the average dose, and individual factors like body size, metabolism, and co-occurring medical or mental health issues.
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- Opiate and Opioid Withdrawal. (April 2022). National Library of Medicine.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
- New directions in the Treatment of Opioid Withdrawal. (July 2020). Lancet.
- Treatment of Opioid-Use Disorders. (2016). The New England Journal of Medicine.
- Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. (2009). World Health Organization.
- Opioid Addiction, Genetic Susceptibility, and Medical Treatments: A Review. (July 2019). International Journal of Molecular Sciences.