Tramadol Detox

  • Generic Name or Active Ingridient: Tramadol

Tramadol is an opioid drug that works similar to morphine to provide relief from moderate to moderately severe pain.

A doctor might prescribe tramadol to a patient who needs long term, around-the-clock protection from persistent pain caused by a chronic condition, most notably arthritis. About three percent of American adults receive long-term opioid therapy using drugs such as tramadol for the treatment of chronic pain from conditions other than cancer.

Tramadol works like other opioids to relieve pain, by acting directly on the nervous system to change the way the brain interprets pain signals. Tramadol causes other neurological reactions, the most immediately noticeable being sedation, relaxation, and a pleasant euphoria. Opioids also affect other body systems, including the cardiovascular and digestive systems, to cause a variety of unwanted side effects.

With continuous use, some of tramadol’s neurological and physical effects become more permanent to alter the way the person thinks, feels, and behaves. These alterations can have a profoundly negative effect on the individual’s ability to work or go to school, take care of family members, or interact with others. These effects place opioid-dependent people at high risk for job loss and financial crisis, divorce or loss of child custody, homelessness, illness, incarceration, overdose, and death.

Most patients use tramadol as directed and dispose of unused medication when they no longer need it for pain. Some people, however, save leftover doses of tramadol to use for non-medical reasons either to get high or to treat a condition unrelated to the one the doctor had intended to treat when he wrote the prescription. Each year, approximately 5 million Americans use painkillers for non-medical reasons.

Anyone who uses tramadol regularly for more than a few weeks can become physically dependent on opioids, whether he uses tramadol for therapeutic or non-medical reasons. The number of opioid-dependent Americans has been steadily increasing. In 2011, there were about 1.9 million people dependent on opioids in the U.S. whereas there were only 1.4 million opioid-dependent Americans in 2004.

When someone takes tramadol regularly, his body adjusts to its presence. In time, the body begins to depend on a certain level of tramadol to feel normal - the individual become opioid-dependent. When tramadol levels drop drastically in an opioid-dependent person, the body struggles to regain stability and detoxify itself from the effects of tramadol. Doctors refer to this as tramadol detoxification.

Withdrawal Symptoms

The opioid-dependent person experiences tramadol detoxification through unpleasant withdrawal symptoms. These withdrawal symptoms begin a few hours after the last dose of tramadol.
Tramadol withdrawal symptoms include:

  • Chills
  • Cough
  • Diarrhea
  • Excessive perspiration
  • Hair standing on end
  • Hallucinations, rarely
  • Nausea
  • Nervousness
  • Numbness
  • Pain, burning, or tingling sensation in the hands or feet
  • Panic
  • Problems sleeping
  • Runny nose
  • Sneezing
  • Uncontrollable shaking of one part of the body

Left uninterrupted, withdrawal symptoms can last five days or longer before fading as the individual completes tramadol detoxification. Once the patient reaches an opioid-free state, withdrawal symptoms do not return unless the individual relapses to an opioid-dependent state.

Benefits of Tramadol Detoxification

Tramadol stops withdrawal symptoms and clears the individual’s thought processes - detoxification makes the patient feel good and helps him to think clearly. In this way, tramadol detoxification encourages the patient to continue recovery efforts. Detoxification is only one part of the recovery process and, by itself, does little to change those behaviors associated with drug abuse that can cause relapse. Most opioid-dependent people benefit from rehabilitation to learn how to live a drug-free life. Detoxification facilitates the patient’s entry into rehabilitation, which often includes counseling and behavior modification that teaches the participant how to recognize situations that may lead to drug abuse and how to refuse tramadol when the opportunity for drug abuse arises.

Tramadol detoxification helps the patient remain in rehabilitation to reverse the neurological and physical effects of chronic opioid use. Detoxification makes the patient feel better; this helps him avoid relapse, and reducing the frequency and severity of relapses when they do occur. Detoxification helps the patient return to work, fulfill personal responsibilities, and interact with others.

Types of Detox

Detoxification also refers to the medical process of lowering opioid levels and lessening withdrawal symptoms. Detoxification can occur at home, through an outpatient clinic, in a hospital, or in a specialized detoxification facility.

Of those needing assistance with substance abuse issues, only about 10 percent got the help they needed from a specialty facility, such as a hospital, outpatient clinic, mental health institution or inpatient detoxification center. Everyone else engaged in self-help, worked with a private doctor, went to an emergency room, or endured detoxification while incarcerated in jail or prison.

Any approach to detoxification is appropriate as long as it brings the patient to an opioid-free state in a safe and effective manner. A person might try several different approaches before finding one that works for her.

Self Detox

When the time comes for patient to discontinue tramadol after using it to treat long-term pain from a chronic illness, her doctor will likely suggest she wean herself from tramadol by taking smaller doses each day. This tapering method reduces withdrawal symptoms in some patients.

Self-detoxification is appropriate for anyone that has been opioid-dependent for only a short time, has no underlying conditions that could cause complications, and experience moderate withdrawal symptoms.

Cold turkey

Some patients experience lingering withdrawal symptoms and quit tramadol abruptly, sometimes referred to as “quitting cold turkey.” These individuals will bear the full brunt of withdrawal symptoms.

Natural remedies

Natural remedies can relax the body and reduce the severity of withdrawal symptoms. A patient might participate in meditation or massage, for example, or take chamomile or cayenne to slow diarrhea.

Some patients create a homemade treatment plan to reduce withdrawal symptoms during tramadol detoxification. One such plan is The Thomas Recipe that calls for a benzodiazepine such as Valium or Xanax to calm nerves and help with sleep. The Thomas Recipe also suggests vitamin B6 to ease muscle aches, Imodium for diarrhea, and L-Tyrosine for energy.

Medication-Assisted Detoxification

Many outpatient and inpatient facilities now offer medication-assisted detoxification, sometimes called medical detoxification. These institutions administer opioid and non-opioid drugs to control the onset of tramadol detoxification and reduce withdrawal symptoms.

Outpatient Detoxification
Outpatient clinicians prescribe opioid replacement drugs, such as methadone and buprenorphine. These medications are opioids, mimicking the effects of tramadol to reduce or stop withdrawal symptoms. When taken as directed in therapeutic doses, methadone and buprenorphine do not get the consumer high.

Most people associate methadone and buprenorphine with maintenance programs, in which the replacement drugs delay the onset of detoxification while the patient engages in rehabilitation. Once he learns how to live without drugs, he weans himself from the replacement drug through tapering or detoxification.

Increasingly, outpatient clinicians prescribe methadone or buprenorphine as an aid to tapering. These drugs lessen the severity of withdrawal symptoms during tapering. The patient starts on a high induction dose of the replacement drug - just enough to stop withdrawal symptoms - then takes successively smaller doses until he reaches a drug-free state.

Outpatient detoxification is appropriate for people dependent on tramadol longer than one year, who require little supervision, and cannot take time away from work or personal responsibilities for inpatient detoxification.

Outpatient detoxification is appropriate for those patients that have been dependent on opioids for more than a year and who require little supervision.


A German chemist first synthesized methadone in 1939 in a search for a safe, effective pain reliever. Doctors worldwide still administer methadone as an analgesic, but U.S. doctors primarily prescribe methadone for the treatment of opioid dependence. Initially, physicians used methadone to treat heroin addicts but now use this replacement drug to treat dependence to other opioids, such as tramadol.

Today, approximately 100,000 Americans use a methadone maintenance program. These individuals come to an outpatient clinic each day to drink a beverage containing methadone. The effects of a single dose of methadone last for 24 to 36 hours.

Many people now use methadone as an aid to tapering. The clinician will typically start the patient on 10 to 15 mg of methadone then increase dosages by 10 mg each day until the patient no longer experiences withdrawal symptoms. The patient stays on this induction dose for a few days until his condition stabilizes. He then decreases his daily methadone dose until reaching an opioid-free state.


A clinician may suggest buprenorphine, sometimes sold as the brand name Subutex, as an aid to medical detoxification. The patient places the buprenorphine under his tongue where it dissolves. The patient starts out on a high induction dose, maintains that dosage until stabilizing his condition then tapers buprenorphine dosages slowly.


While considered safer than methadone, it is still possible to abuse buprenorphine through intravenous administration. Drug manufacturers discourage abuse by adding naloxone to the brand name buprenorphine product, Suboxone. Taken under the tongue, naloxone has no effect on the consumer but neutralizes the effects of buprenorphine when administered intravenously.

Inpatient Tramadol Detoxification
Most opioid-dependent people benefit from inpatient tramadol detoxification received at a hospital or dedicated detoxification treatment center. Most inpatient facilities provide prescreening for underlying conditions that may cause complications, professional treatment plans including non-opioid detoxification and anti-withdrawal drugs, and close patient supervision.

Inpatient tramadol detoxification is appropriate for those who:

  • Are recovering from an overdose
  • Cannot receive treatment safely as an outpatient
  • Are at high risk for severe withdrawal symptoms or complications
  • Have co-existing health conditions or co-existing alcohol or drug problems that make outpatient detoxification unsafe
  • Have not fully engaged with or benefited from less restrictive programs
  • Have psychiatric problems, such as including depression with suicidal thoughts or acute psychosis.
  • May pose a danger to his own safety or to the safety of others

Rapid Detox

Rapid detox brings an opioid-dependent person to an opioid-free state in hours, rather than days or weeks. Rapid detox is a safe and effective procedure where a board-certified anesthesiologist sedates and anesthetizes the patient before administering the standard detoxification and anti-withdrawal drug. The rapid detox patient rests in a comfortable “twilight sleep” during tramadol detoxification, blissfully unaware of the withdrawal symptoms that may have prevented her from achieving an opioid-free state in the past.

Our detox center: Who we are and what we do

We are a team of board-certified anesthesiologists and other specialists who receive advanced training in detoxification procedures. We have helped thousands of people reach an opioid-free state since opening the doors of our accredited facility more than a decade ago.

We prescreen patients for any medical problems that could complicate tramadol detoxification. We then create an individualized treatment plan that may include rapid detox. After becoming opioid-free, the patient may continue her recovery in our aftercare center.

Detox Comparisons

Dependence on tramadol is traumatic and choosing a treatment approach can be confusing. Comparing the various treatments highlights the benefits and disadvantages of each to make that choice easier.

Without the cost of anti-withdrawal drugs and professional care, self-detoxification is less expensive than outpatient or inpatient care but self-detoxification is more likely to produce severe withdrawal symptoms and complications. Outpatient care reduces withdrawal symptoms but prolongs the opioid-dependent state.

Inpatient care requires time away from work and family but dramatically improves the patient’s experience. Rapid detox brings the patient to an opioid-free state in the shortest time possible and provides the patient with the optimal detoxification experience, free from withdrawal symptoms.

Detox Possible Complications

Detoxification from tramadol is not normally life-threatening but the patient may develop dangerous complications, especially in the presence of co-existing medical conditions or substance abuse issues, extremely long-term or acute tramadol abuse, and severe withdrawal symptoms.

Relapse is the primary complication associated with any approach to tramadol detoxification. Overpowering withdrawal symptoms force some people to relapse before completing the detoxification process. Other people relapse sometime after reaching an opioid-free state.

Relapse during detoxification or shortly thereafter increases the risk for toxic overdose. The detoxification process lowers the body’s tolerance of tramadol, making the consumer more sensitive to the effects of opioids. This lowered tolerance and increased sensitivity make it possible for someone to overdose on a smaller amount of tramadol than they would have taken just hours earlier.

Tramadol overdose is a serious medical emergency that may result in death. In 2008, 14,800 Americans died after taking an overdose of tramadol or other opioids. That year, opioid overdose killed more people than heroin and cocaine overdose combined.

Self Detoxification Possible Complications

Self-detoxification can produce severe withdrawal symptoms that can cause complications to the tramadol detoxification process. Severe and prolonged vomiting and diarrhea sometimes results in dehydration and electrolyte imbalances.

Tramadol withdrawal symptoms can aggravate another medical condition. For example, increased blood pressure and heart rate can worsen a heart problem. Tramadol detoxification may heighten anxiety in those with severe mood disorders. Detoxification may cause pain to return in those taking tramadol to treat a chronically painful illness.

Outpatient Care Possible Complications

Methadone and buprenorphine are safer to use long-term than tramadol, but these replacement drugs may pose special complications during tramadol detoxification. The patient may become dependent on the replacement drugs and take methadone or buprenorphine for months or years; some patients take these drugs for the rest of their lives.

Methadone is associated with a rising number of opioid pain reliever deaths - there were 5.5 times as many deaths caused by methadone overdose in 2009 as there were in 1999. Methadone now accounts for about one-third of opioid pain reliever deaths even though it represents only about 2 percent of the prescription painkiller market.

Most medical professionals consider buprenorphine safe than methadone but there is still risk for fatal overdose, especially when the consumer combines buprenorphine with benzodiazepines like those used in The Thomas Recipe.

Possible Complications to Inpatient Detoxification

Despite prescreening, medical grade drugs, and close patient supervision, patients may still suffer complications to inpatient detoxification. One great complication is simultaneous withdrawal from tramadol and other substances, especially alcohol, benzodiazepines, anti-anxiety drugs, and sedatives.

Rapid Detox Possible Complications

Rarely, a patient may suffer an allergic reaction to the drugs used in rapid detox. Any patient who receives anesthesia risks bruising, swelling, or infection at the injection site. Strong sedatives may complicate breathing, blood pressure, or heart rate.

Detox Myths

Despite the wealth of information gathered from decades of research and clinical experience, myths shrouding tramadol detoxification prevent many people from getting appropriate help.

Self Detox Myths

Myth: Self-detoxification is safe for everyone.
Fact: Self-detoxification produces uncontrolled withdrawal symptoms that may result in dangerous or life threatening complications, especially in those with other medical conditions or substance abuse problems.

Myth: Prescription and non-prescription drugs make The Thomas Recipe safe for anyone.
Fact: Combining prescription and over-the-counter medications can result in dangerous drug reactions, especially in the presence of high tramadol levels and co-existing medical conditions.

Outpatient Detox Myths

Myth: Methadone is more expensive than jail time.
Fact: One year of methadone costs an average of $4,700 per patient while that same year of imprisonment will cost taxpayers about $24,000 per inmate.

Myth: Drug manufacturers named one brand of methadone, Dolophine, after Adolf Hitler.
Fact: The pharmaceutical company combined the Latin word for pain, dolor, and the French word for end, fin, to make the word Dolophine.

Inpatient Detox Myths

Myth: Because of their high relapse rates, treating drug addicts in a hospital is a waste of hospital space.
Fact: Everyone with a chronic medical condition, even opioid-dependent people, deserves compassionate care in a professional environment. Despite its reputation as an incurable disease, relapse rates for drug addiction are similar to those of other chronic diseases, such as high blood pressure, diabetes or asthma.

Myth: Spending on drug treatment is like throwing money down a hole.
Fact: Investing in drug treatment provides substantial returns in reduced drug-related crime rates, criminal justice costs and theft. For every dollar spent on drug treatment, experts project a yield between $4 and $7. Factor in savings to healthcare and return rises to $12 gained for every dollar spent.

Rapid Detox Myths

Myth: The pain and degradation of tramadol detoxification is an important aspect of treatment.
Fact: Suffering is never an appropriate part of any treatment plan. Rapid detox provides the most humane treatment for opioid dependence in that it spares the patient from the uncomfortable and demoralizing withdrawal symptoms that may have prevented him from quitting tramadol in the past.

Myth: Medical detoxification takes weeks or months to perform.
Fact: A reputable expert can perform rapid detox in one to two hours.

Detox and Pregnancy
Dependence on opioids increases a woman’s risk for infections, anemia, mood disorders, heart disease, tuberculosis, sexually transmitted diseases, HIV/AIDS, and pneumonia. These conditions increase the risk for complications to the mother and fetus during pregnancy, labor and delivery. Complications include hemorrhage, inflammation of the membrane surrounding the baby, slowed fetal growth, premature labor and delivery, spontaneous abortion, and fetal death.

Methadone reduces these complications and is currently the only approved treatment plan for pregnant women.

A baby born to a mother that uses any opioid during pregnancy, including methadone or tramadol, may suffer withdrawal symptoms during the first weeks or months of life and face low birth weight, seizures, breathing problems, feeding difficulties, and death.

Self Detox and Pregnancy

Self-detoxification can be unsafe for pregnant women.

Inpatient Methadone Induction for Pregnant Women

Doctors usually suggest a pregnant woman start methadone in a hospital, where doctors can establish a safe dose and nurses can monitor the response of the mother and baby to methadone treatments. The doctor will usually start the woman on 10 to 20 mg on the first day and adjust the dosage upwards 5 to 10 mg daily until establishing a safe, effective dose. The maximum dosage for a pregnant woman is 60 mg of methadone.

This inpatient stay typically lasts about three days before doctors discharge the woman to outpatient care, where she will continue methadone treatments until delivery.

Outpatient Induction to Methadone Maintenance

For various reasons, a woman may not be able to start methadone in a hospital and must begin treatments through an outpatient clinic. In the induction phase of treatment, the woman will come to the clinic twice daily, first to receive her daily dose and later for evaluation. Once the outpatient clinician has established a safe dose, the mother may reduce her daily visits to once daily.

The mother may remain on methadone after the birth of her baby. The child will remain under close observation in the hospital for 72 hours after delivery.

What is the best method to detox from tramadol?
The best method to detoxify from tramadol depends heavily on personal need. The individual should assess his potential for severe withdrawal symptoms and complications, and his ability to refrain from drugs then choose the least restrictive approach to treatment that is still likely to bring him to an opioid-free state.

Please contact us for more information on what approach to tramadol detoxification may be right for you or for someone you love.