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  • Tramadol (brand name Ultram) is an opioid analgesic used to treat moderate to severe pain. It targets opioid receptors throughout the body to block pain signals. It also slows down the central nervous system and can produce relaxation and euphoria.

    Some people abuse tramadol for this calming effect. Taking tramadol in any way other than prescribed is considered drug abuse.

    If you take tramadol regularly, you’ll develop a tolerance to it over time, so you’ll need a higher dose to get the same pain relief. As your body adapts to the drug, it develops a physical dependency and reacts adversely if you stop taking it. This reaction is called withdrawal.

    Tramadol Withdrawal Symptoms

    If you stop taking tramadol abruptly, you’re likely to experience withdrawal symptoms. Most doctors will work with you to create a tapering schedule so you can gradually wean off tramadol and reduce these symptoms.

    If you’ve been abusing tramadol, you may have withdrawal symptoms even when you try to cut back. 

    People going through tramadol withdrawal often experience flu-like symptoms, such as:

    • nausea
    • sweating
    • rigors (shivering cold with high body temperature)
    • pain
    • tremors
    • diarrhea
    • upper respiratory issues

    Symptoms of tramadol withdrawal can also include piloerection (hairs standing up), insomnia, and anxiety. 

    Tramadol withdrawal symptoms that are uncommon but have been reported are: 

    • paresthesia (“pins and needles”)
    • severe anxiety
    • panic attacks
    • hallucinations
    • psychosis

    Tramadol Withdrawal Timeline

    Tramadol is processed in the liver, and its main metabolite, M1, is broken down by the kidneys. The effects of tramadol peak after 2 to 3 hours. Its half-life is between 6 and 7 hours, which means half of a dose will be metabolized and excreted from the body in that time. 

    When a significant amount of the drug is out of your system, withdrawal symptoms will start—usually within 12 hours of your last dose. The most intense symptoms happen during acute withdrawal, which generally lasts a week. Milder symptoms may continue for 2 weeks.

    Tramadol withdrawal is different for everyone. The length and severity of the withdrawal process depend on many personal factors, such as:

    • how much you took in your last dose
    • how much you usually take at a time
    • how often you take tramadol
    • how long you’ve been taking it
    • how you take it (orally, nasally, etc.)
    • if you’ve been abusing it
    • if you take it with other drugs 
    • if you stop abruptly (“cold turkey”)
    • your genetics, age, body mass, and overall health

    Post-Acute Withdrawal Syndrome (PAWS)

    Some people experience post-acute withdrawal syndrome (PAWS) when they quit taking opioids. PAWS, also called protracted withdrawal, is a condition in which you may have withdrawal symptoms for weeks or months after stopping drug use. 

    People with PAWS often have psychological symptoms, such as:

    • difficulty concentrating
    • memory problems
    • pessimism or apathy
    • sleep disturbance
    • anxiety or panicky feelings
    • depression
    • irritability
    • drug cravings
    • more sensitivity to stress

    Around 90 percent of people in recovery from opioid abuse have PAWS to some extent. 

    Tapering Off Tramadol

    Tapering off of tramadol is the process of gradually reducing your dosage until you’re able to stop taking it. Tapering usually results in fewer and less intense withdrawal symptoms. 

    While tapering may seem like a simple process, you should only do it with medical support. It’s difficult to know how much to reduce your dose and when. It can be especially challenging to stick with it if you’re experiencing cravings. 

    If you resume your regular dose to alleviate cravings after your body has adjusted to a lower dose, you risk an overdose, which can be fatal.

    A doctor sees the situation from an outside perspective and can make appropriate adjustments to your tapering schedule. 

    Tramadol Detox

    If you’ve been struggling with tramadol abuse or addiction and want to stop using it, recovery may start with detoxification (detox). Detox is the process of ridding your body of drugs, and it can be unpleasant. 

    Opioid withdrawal symptoms aren’t life-threatening but may make you so uncomfortable that you take tramadol for relief. 

    A medically assisted detox program can help you through the withdrawal process. Medical detox takes place in a safe, inpatient setting and is run by medical professionals. Your vital signs are monitored and you may receive medications to make the process more bearable. 

    These medications include anti-diarrhea medicine and over-the-counter painkillers. They might also include Lucemyra (lofexidine), the first FDA-approved non-opioid treatment for reducing opioid withdrawal symptoms in detox.

    Having support during detox increases your chances of successfully stopping substance abuse so you can participate in an abstinence-based recovery program.

    Treatment For Tramadol Addiction

    Because opioid cravings can linger after detox, many people benefit from medication-assisted treatment (MAT) for tramadol addiction. 

    Rather than detoxing then starting an addiction treatment program, people in MAT take medication to reduce cravings while they’re in behavioral therapy.

    Medications used in MAT include:

    • Methadone: an opioid medication that reduces cravings and blocks the effects of opioids
    • Buprenorphine: an opioid medication that decreases cravings without causing a high
    • Naltrexone: a non-opioid medication that blocks the effects of opioids (this one can only be used once you’ve detoxed completely)

    Whether you’re in MAT or an abstinence-based drug rehab program, addiction treatment should be tailored to your unique needs. Our personalized tramadol treatment programs at Ark Behavioral Health nurture your physical and mental health as you heal from substance abuse.

    To learn more about tramadol withdrawal, detox, and treatment options, speak with an Ark Behavioral Health specialist today.

    Written by Ark Behavioral Health Editorial Team
    ©2023 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    FDA - FDA approves the first non-opioid treatment for management of opioid withdrawal symptoms in adults
    National Institute for Biotechnology Information - Psychosis following Tramadol Withdrawal
    Substance Abuse and Mental Health Services Administration - MAT Medications, Counseling, and Related Conditions
    U.S. National Library of Medicine: DailyMed - tramadol hcl - Tramadol hydrochloride tablet
    U.S. National Library of Medicine: MedlinePlus - Opiate and opioid withdrawal

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 18, 2022
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