Tramadol Withdrawals and the Detox Process: What You Can Expect

Like so many other opioid pain relievers, withdrawals from Tramadol can be uncomfortable, overwhelming, and maddening.

Recovering users are often faced with an onslaught of physical discomforts like gastrointestinal problems and muscle aches for days at a time. And on top of that, the psychological effects like insomnia and anxiety can be just as torturous.

These effects often drive tramadol abusers to turn back to using, thus starting the cycle of addiction all over again.


What Is Tramadol Anyway?

Tramadol is an opioid pain reliever (a.k.a. narcotic analgesic) that’s chemically similar to codeine, another popular opioid. However, tramadol is a synthetic opioid, meaning it’s entirely man-made and isn’t derived from the poppy plant like morphine, codeine, and thebaine – all naturally occurring opiates.

All opioids are good at relieving pain due to the fact that they stimulate the mu-opioid receptors in the body and the brain.

And in fact, tramadol is most commonly prescribed precisely for that – to help treat moderate to severe pain.

Unlike other opioids, however, tramadol also has antidepressant effects as well. Rather than making users drowsy, then, it can actually bring about feelings of energy and an uplifted mood.

This has to do with the fact that tramadol also has the dual effect of increasing the duration of norepinephrine and serotonin’s actions in the brain (serotonin-norepinephrine reuptake inhibitor or SNRI). These two chemicals, along with dopamine, are some of the most important for regulating mood.

It’s sold under a couple of different brand names including:

  • Conzip
  • Rybix ODT
  • Ryzolt
  • Ultram
  • Ultram ER

And for most of its time being used as a prescription pain reliever, it was marketed as an entirely non-addictive alternative to other risky drugs like Vicodin, Percocet, and OxyContin.

However, the medical community and the public as a whole are becoming increasingly aware that despite its earlier reputation, tramadol is in fact quite addictive. And just like any other drug, it can end up ruining lives.

Part of the danger of this drug comes from the particularly painful tramadol withdrawal process. Although many physicians claim that this drug doesn’t have any addiction potential, past users have actually described detoxing from this drug as more painful than other more infamous drugs like crystal meth, coke, and even heroin.

Before getting into tramadol’s unique withdrawal process, let’s take a quick look at withdrawal and detoxification as a whole. What are they? Are they necessary for recovery? And why do they happen?

Over the course of any addiction, the body and the mind become more and more used to a substance being in the bloodstream. In fact, it eventually becomes so normalized that the body can’t function regularly without the drug.

And over time, it takes more and more of the substance to produce the same effects, a phenomenon known as building tolerance.

When the drug is abruptly removed from an addict’s routine, the body struggles to readjust to functioning without it. And that readjustment period can produce some incredibly uncomfortable symptoms known as withdrawals.

This entire process is known as detoxification – when the body reacclimates to life without drugs and starts to function on its own again.

After drug use has stopped entirely, the body will naturally begin to detoxify itself all on its own. However, there are various tools, strategies, and medications that professional addiction facilities use to speed the process along and make it less painful throughout.


What to Expect When Detoxing from Conzip

Tramadol is a deceptive drug. Many in the medical community claimed that this drug is far less addictive than other opioids and, ultimately, withdrawal from it is likely going to be much easier to get through.

The truth of the matter, however, is that quitting tramadol is no walk in the park. And in fact, some users have claimed that this type of withdrawal is actually far more difficult to get through than other opioids – even withdrawals from heavy hitters like heroin.

There are a couple of factors that play into why this first stage of recovering from a tramadol addiction is so painful for some. The first is that tramadol is a relatively slow-acting drug. And since the duration of the withdrawal process generally scales with how long it takes for the drugs to come into effect, detox can end up being longer than with other opioids.

The other reason is because of tramadol’s dual effect of treating pain and acting as an antidepressant. As a result, two areas of the brain and body are essentially being deprived of the drug they’ve grown dependent on, not just one.

And for some, that might mean that the process of withdrawal is even more intense.


Here are just some personal accounts of tramadol withdrawal collected from the online drug forums Bluelight and Drugs-Forum.

These can give a glimpse of what others have experienced when going through withdrawal from tramadol and provide a better idea of what to expect from the process.  

Going cold turkey off tramadol is absolutely hideous without benzos. The withdrawals are not the same as 'single action' opiates/opioids. I'm sure you are aware of tram/tapen's anti-depressant effects. After just a few weeks of using tramadol and then stopping abruptly, I had some of the worst withdrawals I've ever experienced. I say that because there is a much more pronounced mental (ie. bizarre mindf***) aspect alongside the typical physical symptoms compared to those of oxy or morphine or even fentanyl… Cold turkey from these can be, no exaggeration, downright traumatic. Extreme depression and mental instability, bizarre and frightening dreams/hallucinations (including in the daytime when just sitting down zoning out), and a desperation/hopelessness that has you willing to do/take anything to make it stop.

Halif via

Tramadol withdrawal is honestly the worst withdrawal I have gone through… I suffered possibly the worst withdrawals any person could imagine. I suffered from "brain shocks", feelings of electricity jolting throughout my body, constant body aches and pains of a severe degree, cold chills, cold sweats, inability to move due to the massive amount of pain, strange twitch movements, inability to sleep, constipation that resulted in 3+ weeks of not being able to pass a bowel movement… as well as many other equally horrific symptoms. This lasted for WEEKS! After the most recent suffer of withdrawal I swore never to touch this horrible drug again.

StonedStupid via

As others have said, the w/d from Tramadol can be the most miserable few days if not weeks of your life… I got zero sleep for a week, was not comfortable whatsoever for a week, had SEVERE restless syndrome at all hours, and the chills were the worst I had ever encountered.

I frankly don't care how "high" I could ever get off Tramadol....the w/d week was enough to make me never want to see that pill again


dlink01 via

Personally, I feel as though Tramadol withdrawal was worse than benzo withdrawal. At least for me. I think you're wrong in saying that Tramadol is easier to get off of than other opiates. For me, it was harder to get off of than heroin. Also, it has anti-depressant properties, so when you withdraw from Tramadol, it's like going through withdrawal from an SNRI and an opiate at the same time. I came off of Tramadol very slowly, and still went through the worse withdrawal of my life for 6 months.

GirlAnachronism via

Tramadol Withdrawal and Detox

Is Withdrawal the Same for Everyone?

As tramadol addicts go through detoxification, they’re likely to experience a wide range of symptoms, some of which can be quite uncomfortable. Plus, this type of drug withdrawal is composed of both physical and psychological symptoms as well.

It’s worth noting, however, that not everyone will experience the same exact symptoms of withdrawal as everyone else. On top of that, the duration of these symptoms is likely to vary from person to person. This process is typically highly unique to the individual.

That's because the types of symptoms, as well as their severity and duration, depend on a variety of factors, such as:

  • Severity of addiction
  • Duration of substance abuse
  • Individual physiology
  • The presence of other co-occurring addictions or disorders
  • Genetics
  • Metabolism
  • Age
  • Gender
  • Going cold turkey vs. tapering
  • Whether or not professional treatments are used

As you can see, there’s a lot that goes into withdrawal and not everyone’s experience is going to be the same.

Having said that, there are a variety of symptoms that most people will experience when quitting tramadol.


Symptoms of Tramadol Withdrawal

According to Mental Health Daily, some of the most common symptoms include:


  • Abdominal cramps
  • Dilated pupils
  • Diarrhea
  • Dizziness
  • Fatigue
  • Goose bumps
  • Headaches
  • Muscle cramps
  • Nausea
  • Pain
  • Sweating
  • Tremors
  • Vomiting


This withdrawal syndrome is pretty consistent among most opioids, with different compounds producing various levels of intensity of the symptoms. However, as the Drug Enforcement Administration points out, this type of withdrawal only occurs in about 90% of tramadol detox cases.

The other 10% usually experience a syndrome that is unusual for opioids. It involves a host of psychological effects that can be quite terrifying if you don’t know what to expect. Some symptoms the DEA lists that might be common in this type of withdrawal include:
  • Hallucinations
  • Paranoia
  • Extreme anxiety
  • Panic attacks
  • Confusion
  • Numbness
  • Tingling in the extremities

As you can see, this is not a typical opioid. And as a result, it’s even more important that anyone trying to get through tramadol withdrawals should enlist the help of a proper addiction professional. Home detox from this drug can be uncomfortable, terrifying, and even deadly.


Going through tramadol detox is a process. And just like withdrawal timelines of other drugs, various symptoms are likely to pop up, and others are going to disappear entirely over the course of the process.

In general, there are three major stages of withdrawal, each with their own set of symptoms and unique timeline. Overall, detoxification from this type of opioid usually takes around 7 to 10 days, though it may take weeks and even months to fully recover for some people.

Stage 1 – The first stage of tramadol withdrawal usually begins within a day after the last dose. For some, it may be as soon as several hours after using, depending on the severity of the addiction.

Symptoms during this stage will continue to increase in severity and will generally peak in intensity around day 3 or 4 of the detox.

Some of the most common early symptoms of withdrawal from opioids like tramadol include:

  • Agitation
  • Anxiety
  • Muscle aches
  • Increased tearing
  • Insomnia
  • Runny nose
  • Sweating
  • Yawning

Stage 2 – The second stage begins after the initial stage symptoms have peaked and started to subside. This stage is marked mostly by gastrointestinal problems. It can also come with symptoms similar to a much more intense version of the flu.

This stage will usually last for around 3 to 4 days and will generally start to subside around day 7 to 10 after last using.

Common symptoms during this stage include:

  • Abdominal cramping
  • Diarrhea
  • Dilated pupils
  • Goose bumps
  • Nausea
  • Vomiting

Stage 3 – This stage, also known as post-acute withdrawal syndrome or PAWS, is relatively rare and won’t affect everyone trying to kick their tramadol addiction. That being said, it’s important to learn a bit more about this unique syndrome, just in case.

People affected by PAWS will generally experience troubling symptoms long after the average duration of withdrawal has passed. In fact, some recovering tramadol addicts might actually not feel right for weeks, months, or even years after quitting.

With proper help from a professional addiction facility, the duration and severity of these symptoms can be reduced.

PAWS includes symptoms that aren’t quite the same as during earlier withdrawal. And in most cases, these symptoms are mainly psychological in nature. They include:

  • Anxiety
  • Sleep difficulties
  • Problems with short-term memory
  • Persistent fatigue
  • Difficulty concentrating and making decisions
  • Alcohol or drug cravings
  • Impaired executive control
  • Anhedonia
  • Difficulty focusing on tasks
  • Dysphoria or depression
  • Irritability
  • Unexplained physical complaints
  • Reduced interest in sex

The Dangers of At-Home Detox

In general, at-home detoxification from tramadol should be avoided at all costs. Withdrawal is a complicated process, and when handled improperly, it can have dangerous and even fatal repercussions.

The most notable danger of trying to detox from opioids like tramadol at home rather than partnering with a professional facility is the increased risk of deadly overdose.

To explain, opioids have a tendency to build up tolerance quicker than many other drugs. In fact, studies have shown that tolerance to opioids can develop within hours of taking high doses.

But in the same way, tolerance to the drugs also drops quicker than normal as well. And if someone trying to quit tramadol ends up relapsing and using the same dosage as before to get high, it might actually be more than their body can take.

These accidental overdoses on opioids are a main source of the ever-rising death toll.

And since at-home detox carries with it a much higher risk of relapsing than detoxing with a professional facility, this form of getting through withdrawal is far more dangerous.


In addition to the danger of relapsing when going through withdrawal from tramadol addiction without professional help, there are a number of other complications that can end up being deadly if left untreated.

Some of the most common complications that may occur during detoxification include: 

  • Malnutrition – Drug addictions of all kinds typically lead users to put their needs on the backburner in favor of using. And as a result, many serious addicts tend to have poor nutrition when they first begin detoxification. A well-maintained and nutrition-rich meal plan is important in counteracting some of the dangerous side effects of malnutrition.
  • Dehydration – Due to the near-constant vomiting and diarrhea that many tramadol addicts encounter when trying to quit, dehydration is more than just a passing concern. Drinking plenty of water and rebalancing electrolytes during this period is critical.
  • Choking – Vomiting is quite common during detox, and unfortunately, it can even be life-threatening. When left unattended and untreated, some recovering addicts actually can choke on their own vomit. Having a friend, family member, or (better yet) an addiction professional by your side can be a literal lifesaver then.
  • Pulmonary Aspiration – An infection of the lungs that can occur when vomit is actually inhaled, pulmonary aspiration can lead to pneumonia and other serious diseases. Plus, it can even be fatal.
  • Arrhythmia & Cardiac Events – As the body readjusts to functioning without tramadol, essential organs like the heart can be thrown out of their normal rhythm. And when that happens, the risk of cardiac events like heart attack and stroke tend to skyrocket.

What Makes Professional Detoxification So Much Better?

Partnering with a professional medical detox facility is by far the safest and most effective way of pushing through withdrawals and securing a strong foundation for the rest of recovery.

The knowledgeable staff and physicians in this program will not only provide expert advice and guidance for making detoxification as successful as possible but will also be able to administer life-saving care and treatment.

The many complications that can occur during detox, then, can be avoided entirely with medical detoxification from tramadol addiction.

Plus, professional detoxification may also make use of a variety of specialized medications that have been proven to make withdrawals much more manageable. These medications include:

  • Methadone – One of the earliest drugs for treating opioid addiction, methadone is actually an opioid itself, albeit a much milder, more manageable one. Patients usually take one dose of this oral solution a day to help stave off cravings and reduce the intensity of withdrawals. However, methadone can be addictive and can only be administered by an addiction professional.
  • Buprenorphine – A rising star in the world of opioid addiction treatment, buprenorphine (Suboxone) has a lower risk of abuse than methadone because of its ceiling effect. Only a certain amount of the drug is effective and taking more of it yields no greater effect.
  • Naltrexone – This compound essentially blocks opioid receptors entirely without activating them (unlike methadone and buprenorphine). As a result, if someone relapses while on naltrexone, the opioid will not have any effect on the body, thereby removing the incentive to use again. It also comes in an easily administered shot and may even be as effective as buprenorphine.

Some of the most serious short-term side effects of abusing tramadol include:

  • Dizziness
  • Headache
  • Drowsiness
  • Nausea and vomiting
  • Constipation
  • Lack of energy
  • Sweating
  • Dry mouth
  • Adrenal insufficiency
  • Androgen deficiency

One of the most dangerous short-term side effects of tramadol abuse is, of course, overdose. Like other opioids, tramadol tends to slow down the body’s natural rate of breathing. And when it’s taken at high doses or with other drugs, breathing can become so depressed that it can actually end up being deadly.

Some symptoms of a tramadol overdose to watch out for include:

  • Decreased size of the pupil (the black circle in the center of the eye)
  • Difficulty breathing
  • Extreme drowsiness
  • Unconsciousness
  • Coma (loss of consciousness for a period of time)
  • Slowed heartbeat
  • Muscle weakness
  • Cold, clammy skin

Long-Term Consequences of Abusing Ultram

In the long-term, tramadol abuse can and often does develop into a full-blown addiction. And besides the physical dependency that tends to develop alongside an addiction, there are plenty of other negative effects that addiction can cause. These include:

  • Jeopardizing relationships with friends and family
  • Losing your job or risking your career goals
  • Experiencing numerous health problems
  • Getting into trouble with the law
  • Sacrificing your personal freedom

Tramadol abuse can also lead to a potentially fatal disorder called serotonin syndrome. It’s caused by a buildup of serotonin, one of the brain’s neurotransmitters. Since tramadol blocks the body’s natural reabsorption of serotonin, taking it improperly (either alone or with other drugs) can lead to the development of this serious condition.

Some symptoms of serotonin syndrome include:

  • Agitation or restlessness
  • Confusion
  • Rapid heart rate and high blood pressure
  • Dilated pupils
  • Loss of muscle coordination or twitching muscles
  • Muscle rigidity
  • Heavy sweating
  • Diarrhea
  • Headache
  • Shivering
  • Goose bumps
  • High fever
  • Seizures
  • Irregular heartbeat
  • Unconsciousness

Opioids like tramadol are both dangerous and highly addictive – that much is clear. But why do these drugs in particular cause so much of a problem for so many people today?

Why is it opioids that are behind some of the most shocking new statistics on overdose deaths today?

And why has the problem gotten so bad that drug overdose is now the #1 cause of death for Americans under the age of 50?

Part of the reason is that opioids like tramadol can end up building tolerance extremely quickly. In fact, according to the CDC, “as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction.”

Even when administered in a clinical setting, then, opioids can still become highly addictive. That’s because these drugs cause an intense and particularly pleasurable euphoria when taken improperly.

That high is caused by a flood of dopamine in the brain, the body’s primary pleasure neurotransmitter. Natural activities like exercising, eating, and having sex all cause a similar release of dopamine. But when opioids are abused, they tend to release much more.

Think of it like hijacking the body’s natural reward system.

Eventually, that system doesn’t work as well on its own. And soon, opioids like tramadol are the only things that can trigger the release of dopamine. The result is a bleak and joyless life where the only pleasure comes from abusing these drugs.  

Added to that is the fact that the withdrawal symptoms from tramadol are, as we’ve seen, incredibly uncomfortable.

In the end, addiction is fueled by the fact that the brain becomes physically hardwired to be unable to experience pleasure without using drugs. And if an addict waits too long to use, they’ll start feeling sicker than they ever have in their life too.

It’s a vicious spiral. And it’s one that only professional treatment can break through.

Given just how addictive tramadol can be, you’d be surprised at how tough it can be to actually spot the symptoms of an addiction in the first place.

However, there are a few telltale signs of a substance use disorder to watch out for. And for tramadol addiction, these include:  

  1. You’re mainly spending time with people who use drugs.
  2. Most of your thoughts are centered around using drugs.
  3. You’re using drugs even when you told yourself that you wouldn’t.
  4. You’re not able to stop using drugs when you want to.
  5. Using drugs is having a negative impact on your life.
  6. Your family is telling you that you have a drug use problem.
  7. You don’t care about activities and hobbies anymore that you used to love.
  8. You’re stealing money in order to be able to afford your drugs.
  9. You’re having health issues that are related to your drug use.
  10. You’re unable to hold down a steady job because of your drug use.

If you think you or someone you know is struggling with an addiction to tramadol, there are a couple of other places you can look to get a better idea of how bad the problem has gotten.

For instance, you can take one of the addiction quizzes below to help narrow down the severity of the problem. Each only takes just a few minutes to complete and can be a vital first step towards getting clean for good. 

You can also get in touch directly with an addiction professional for a free addiction phone assessment as well. These calls are a little more in-depth and usually take around 20 minutes. But this method also offers a much more personalized approach. Callers can ask questions, get clarifications, and even be directed to other helpful resources in the area.

And of course, each call is 100% obligation-free and completely confidential too.

In the end, the most important thing to remember is that getting treatment early on is the absolute best way of preventing a more long-term (and potentially permanent) addiction to this dangerous drug.

How Is Addiction to Tramadol Treated?

The first phase of tramadol addiction treatment is detoxification. This process is crucial for setting the proper foundation for recovery and when done properly, can significantly reduce the risk of relapse further down the line.

However, detox is only the first step on the road to recovery. And in fact, the National Institute on Drug Abuse (NIDA) points out that medical detoxification “by itself does little to change long-term drug use.”

In order for treatment to be effective, then, it has to be coupled with further care. And that care is rehabilitation.

While detox can be thought of as healing the body of an addiction, rehab is more focused on the mind. Addiction, after all, isn’t just about physical dependency. It’s about the patterns of drug-seeking behavior that become compulsive and out of a person’s control. And those behaviors all originate in the brain, not the body.

Rehab from addiction to tramadol helps addicts essentially rewire their brain and learn new methods of coping with stress and life as a whole. It’s a deeper, more important part of recovery that, sadly, most people don’t consider.

Rehabilitation usually comes in three different formats: inpatient, outpatient, and intensive outpatient.

  • Inpatient RehabThis kind of program is what most people think of when they imagine rehab. Patients are required to eat, sleep, and stay on the campus premises at all times in most cases. This allows for a more controlled environment with less exposure to triggers and temptations while also allowing recovering addicts to put all their focus on healing. They usually last for around one month.
  • Outpatient RehabilitationContrary to inpatient programs, an outpatient treatment protocol allows patients to attend evening sessions throughout the week for treatment. During the day, patients are allowed to go to work or school and meet normal family obligations as well. However, the tradeoff is a less intense treatment and more exposure to temptation. These programs typically last for about 3 months.
  • Intensive Outpatient Programs (IOPs)A comfortable middle ground between inpatient and outpatient, IOPs hold treatment sessions in the evenings like an outpatient program. But these sessions generally last longer and occur more frequently throughout the week. These programs also tend to last for around 3 months.

There are a number of different therapies used in treating tramadol addiction and addiction as a whole. And the very best facilities will offer an enormous variety of approaches to treating this disease rather than just one cookie-cutter plan.

After all, one of NIDA’s 13 principles of effective treatment is that “No single treatment is appropriate for everyone.”

Some of the most common and effective treatments include:

  • Cognitive Behavioral TherapyMore commonly known as CBT, this type of behavioral therapy focuses on identifying triggers and avoiding high-risk situations so as to reduce the likelihood of experiencing cravings. This type of therapy also provides proven tools and strategies for dealing with these cravings should any arise.
  • Individual Therapy – Substance abuse and addiction often develop due to problems with self-medication. Often addicts have underlying trauma or other co-occurring disorders and using is a way of treating those problems on their own. Individual therapy can help patients get to the root of their addiction and start treating the cause rather than just the symptoms.
  • Family Counseling – The family unit is one of the most powerful support networks an addict will ever have. Consequently, many addiction facilities offer family counseling to help strengthen this integral unit and hopefully mend any relationships that have suffered as a result of the tramadol addiction. These sessions may also use family behavior therapy, also known as FBT.
  • Group Therapy – Following in the footsteps of 12-step meetings like Narcotics Anonymous (NA), group talk therapy is a way for addicts to better come to terms with their tramadol addiction while also learning from the stories of others. Patients can also build up their social support network and learn new coping strategies they may not have otherwise known about.
  • Holistic Therapy – Holistic therapy involves nourishing the body as a whole as a means of speeding along recovery and reducing the severity of cravings and other withdrawals. The focus of holistic therapy is on proper nutrition to fuel the body’s natural healing, exercise to boost feel-good endorphins, and stress management techniques like mindful meditation and yoga.
  • Alternative Therapies – Treatment may also include other alternative therapies such as:
    • Acupuncture
    • Leadership excursions
    • Outdoor team-building sessions
    • Biofeedback therapy
    • Art therapy
    • Music therapy
    • Equine therapy
    • Eye Movement Desensitization and Reprocessing (EMDR)

Northpoint Washington: The Best Choice for Recovery

As you can see, recovering from a tramadol addiction is no picnic. Despite the reputation it’s falsely earned in the medical community, this drug can be highly addictive and can cause serious substance use disorders when not used properly.

On top of that, tramadol withdrawals can be excruciating due to its dual nature as an opioid pain reliever and an SNRI antidepressant.

It’s critical, then, that if you or someone you love is struggling with an addiction to tramadol, you find the right professional addiction facility to partner with. Doing so will ensure the very best outcome of the detox process and will also protect their safety along the way.

And at Northpoint Washington, we’re proud to be one of the best tramadol addiction treatment programs available. Our clean and modern facility provides cutting-edge treatment that’s rooted in empirical evidence and is proven effective. On top of that, we offer fully individualized treatment plans – no cookie-cutter programs here.

Plus our staff-to-patient ratio is one of the highest in the area so you can be sure you’re getting the attention you deserve.

It’s these qualities and more that led us to be nationally accredited by the Joint Commission – a true testament to our exceptionally high standards of quality.

Do you have questions about addiction or treatment? Are you looking for a proven treatment facility to help you recover from your addiction to tramadol?

If so, give us a call today, and we can begin your recovery.

Sobriety is possible, and addiction isn’t a death sentence. And we’d love to help you get back control of your life again.

Please, get in touch today.  

Talk to a Rehab Specialist

Our admissions coordinators are here to help you get started with treatment the right way. They'll verify your health insurance, help set up travel arrangements, and make sure your transition into treatment is smooth and hassle-free.

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