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Tramadol insomnia: The effects of two single doses of tramadol on sleep: a randomized, cross-over trial in healthy volunteers


Common and Rare Side Effects for tramadol oral

COMMON side effects

If experienced, these tend to have a Severe expression i

Sorry, we have no data available. Please contact your doctor or pharmacist.

If experienced, these tend to have a Less Severe expression i

  • dry mouth
  • constipation
  • sensation of spinning or whirling
  • dizziness
  • difficulty sleeping
  • temporary redness of face and neck
  • headache
  • nausea
  • vomiting

INFREQUENT side effects

If experienced, these tend to have a Severe expression i

If experienced, these tend to have a Less Severe expression i

  • confusion
  • blurred vision
  • high blood pressure
  • widening of blood vessels
  • indigestion
  • joint pain
  • drowsiness
  • excessive sweating
  • a skin rash
  • decreased appetite
  • gas
  • diarrhea
  • nervousness
  • generalized weakness
  • intense abdominal pain
  • anxious feelings

RARE side effects

If experienced, these tend to have a Severe expression i

  • low blood sugar
  • decreased function of the adrenal gland
  • deficiency of a substance that promotes masculinization
  • anemia
  • suicidal behavior
  • addiction to a drug
  • serotonin syndrome, a type of disorder with high serotonin levels
  • hearing loss
  • a low supply of oxygen rich blood to the heart
  • a clot in the lung
  • abnormal heart electrical signals
  • prolonged QT interval on EKG
  • inadequate blood flow in the extremities
  • fluid in the lungs
  • bronchospasm
  • liver failure
  • inflammation of the liver called hepatitis
  • a skin disorder with blistering and peeling skin called toxic epidermal necrolysis
  • a skin disorder with blistering and peeling skin called Stevens-Johnson syndrome
  • seizures
  • sleep apnea
  • trouble breathing
  • an increased need to urinate often
  • a significant type of allergic reaction called anaphylaxis
  • a type of allergic reaction called angioedema
  • accidental falls
  • an accidental injury
  • fast heartbeat

If experienced, these tend to have a Less Severe expression i

  • mood changes
  • agitation
  • an extreme sense of wellbeing called euphoria
  • depression
  • a change in vision
  • decreased pupil size
  • ringing in the ears
  • bruising under the skin
  • throat irritation
  • inflammation of the tissue lining the sinuses
  • stomatitis, a condition with painful swelling and sores inside the mouth
  • inflammation of the lining of the stomach and intestines
  • urinary tract infection
  • bloody urine
  • the inability to have an erection
  • a problem with menstrual periods
  • neck stiffness
  • an abnormal increase in muscle tone
  • muscle pain
  • leg cramps
  • delirium
  • fainting
  • a sleep disorder
  • fever
  • flu-like symptoms
  • chills
  • muscle twitching
  • taste impairment
  • fluid retention in the legs, feet, arms or hands
  • weight loss
  • heart throbbing or pounding
  • yawning
  • difficult or painful urination
  • high blood sugar
  • bruising
  • indifferent behavior
  • abnormal dreams
  • night sweats

Tramadol is an odd, unpredictable opioid, scientists say

Scientists who’ve studied the curious chemistry of the opioid tramadol use an array of adjectives to describe it: “unpredictable,” “messy,” “crazy.

Tramadol is unlike most other opioids in that it must pass through the liver to be metabolized into its most potent form. At the same time, it releases another type of drug that acts as an antidepressant because it increases levels of serotonin in the brain, which elevates mood.

But how much opioid and how much antidepressant is released is heavily dependent on users’ genetics, said Bertha Madras, professor of psychobiology at Harvard Medical School. One person might get a potent dose of opioid, while the next gets nearly none.

Research has shown that some ethnic groups are prone to process tramadol as a far more potent opioid, upping the risk of addiction, Madras said. In a cruel twist, those groups are largely clustered in the areas that lack access to other opioid medications, so are dependent on tramadol for pain relief: Africa, the Middle East and parts of Asia. Studies suggest nearly 30% of North Africans metabolize tramadol to the most active opioid potency, she said, compared with about 1 percent of northern Europeans.

Grunenthal, the German pharmaceutical company that originally synthesized tramadol, also points to its strange chemistry to defend its claim that the drug is less prone to be abused. As people begin to abuse most opioids, they move to higher doses, then to snorting or shooting up as they build up tolerance and no longer feel the same high from the same dose. But tramadol, one recent survey suggests, might naturally deter that trajectory because as doses increase, nasty side effects become more pronounced. And since it must pass through the liver to reach full effect, users do not transition to snorting or injecting.

Tramadol taken at high doses — particularly when combined with other drugs — can cause the respiratory depression that leads to overdose deaths. The United Kingdom, for example, decided to regulate the drug in 2014, after researchers found that as the number of tramadol prescriptions increased, so did the number of times it was mentioned on death certificates. But it has not as routinely caused overdose as more traditional opioids. Users who take too much often first have a side effect different than other opioids: an overload of serotonin that causes seizures.

“Tramadol is most likely not as problematic as some of the big gun opioids like oxycodone and fentanyl and heroin,” Madras said. “But it certainly can be in certain populations and it certainly can be if it’s abused by a wider and wider swath of the population.”

When people who’ve become dependent try to stop taking tramadol, they have withdrawal symptoms like those of traditional opioids, including pain, sweating, diarrhea and insomnia, according to the World Health Organization. But the serotonin crash adds other problems: hallucinations, panic, paranoia and confusion.

I can’t sleep. What drugs can I (safely) take?

If you’re having trouble sleeping, medicines shouldn’t be your first option. Exercise regularly, cut back on coffee (and other caffeinated drinks) after midday, eat less in the evening, ease up on “screen time” before, and in, bed, practise meditation and try to have a quiet, dark bedroom dedicated mostly to sleep.

But what if you’ve tried everything and are still struggling with sleep? Many people will want to turn to a medicine for help. Navigating the various options for effectiveness, safety and the potential to become habit-forming can be difficult.

Long-term regular use of medicines to promote sleep should be avoided, as initial effectiveness declines rapidly over a few weeks and dependence and adverse effects become problematic. But in the short short term, sleep medications do have their place. Unfortunately they are often over-used, especially in older people.

Read more:
Why getting enough sleep should be on your list of New Year’s resolutions


Benzodiazepines are drugs such as Valium, also used to treat anxiety. They are the most commonly prescribed sleeping pills.

Their effects, which include some muscle relaxing properties, are achieved by enhancing the effect of GABA, an inhibitory neurotransmitter operating throughout the brain. Rarely, some people experience the opposite and become over-excited and more anxious.

As benzodiazepines depress brain function (they depress the central nervous system), their effects add to other central nervous system depressants including alcohol, sedating antihistamines and opioid analgesics such as oxycodone (Endone). This can be very dangerous, and when combined can lead to respiratory failure, coma and even death.

Physiological and psychological dependence on the drug can develop after only a few days in some people, or weeks in most. Unfortunately, far too many people are dependent.

Read more:
Weekly Dose: Valium, the ‘safer choice’ that led to dependence and addiction

Importantly, the effectiveness for inducing sleep wears off after a few weeks. It can be very hard to stop taking benzodiazepines as insomnia and often anxiety returns. The duration of “withdrawal” is related to the length of time these are taken.

Stopping suddenly after long-term use can be dangerous, with violent withdrawal reactions possible, including epileptic seizures. Ceasing these medicines needs to be managed by your doctor. Essentially, a gradual reduction in dose is needed with support and counselling to assist with the temporary increase in insomnia and perhaps anxiety.

Side effects include a “dulling” of cognitive function, memory impairment and the increased risk for accidents, especially unsteadiness and falls in older people.

Benzodiazepines should only be used for two to four weeks, or intermittently, and only in addition to good sleep hygiene (that is, practising the measures listed in the first paragraph).

Temazepam (brand names Normison, Temaze, Temtabs) and lorazepam (brand name Ativan) are reasonable choices from the many benzodiazepines available. That’s because they have a faster onset and short duration of effect so as to avoid a “hangover” the next day.

Read more:
Health Check: how to soothe yourself to sleep

Z-drugs (hypnotics)

Zopiclone (brand names Imovane and Imrest) and zolpidem (brand name Stilnox) are similar in their pharmacology and effects to the benzodiazepines. These prescription-only medicines also enhance the actions of GABA to depress brain activity and have the same hazards related to excessive sedation and dependence.

Bizarre behaviours and symptoms, for example hallucinations and sleep-walking that can be dangerous, are more likely than with benzodiazepines.

Medications for sleep can’t be used long term.
from www.shutterstock.com


Older antihistamine medicines, now known as sedating antihistamines, induce drowsiness through their central nervous system-depressing properties. These are available over the counter from pharmacies. Common examples include diphenhydramine (brand name Unisom Sleep Gels), doxylamine (brand name Restavit) and promethazine (branded Phenergan).

Especially in those with allergies such as hay fever disturbing their sleep, these may be a reasonable short-term option. Dependence on these medications to sleep is a hazard.

These medicines have side effects including dry mouth, blurred vision, constipation, confusion, dizziness and urinary retention in men with prostrate problems. All side-effects are worse in older people.

By contrast, over-the-counter antihistamines commonly used to treat hay fever (such as brand names Telfast, Zyrtec and Claratyne) are non-sedating, and therefore not likely to make you drowsy.


Any opioid-containing medicine, all now requiring a prescription, will induce drowsiness (depending on the dose) because they also depress our central nervous system. Codeine (in Panadeine, Panadeine Forte or Nurofen Plus), tramadol, tapentadol, morphine or oxycodone will make us sleepy, but they’re not recommended to treat insomnia.

These powerful medicines are best reserved for judicious use in pain relief, given the severe hazards of dependence and overdose. Older people are more sensitive to the central nervous system-depressing effects and also to constipation.

Read more:
Health Check: five ways to get a better night’s sleep


Our sleep-wake cycle is dependent on the hormone melatonin released cyclically from a gland in our brain. Melatonin administered orally helps induce sleep in some people, but is not as effective as other sedatives.

However, a recent Australian study tested melatonin in people with sleep problems caused by delayed melatonin release in their brains. These people have trouble falling asleep and waking at times appropriate for proper functioning.

Taken one hour prior to bed time, melatonin (0.5mg) accompanied by a behavioural intervention (such as learning how to meditate) helped the participants get to sleep and improved common accompanying impairments such as low mood, anxiety and difficulty concentrating.

You need a prescription for melatonin in Australia. It’s best to avoid alcohol as it interferes with sleep, thereby reducing any effect of melatonin. It is worth trying as it is generally well tolerated, although some people experience back pain. It may work in other types of sleep disturbances, not due to delayed release of melatonin. A dose of 2mg, controlled release one to two hours before bedtime is most commonly used.


Antipsychotic medicines (such as quetiapine) have been increasingly used to treat insomnia.

Typically used at a lower dose, quetiapine can induce sleep but carries a significant burden of possible harmful effects. These include a fast heart rate, agitation, low blood pressure and unsteadiness. These make quetiapine not appropriate for treating common sleep problems.


Antidepressants are typically prescribed at a low dose for insomnia, but the supporting evidence of efficacy (despite the wide use) is low quality and there is the risk of adverse effects such as confusion, dry mouth and blurred vision.

Herbal and complementary medicines

Herbal remedies such as valerian, lavender, passiflora, chamomile, hops and catnip are widely promoted to promote “sleep health”. Research to support their efficacy is limited.

Read more:
Is it possible to catch up on sleep? We asked five experts

Many newer and emerging medicines are being tested for insomnia, so in the future more options should be available.

For now it’s important to remember none of the options listed above is without side effects, and most will cause dependence if used long term, meaning falling asleep without them will be even harder than it was before.

Improve your sleep hygiene, and if that hasn’t worked for you, speak with your doctor about what’s keeping you up at night. She’ll be able to prescribe the best type of medication for you to use in the short term.

How to Ease Withdrawal Insomnia During Recovery

Trouble sleeping is a common withdrawal symptom for people who are addicted to drugs and alcohol. This can be troubling and lead to increased anxiety. While withdrawal insomnia is common, there are ways that you can deal with it and try to get a better night’s sleep.

How Addiction and Recovery Affect Sleep

Sleep problems can occur with any type of addiction. Sleep problems are also a common withdrawal symptom for people recovering from overuse of alcohol, cannabis, opioids, sedatives, anxiety medications, and stimulants.  Because every person and every addiction is different, the nature and degree of sleep problems varies.

People recovering from addictions may not return to normal sleep patterns for six months or longer. However, the initial few days of withdrawal can be particularly troubling. Sleep deprivation only makes the experience of withdrawal more uncomfortable.

This is because your body is out of its normal rhythm. The time you spent using drugs or drinking excessively has changed the way your body works, and this commonly includes sleeping patterns. During recovery, your body is changing once again and trying to get used to being free of the substance. It is only natural that your sleep will be disrupted again.

How to Ease Withdrawal Insomnia

The good news is that for most people, withdrawal insomnia is only temporary. It is one of the side effects of cleaning out your body and returning to a substance-free life. 

The more disciplined you are in following guidelines for good sleep hygiene, the quicker your withdrawal insomnia will disappear. Quite often, the simplest things you can do are the best.

  • Establish sleep rituals. Much of recovery is about replacing bad habits with healthy ones. When it comes to sleep, try to go to bed and wake up at the same times. Wind down with quiet activities like reading before bed. Anything that will calm and relax you before trying to sleep will help.
  • Re-establish your circadian rhythms. Addiction can be difficult on your natural sleep cycle, and your body may have become accustomed to staying up most of the night. One way to counteract that is to expose your eyes—without sunglasses—to outdoor daylight early in the day. Do not look directly at the sun. 
  • Try natural approaches first. Drink a warm cup of soothing, caffeine-free tea before bed, try meditation, and stay active during the day. These are just a few natural approaches you can take to improving your sleep. Stick with it and combine methods if needed. It’s likely you’ll find better sleep soon.

Sleep Medication Precautions

Addictions can lead to other addictive behavior. It is most important that you try and avoid things that have the potential to become a substitute for your drug of choice. This is particularly true in the early stages when you’re going through withdrawal and you’re most tempted to find fast relief.

Try to avoid self-medicating with other drugs while you are going through withdrawal. This includes over-the-counter (OTC) sleep aids, marijuana, and alcohol.

Talk to your physician about whether short-term use of prescribed medications may help you sleep for the first few days. Some medications may be helpful in easing other withdrawal symptoms. These are very specific to the drug you are withdrawing from as well as the drug you are prescribed.

Discuss potential side effects with your physician before taking these medications, and make sure to follow your physician’s instructions to the letter. Under no circumstances should you take more than prescribed, or for longer than prescribed. You may become ill or simply develop a substitute addiction.

Why Good Sleep Is Key to Recovery

As difficult as it may be, establishing good sleep habits early in your recovery can increase your chances of avoiding a relapse. You will hear this advice from former addicts, recovering alcoholics, and, most likely, your doctors and counselors as well.

A study of cocaine-addicted rats showed that sleep abnormalities increased the chances of relapse. Those animals that slept longer, with fewer interruptions, were less likely to exhibit cravings for cocaine. While findings from animal studies often don’t correspond with results in humans, the researchers speculate that the same association supports sleep-based therapies for people with cocaine addiction.

This is a reasonable hypothesis because sleep is one of the keys to a healthy body. That is, after all, one of the goals for overcoming addiction. While it may seem impossible at the moment, whatever you can do to improve your sleep can help in your long-term recovery.

Side Effects And Symptoms Of Tramadol (Ultram) Addiction

Tramadol is an opioid analgesic that treats acute or chronic pain. Tramadol interacts with the brain’s reward center, and long-term use can result in cravings and dependence. People who become dependent on tramadol may suffer from withdrawal, addiction, and overdose.

This prescription narcotic may be sold under the brand names Ultram, Ryzolt, or Conzip. This drug is considered to have a low dependence potential, compared to other opioids. While tramadol is not as potent as other drugs in its class, people can still become physically dependent.

Being physically dependent on tramadol can lead a person to abuse their prescription and become addicted. People who are dependent on the drug will also require large amounts of the substance in order for their body to function properly. This can lead people to abuse the drug, and take tramadol other than how it’s directed.

People who abuse tramadol may also show symptoms of addiction, including changing the method of use or visiting multiple doctors. If you or someone you love is struggling with tramadol, an addiction treatment center may be able to help you overcome the addiction.

Side Effects Of Tramadol (Ultram) Abuse

Like most other medications, people can have various reactions to tramadol. Some people may take their prescription as directed and have no adverse effects. Others may take the drug in a similar manner and suffer from side effects such as insomnia.

If a person abuses the medication, tramadol’s potential side effects may be intensified. These side effects may range from mild to severe, depending on how much tramadol a person ingests. If a person abuses tramadol with any other substances (called “polydrug use”), the risk of side effects is increased.

Abusing tramadol can lead to additional side effects, including:

  • nervousness
  • uncontrollable shaking of a part of the body
  • tight or sore muscles
  • heartburn
  • drowsiness
  • dry mouth
  • headache
  • stomach pain
  • irritability
  • change in appetite

Tramadol is also known to cause a drug tolerance. When a person takes an opioid for any length of time, their body may become tolerant to its usual dose. This means that as time goes on, their body requires larger or more frequent doses of the drug in order to get the same effects.

If a person continually increases their dose, they may resort to abusing the drug, or take it other than how it’s directed. Prescription drug abuse can cause a person to display certain symptoms of tramadol addiction.

Symptoms Of Tramadol (Ultram) Addiction

The signs of opioid addiction are not always obvious. Because people often begin their use with a valid prescription, they may not fully consider the risk of addiction. Unfortunately, taking tramadol for any length of time can lead to physical dependence, tolerance, and overdose — often before a person realizes they are addicted.

Opioid overdoses kill 130 people every day in the U.S. If you are concerned that someone you love is struggling with tramadol addiction, it’s important to familiarize yourself with the signs and symptoms of tramadol abuse.

A person struggling with tramadol addiction may show symptoms such as:

  • mental preoccupation with the drug
  • nonmedical use of the drug (snorting, smoking, or injecting the substance for stronger effects)
  • doctor shopping (visiting multiple providers in order to obtain extra prescriptions)
  • missing money or valuables
  • intense cravings for tramadol
  • inability to cut back or stop using the drug
  • changes in mood or personality
  • falling in and out of consciousness (“nodding out”)
  • withdrawal symptoms, including anxiety and depression

Dangers Of Tramadol (Ultram) Addiction

In addition to an increased risk of side effects, tramadol addiction can lead to other physical and mental health hazards.

Additional risks of tramadol addiction include:

Detox And Withdrawal

If a person has been taking high doses of the drug, they are likely already dependent on the substance. This means they will need continuous doses of tramadol in order to avoid withdrawal symptoms.

People who suddenly stop taking tramadol may experience withdrawal symptoms, including panic, sneezing, nausea, and chills. These withdrawal symptoms are the body’s way of detoxing itself from the substance, and can begin as soon as several hours after a person’s last dose.

Opioid withdrawal typically takes about a week to complete. While tramadol withdrawal is not usually life-threatening, it can be physically and psychologically agonizing. Many people who are addicted to opioids return to the drug (called a “relapse”) simply to avoid withdrawal symptoms. The safest way to get off drugs like tramadol is in a medically supervised detox program.

Tramadol Overdose

Taking too much tramadol can result in overdose. Any type of opioid overdose can be fatal. Synthetic opioids like tramadol are involved in more overdoses per year than any other opioid.

If a person uses alcohol or other prescription drugs with tramadol, they are at a severe risk for overdose. Opioids slow down the central nervous system, including a person’s breathing. When a person takes too much tramadol, their heart rate and breathing pattern can decrease. Slowed or stopped breathing is the number one cause of fatal overdose.

Other signs of tramadol overdose include a bluish tint to the lips and skin, muscle weakness, and unconsciousness. If you see a person displaying these symptoms, call 911 immediately — and try to keep them awake until help arrives.

Finding Treatment For Tramadol (Ultram) Addiction

It can be overwhelming to realize that you or someone you love is battling tramadol addiction. Because opioids are often prescribed by physicians, it’s easy to lose sight of proper usage. Unfortunately, this leads many people to abuse the drug and end up in the cycle of addiction.

The best way to get help with tramadol addiction is through a formal treatment program. At Vertava Health, we provide comprehensive treatment that includes medication-assisted treatment, personalized therapies, family counseling, and aftercare support.

Some people who recognize their dependence may attempt to quit tramadol “cold turkey.” This can result in a painful withdrawal period that can be difficult to manage. Vertava Health provide medical detox as part of our inpatient treatment programs. Here, patients are provided with the support they need to successfully detox from opioids and begin their recovery journey.

For more information about the side effects and symptoms of tramadol addiction, reach out to one of our treatment specialists today.

Tramadol for Back Pain

Tramadol is a type of opioid often prescribed for moderate or severe pain in adults. It is a synthetic form of codeine designed to have less potential for abuse than other opioids. Tramadol works in the brain to alter the body’s response to pain.

See Opioids for Back Pain: Potential for Abuse, Assessment Tools, and Addiction Treatment

Tramadol is available as a generic and under brand names, including:

  • Ultram
  • Synapryn FusePaq
  • ConZip

Tramadol is generally prescribed to provide short-term pain relief. The body can develop a tolerance to tramadol quickly, making the dose less effective over time.

See The Difference Between Opioid Addiction and Physical Dependence

Tramadol is generally advised for just one or two weeks’ use, to reduce the risk of dependency. Also, the body develops a tolerance for tramadol quickly, making the dose less effective over time. The doctor may suggest a longer interval between doses for those older than 75.

Like all medications, tramadol has potential benefits and drawbacks. Understanding them may help people avoid tramadol’s side effects and risks.

See Opioid Medication Potential Risks and Complications


How Tramadol Is Used

Tramadol is available in several forms and strengths. Examples of tramadol formulations include:

Immediate-release form of tramadol (Ultram).

This form of tramadol is available as a tablet and typically is prescribed to be taken every 4 to 6 hours. It is used for back pain, sciatica, and for postoperative pain following spine surgery. For most adults, the maximum safe dose is 400 mg per day of the immediate-release tablets.

See Getting Adequate Pain Control After Back Surgery

Extended-release tramadol (ConZip).

An extended-release (ER) form of tramadol is available as a capsule that contains more medication than the immediate release tablets. Taken just once a day, the extended release medication is formulated to be released in the body gradually over a 24-hour period.

See Addressing Pain and Medical Problems Disrupting Sleep

Extended release tramadol products are designed to help individuals with chronic pain. Their 24-hour effectiveness can potentially help prevent pain from re-appearing throughout the day and promote better sleep. The extended-release medication should not be split or crushed, as that could cause a dangerously strong amount of medication to be activated at once. The maximum dose of the extended-release formulations is typically 300 mg per day. Dosages may need to be decreased for those with renal or hepatic impairment.

See Pain Management for Chronic Back Pain

As a general rule, doctors prescribing tramadol will typically start with a low dose and may increase the dose slowly and as needed for pain relief.

In This Article:

Follow prescription instructions

Label instructions for both the dose and the timing of the doses should be followed exactly. If the medication does not seem to work, the doctor should be contacted. The dose should never be increased without a doctor’s approval.


How Tramadol Works

Tramadol works similarly to other opioids by binding to receptors in the brain and spinal cord— located on nerve endings—that work to block pain signals from being transmitted. However, some researchers believe that tramadol may also effect levels of the neurotransmitters serotonin and norepinephrine, similarly to how an antidepressant medication works. 1

See How Opioids Work in the Brain on Pain-health.com

As with all medications, there are several unique potential risks and complications associated with tramadol that are important to know about.


  • 1.Dayer P, Desmeules J, Collart L. [Pharmacology of tramadol]. Drugs. 1997;53 Suppl 2:18-24. doi: 10.2165/00003495-199700532-00006. Review. PubMed PMID: 9190321.

FDA adds Boxed Warning for risk of serious injuries caused by sleepwalking with certain prescription insomnia medicines

[04-30-2019] The Food and Drug Administration (FDA) is advising that rare but serious injuries have happened with certain common prescription insomnia medicines because of sleep behaviors, including sleepwalking, sleep driving, and engaging in other activities while not fully awake. These complex sleep behaviors have also resulted in deaths. These behaviors appear to be more common with eszopiclone (Lunesta), zaleplon (Sonata), and zolpidem (Ambien, Ambien CR, Edluar, Intermezzo, Zolpimist) than other prescription medicines used for sleep.

As a result, we are requiring a Boxed Warning, our most prominent warning, to be added to the prescribing information and the patient Medication Guides for these medicines. We are also requiring a Contraindication, our strongest warning, to avoid use in patients who have previously experienced an episode of complex sleep behavior with eszopiclone, zaleplon, and zolpidem.

Serious injuries and death from complex sleep behaviors have occurred in patients with and without a history of such behaviors, even at the lowest recommended doses, and the behaviors can occur after just one dose. These behaviors can occur after taking these medicines with or without alcohol or other central nervous system depressants that may be sedating such as tranquilizers, opioids, and anti-anxiety medicines.

Eszopiclone, zaleplon, and zolpidem are medicines used to treat insomnia in adults who have difficulty falling asleep or staying asleep. They are in a class of medicines called sedative-hypnotics and have been approved and on the market for many years. These insomnia medicines work by slowing activity in the brain to allow sleep. Quality sleep can have a positive impact on physical and mental health.

Health care professionals should not prescribe eszopiclone, zaleplon, or zolpidem to patients who have previously experienced complex sleep behaviors after taking any of these medicines. Advise all patients that although rare, the behaviors caused by these medicines have led to serious injuries or death. Tell the patient to discontinue taking these medicines if they experience an episode of complex sleep behavior.

Patients should stop taking your insomnia medicine and contact your health care professional right away if you experience a complex sleep behavior where you engage in activities while you are not fully awake or if you do not remember activities you have done while taking the medicine.

We identified 66 cases of complex sleep behaviors occurring with these medicines over the past 26 years that resulted in serious injuries, including death (see Data Summary). This number includes only reports submitted to FDA* or those found in the medical literature,1-5 so there may be additional cases about which we are unaware. These cases included accidental overdoses, falls, burns, near drowning, exposure to extreme cold temperatures leading to loss of limb, carbon monoxide poisoning, drowning, hypothermia, motor vehicle collisions with the patient driving, and self-injuries such as gunshot wounds and apparent suicide attempts. Patients usually did not remember these events. The underlying mechanisms by which these insomnia medicines cause complex sleep behaviors are not completely understood.

FDA is also reminding the public that all medicines taken for insomnia can impair driving and activities that require alertness the morning after use. Drowsiness is already listed as a common side effect in the drug labels of all insomnia medicines, along with warnings that patients may still feel drowsy the day after taking these products. Patients who take insomnia medicines can experience decreased mental alertness the morning after use even if they feel fully awake.

We communicated safety information associated with certain insomnia medicines in January 2013 (risk of next-morning impairment with zolpidem), May 2013 (approved lower recommended doses for zolpidem), and May 2014 (risk of next-morning impairment with eszopiclone; lowered recommended dose). We are continuing to monitor the safety of insomnia medicines and will update the public as new information becomes available.

To help FDA better track safety issues with medicines, we urge health care professionals and patients to report side effects involving eszopiclone, zaleplon, and zolpidem or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.

*The cases were reported to the FDA Adverse Event Reporting System (FAERS).

Tramadol addiction treatment

Tramadol addiction treatment

Tramadol is a drug that possesses. Available in both capsules and ampoules for injection. Injections are given if the patient’s illness is severe or with complications. Tramadol is the second most effective drug after morphine. It is used exclusively as directed by a physician and most often only in specialized hospitals.

Tramadol is a drug and therefore patients quickly get used to it.Also, due to its
belonging to narcotic substances, Tramadol cannot be purchased without a prescription from the doctor attending
. It is in great demand not only because of its strong analgesic effect, but also because of that. that this effect lasts for a relatively long time. Naturally, when using it, the patient experiences a feeling of euphoria and relaxation.

If you sharply reduce the dose of this drug, the patient will experience withdrawal symptoms, or, simply put, “withdrawal”. If the patient has begun withdrawal, then he should immediately contact a narcologist.Specialists in a short period of time will get rid of drug addiction, and there will be no consequences for both the physical and mental health of the patient.

Is it possible to get rid of tramadol addiction at home?

Patients who have become addicted to Tramadol most often try to cure
at home. Very rarely, the help of relatives and the awareness of a person gives the desired effect
, but most often it is practically impossible to stop the addicted state from the drug without the intervention of a narcologist

If the patient decides to be treated for addiction at home, then the following problems and
dangers await him:

  • He will not be able to receive medical care during withdrawal.
  • The patient and his relatives will not be able to influence the psyche strongly enough to motivate him to recover.
  • While staying at home, the patient is tempted to get into a familiar environment where drug use may be the norm.
  • The patient is not under observation around the clock and therefore it is more difficult for him to fight attacks of the desire to take a dose of drugs.

Relatives of a drug addict, as a rule, do not have a medical education and therefore cannot know all the nuances of using Tramadol and its effects on the body. Going to a rehabilitation center on time means increasing the chances of recovery by several dozen times.

Treatment of Tramadol Addiction in the Clean Way Clinic

If a patient took Tramadol without a doctor’s prescription, then after he stops taking it, he will definitely have withdrawal.The body becomes addicted immediately after the first dose. Breakage in case of refusal from narcotic painkillers is especially strong and even dangerous for the patient.

Narcologists of the Clean Way clinic quickly and effectively dive the withdrawal symptoms, which include:

  • convulsions, their own nervous systems;
  • vomiting;
  • muscle pain;
  • fainting; 90,027 90,026 breathing problems;
  • weakness;
  • increased body temperature.

Of course, the list of complications is much longer, but we have given the most common ones. Effective treatment of a drug addict is possible only in a specialized institution.

Treatment, as a rule, implies an integrated approach: not only a narcologist, but also a psychologist is involved in working with a patient, who helps to more accurately establish the causes of addiction and get rid of it. This approach significantly increases the patient’s chances of recovering sooner, and also reduces the risk of relapse.

What does the tramadol addiction treatment program include?

The definition of drug addiction includes such specific signs as lack of responsibility for one’s life and a violation of the human psyche. Treatment of patients who have become addicted to Tramadol takes place in several stages:

1. Detoxification.
2. Therapy to strengthen the body.
3. Working with a psychologist.

Treatment must be carried out in a hospital. All steps are strictly required. So, due to drug use, toxic substances accumulate in the patient’s blood, which are formed as a result of the disintegration of the drug. It is because of the toxins that the patient begins to feel bad: they affect almost all systems in the body, including the gastrointestinal tract, heart and blood vessels, and nerves.

Working with a psychologist is also mandatory. Defeating addiction at the physical level is the easiest way. However, it is very difficult to overcome the craving for drugs on a mental level.The risk of relapse, even after a course of rehabilitation, persists for 10-15 years, however, a psychologist can minimize it.

Terms of treatment for tramadol addiction

Each case is individual and requires a special approach. The duration of treatment for addiction is influenced by such factors as the period of drug use, the patient’s health, etc. Most often, the center’s specialists cope with drug addiction treatment within 3 months. However, it is difficult to say exactly how long the patient will stay in the hospital: it all depends on the degree of exhaustion and the patient’s desire to overcome addiction.

Detoxification and withdrawal symptoms can be performed in as little as 1 week. During this time, the patient is given droppers and cleanses the body of toxins.

The longest and most difficult stage is psychological assistance, which also includes adaptation to society: it is he who occupies a key place in the patient’s rehabilitation and can last for several months. Therapy is carried out both in group sessions and in individual conversations with a psychologist, during which he teaches patients to analyze what is happening and control themselves, as well as to choose the right circle of friends and set goals and priorities.

Addiction to such a strong narcotic reliever as Tramadol is not a sentence, however, if the disease is not treated, it can lead to very adverse consequences. In rare cases, even death is possible.

The specialists of the Clean Path clinic were able to prove that timely seeking medical help leads to the fact that patients quickly overcome their “illness” and return to a healthy life in society.

dependence on tablets, use and analogs

Tramadol is a medicinal analgesic, synthetic opioid.Sold in the form of ampoules, tablets and capsules. It has a strong analgesic effect. It is prescribed for pain of a different nature after injuries, operations and during oncology. The drug is addictive, therefore it belongs to narcotic substances.


Tramadol is one of the most common pharmaceutical drugs. These pills were popular in the 90s of the last century. Many addicts started with this drug and then switched to more powerful opioids.

Although tramadol is a prescription drug, it is not difficult to obtain. Drug addicts negotiate with pharmacists or doctors. Often, representatives of these professions are directly associated with dealers. They get their income from selling addictive pills.

Creation history

The drug was created synthetically in 1962 in Germany by an employee of the pharmaceutical company “Grunental”. The inventor is Kurt Flick. Soon, the drug became the most popular mono-analgesic in many countries.It is still used for medicinal purposes and is only sold by prescription.

Effects on the body

The addiction to tramadol begins after a few uses. Starting to take this drug in large doses, the addict ceases to control himself, since the psyche and physical condition of the body suffer from tramadol. After the substance enters the bloodstream, its effect on the nervous system begins. The drug dulls pain, relieves pain.

The use of the drug for treatment according to the scheme agreed with the doctor does not cause pronounced side effects.

Physiological symptoms

An opioid pain reliever has a mixed mechanism of action. It has a strong analgesic effect. It is an antagonist of opioid receptors in the central nervous system. It inhibits the seizure of norepinephrine by neurons, causes a rapid release of serotonin. It also has antitussive properties, does not affect the motility of the gastrointestinal tract. The duration of exposure is from 4 to 8 hours.

Physiological changes after taking tramadol:

  • The pain dulls until it disappears completely;
  • The muscular system relaxes;
  • Slight heaviness in the legs and arms.

Psycho-emotional manifestations

Since tramadol affects the nervous system, the following emotional symptoms are observed:

  • Confusion of thoughts;
  • Light euphoria;
  • Relaxed behavior.

This action is the key factor for drug addicts. But it should be borne in mind that the drug has a number of side effects for the whole body.

Signs of a drug addict

Since tramadol is a psychoactive medication, signs of its use are manifested in strange behavior. All symptoms are individual, but a number of common ones can be distinguished:

  • Lethargy;
  • Apathy;
  • Decreased memory;
  • Heightened perception;
  • Severe mood swings;
  • Unkempt appearance;
  • New suspicious friends;
  • Theft, deceit.

External symptoms of tramadol addiction include:

  • Constricted pupils;
  • Pale skin;
  • Rash on the face;
  • Excessive thinness;
  • Slow slurred speech;
  • Movement coordination disorder.

Drug composition

Depending on the form of release and the manufacturer, the composition of the drug is different. The main active ingredient is tramadol hydrochloride. Among the auxiliary ingredients are:

  • Distilled water;
  • Magnesium stearate;
  • Sodium acetate, etc.

Drug harm

Even with the use of tramadol for medicinal purposes under the supervision of a doctor, side effects are possible. When the drug is taken in high doses for recreational purposes, it becomes more hazardous to health, and the risk of overdose increases.

Attention! The combination of tramadol with alcoholic beverages and other psychotropic drugs increases the risk of dangerous side effects and can lead to death.

Tramadol leads to focal damage to the liver and urinary organs. The fact is that the substance is excreted by the kidneys and processed in the liver, it is these organs that come under attack.The drug can lead to urinary retention, since the active ingredient increases the tone of the muscles of the bladder.

The harm from frequent drug use is as follows:

  • Vomiting, dizziness;
  • Retention of feces and urine;
  • Pain in the head;
  • Abrupt mood swings;
  • Increased anxiety;
  • Muscle spasms;
  • Lethargy, weakness;
  • Dryness of mucous membranes;
  • Increased sweating;
  • Rash and itching of the skin;
  • Partial memory loss;
  • Decreased cognitive function;
  • Increase in the lumen of blood vessels;
  • Depressive states;
  • Lack of concentration;
  • Violation of the cycle of menstruation;
  • Increased fatigue even without physical exertion;
  • Increased heart rate;
  • Tremor of the legs and arms;
  • Severe withdrawal symptoms;
  • Respiratory depression;
  • Decrease in the production of sex hormones;
  • Serotonin syndrome.

This does not mean that every patient undergoing tramadol treatment experiences all these actions on themselves. But at least 5-7 signs are guaranteed to cause irreparable harm to health.

Consequences of long-term use

The following detrimental effects of long-term use of tramadol as a psychotropic drug are possible:

  • The bone tissue of tramadol addicts is significantly weakened. This leads to an increased frequency and risk of fractures, tooth decay, hair loss;
  • With regular use of the drug without treatment, death can occur in 3-4 years;
  • Even after rehabilitation, the consequences and side effects persist for a long time, sometimes for a lifetime;
  • After 2 years of regular use, epilepsy, dullness develops;
  • Liver damage, development of cirrhosis or hepatitis;
  • Mental disorders: paranoia, obsessive thoughts, depression, permanent irritability;
  • Risk of overdose due to the development of tolerance;
  • Severity of withdrawal symptoms may lead to suicide;
  • Dysfunction of internal organs, up to and including their failure, leads to lethal consequences.

Danger of methods of use

Tramadol can be taken:

  • As capsules inside;
  • Intramuscularly – solution injection;
  • Rectally – in the form of capsules.

Drug addicts most often take capsules. Each method leads to serious complications and is harmful to health.

Drug overdose

Exceeding the dose leads to general intoxication of the body, expressed in:

  • Nausea and vomiting;
  • Difficulty swallowing;
  • Respiratory depression;
  • Decreased visual acuity;
  • Skin rashes;
  • Reducing the feeling of pain;
  • Epilepsy;
  • Fainting conditions;
  • Weak pulse.

Reasons for overdose

Common causes of overdose:

  • Opioid dependence after a reduction in tolerance, eg after the end of treatment;
  • Taking injectable opioids with tramadol;
  • Desire for a more pronounced effect;
  • Concurrent use of other psychotropic drugs;
  • Presence of diseases of the liver, lungs and kidneys, immune pathologies.

First aid

In case of tramadol poisoning, you must immediately call an ambulance. It is important to explain to the doctor the patient’s condition by phone and list the medications taken so that the specialists understand how to act.

Until a team of doctors arrives, it is necessary: ​​

  • Prevent the person from fainting;
  • Monitor the pulse;
  • When vomiting, lay on the side so that the patient does not suffocate from his own vomit;
  • Do not give any medication;
  • Provide fresh air in the room.

Medical assistance

Help for doctors with tramadol intoxication:

  • Urgent hospitalization;
  • Maintenance of respiratory function, installation of a ventilator;
  • Detoxification with drugs in combination with hemodialysis or hemofiltration;
  • Symptomatic treatment.

Consequences of lack of assistance

In case of severe overdose, the lack of first aid and hospitalization in a medical institution threatens with the following consequences:

  • Damage to kidneys, liver, lungs, brain;
  • Irreversible destruction of internal organs will cause disability;
  • Respiratory depression may result in asphyxiation;
  • Lethal outcome.

Lethal dose

Lethal dose is individual. It depends on the state of health, age, body weight, rate of metabolic processes. But there is an average value – the risk of fatal intoxication begins with a dose of 150 mg per kilogram of body weight.

How to discontinue action (antidotes)

The drug naloxone will become the antidote of tramadol for respiratory depression. If an overdose has caused seizures, drugs of the benzodiazepine group are prescribed.


After a sharp rejection of tramadol comes “withdrawal”. The syndrome lasts up to 1 month. It is characterized by the following symptoms:

  • Appearance of hallucinations, nightmares of dreams;
  • Mental disorders, thoughts of suicide against the background of depression;
  • Hysterical behavior, aggression.

With withdrawal symptoms, the addict experiences an acute sense of guilt. He is afraid of being alone, ashamed of his actions.

Physiological characteristics:

  • Pain in the head, dizziness;
  • High pressure;
  • Excessive sweating;
  • Fever, chills;
  • Joint aches;
  • Muscle discomfort;
  • Violation of heart rate;
  • Shortness of breath.

Loss of appetite, insomnia, constant weakness are also possible. During the entire withdrawal period, the patient does not want to get out of bed.Symptoms worsen at night.

How to Ease Withdrawal Syndrome

It is important to endure the withdrawal. To alleviate it, symptomatic treatment is prescribed. The main thing is to wait for the complete cleansing of the body, not succumbing to the urge to take a new dose. Specialists can assign:

  • Anxiolytics;
  • Antipsychotics;
  • Sedatives;
  • Analgesics that reduce withdrawal pain symptoms: ketans, ibuprofen.

To speed up drug elimination, it is recommended:

  • Drink plenty of clean water;
  • Establish proper nutrition;
  • Eat foods with a diuretic effect to remove toxins;
  • Take vitamins and minerals to support organ function and boost immunity.

How much is kept in the body

After a single use of tramadol, its half-life is up to 8 hours.If the addict has been using the drug for a long time in large doses, this period will be 2-3 times longer.

The decay products of tramadol are completely excreted from the body within 3 days. The duration of cleansing is individual and depends on the dosage, age, health status and body weight of a person. To identify a substance in the body, blood, urine, saliva or hair samples are taken for analysis.

In the blood

To detect the breakdown products of tramadol in the blood, a sample must be taken within 2 days of the last dose.A blood test is the most indicative and often used in practice.

In urine

A urine sample is taken for rapid pharmacy tests and laboratory analyzes. For the test to give a result, you need to take urine within 3-4 days after taking the drug.

In saliva

The substances contained in tramadol are found in saliva within 2 days of the last dose. With prolonged use of the drug and weak metabolism, the substance is delayed up to 5-7 days.

In hair

Hair analysis is an effective test that allows you to establish the duration of the drug intake, but not the fact of the intoxication itself. Even 90-120 days after the last dose, hair follicle testing is positive.

How to accelerate excretion from the body (at home)

To accelerate the cleaning of the body at home, it is recommended:

  • Strengthen the drinking regime;
  • Eat a balanced diet;
  • Go in for sports;
  • Visit a bathhouse, sauna to “drive out” toxins through sweat;
  • Drink vitamin complexes;
  • Take diuretics.

Inpatient detoxification

Detoxification takes 2-4 weeks. At this time, the patient is prescribed:

  • Accelerated diuresis: taking copious amounts of water and diuretics;
  • UBOD method – ultra-fast detoxification, carried out in 6-8 hours;
  • Apparatus blood purification: plasmapheresis or hemosorption.

The key to successful treatment is the complete and irrevocable rejection of tramadol and compliance with all the recommendations of doctors.

For symptomatic treatment the following are prescribed:

  • Pain relievers;
  • Cardiac glycosides;
  • Analeptics;
  • Pyroxan, clonidine;
  • Tranquilizers.

Types of drug tests

Pharmacy tests for self-determination of the presence of tramadol are intended for the analysis of a urine sample. Based on the method of immunochromatographic testing, which reveals the fact of taking tramadol in a biological fluid.The analysis is qualitative, that is, it does not show the amount of the drug. Release form – test strips.

Test names:

  • Set of strips “Creative MP”.
  • SNIPER Test.
  • RightSign Express Test Panel.

Is it possible to cheat the test

Drug addicts come up with different ways to cheat the tramadol test. Typically, tricks can only work to test urine.For this:

  • Substitute biomaterial: ask another person to be tested or buy synthetic urine substitutes;
  • The material is diluted with various substances: whiteness, vinegar, soda, eye drops;
  • Accelerate the elimination of toxins with the help of diuretics and drinking plenty of fluids.

After preliminary drug testing by express methods, complete laboratory blood and urine tests are prescribed.They cannot be deceived.

Analogues and their danger

Tramadol has a number of pharmacy analogues and substitutes:

  • Tramal;
  • Tramaclosidol;
  • Tramoline;
  • Tramadol-rd;
  • Tramadol Acry.

Also indirect analogs include all drugs from the group of synthetic opioids. Each of them is a narcotic substance, as it is addictive and dangerous.

How addiction is formed

Addiction to tramadol is formed in the following stages:

  • Acquaintance with the preparation, first experience. After the first drug intake, a person experiences mild euphoria. He wants to repeat this feeling one more time. Gradually, he switches to the daily use of pills, and after 3 weeks of stable intake of tramadol in the body, mental dependence develops.
  • Psychic addiction is a permanent attraction to drugs.All thoughts are only about the next dose. Feeling depressed in the absence of tramadol, mood improvement as soon as possible. In a state of intoxication, mental comfort is achieved, but not euphoria. This is not about getting pleasure, but about suppressing the feeling of discomfort.
  • Physical dependence – attraction at the physiological level. After taking the dose, physical comfort is achieved, and then withdrawal develops. Withdrawal is manifested by muscle pain, fever.At this stage, the body weakens, the work of vital organs is disrupted. Fatigue does not leave the addict. At the same time, psychological dependence is growing.

The mechanism of formation of tramadol dependence is in many ways similar to the stages of addiction to other opioids.

90 095 How long do drug addicts live 90 096

With regular use of tramadol without proper treatment, the death of an addict can occur in 4 years. Even successful rehabilitation will not completely cure an addict.The consequences of drug addiction persist for many years.


The rehabilitation process includes the following activities:

  • Restoration of vital functions and organs;
  • Correction of drug addict behavior;
  • Combating cravings with tramadol;
  • Taking antipsychotics, nootropics and antidepressants;
  • Psychotherapeutic assistance to patients: individual and group courses.

The most difficult and longest stage of recovery is psychological correction, which includes the restoration of a person as a full-fledged member of society.This period is a key moment in rehabilitation and lasts up to 6 months. In the course of treatment, the patient learns to control himself, to give an analytical assessment of reality and events. The patient has goals, life priorities.

Why you can’t be treated at home

Drug addicts often try to quit tramadol on their own. But only in rare cases (and usually in the early stages) the determination and help of family members give a successful result. More often it is not possible to overcome addiction without the help of specialists.

Cons of home self-medication:

  • Lack of medical attention with abstinence;
  • Lack of psychological assistance to strengthen motivation to fight drug addiction;
  • High risk of relapse, as there is always a temptation to take a new dose at home;
  • Difficulty fighting drug cravings;
  • Close people without medical education will not help in the treatment of the consequences of taking tramadol.

Fighting addiction is a complex and lengthy process. It is extremely difficult for a drug addict to cope with withdrawal symptoms, drug cravings at home, even with the constant support of relatives.

Working with codependents

Relatives and close people of the addict are often so carried away by the problem of his addiction that they do not notice how they themselves become codependent. The fight against drug addiction is impossible without psychological support from family members.But they themselves need the help of specialists to get rid of codependency. Psychologists help to part with:

  • Excessive custody of a drug addict;
  • Complexes related to a family problem;
  • Personal degradation, as codependents often stop taking time for themselves and their hobbies;
  • Fears and worries about a loved one.

To support codependents, psychologists prescribe:

  • Listening to lecture material;
  • Individual consultations;
  • Attendance at group sessions.


Outpatient therapy has a number of benefits for addicts:

  • The patient stays at home, does not change the usual environment, does not part with relatives for a long time;
  • Regular visits to the clinic, consultations of psychologists, narcologists facilitate the period of abstinence;
  • The doctor monitors the intake of medications, selects the appropriate treatment regimen for addiction;
  • After overcoming withdrawal and detoxification, the patient receives qualified symptomatic treatment of the consequences of tramadol consumption;
  • Completion of a course of rehabilitation and re-socialization;
  • There is an opportunity to attend psychological and psychotherapeutic classes.

During the period of outpatient treatment, the addict receives both medical help and support from family members.


The final stage of drug addiction treatment is the return of patients to society. After completing a full course of drug and psychotherapeutic therapy, the recovered person will have to work with a psychologist for a long time. The purpose of re-socialization is to help in:

  • Finding a place in life;
  • Applying for work or study;
  • Restoration of communication skills with others.

Many rehabilitation centers help their wards with employment, search for new housing.

How to quit on your own

After refusal from tramadol, withdrawal symptoms occur, which is important to survive. Until the body is completely detoxified, the symptoms of withdrawal do not disappear. To facilitate this period, you need:

  • Enlist the support of loved ones;
  • Have sustained motivation;
  • Establish a healthy lifestyle – do not substitute alcohol or other drugs for the drug;
  • Drink vitamin and mineral complexes for the speedy recovery of the body;
  • To resort to physical activity – sport improves mood and accelerates the elimination of toxins.

If, after a long tarmadol addiction, serious pathologies of internal organs have appeared, medical care cannot be ignored. Also, you can not quit the drug at home after a severe overdose – you will need hospitalization. The right decision is to be treated in specialized centers, not at home.

Treatment for Tramadol

Tramadol is a psychotropic drug belonging to the group of opioid analgesics. This drug is distinguished by the presence of pronounced analgesic properties.Due to the effect of Tramadol on the central nervous system and active stimulation of opioid receptors, the medication is also used to achieve a state of narcotic intoxication.

Action of Tramadol

Upon penetration into the bloodstream, the active substances of Tramadol cause a state of pleasant euphoria, a person becomes emotionally susceptible, feels a surge of strength and energy, feels free and liberated. However, tolerance to the drug develops quite quickly and soon the euphoria after administration is reduced from 36 hours to 5 minutes.The person is forced to constantly increase the dosage. The state of “tramadol withdrawal” is accompanied by severe pain, sleep disturbances, panic conditions, leading to the development of paranoia.

Effects of Tramadol on the body

Addiction to Tramadol develops rapidly. After a few months of drug use, the patient shows signs of physical and psychological exhaustion. A person becomes depressed, irritable, begins to lose weight sharply, suffers from a permanent lack of appetite, insomnia.

Further, the following consequences from Tramadol appear:

  • tearfulness;
  • headaches;
  • drops in blood pressure;
  • fainting;
  • Memory impairment, decreased ability to concentrate.

After a year of using Tramadol, the patient’s appearance changes, hair begins to fall out, teeth decay. In addition, there is a weakening of bone tissue structures, which causes frequent fractures.As a rule, in the absence of timely provision of qualified assistance, a person dies from an overdose within 3-4 years. The insidiousness of Tramadol lies in the fact that this drug causes a strong psychological dependence, the manifestations of which have to be fought for 10-15 years after stopping the use of Tramadol.

Methods of treatment for Tramadol

Treatment for Tramadol should be carried out in a hospital setting of the patient, with complete isolation from the usual environment.The therapeutic course begins with a comprehensive detoxification and the use of general strengthening techniques. The duration of detoxification is about 3-4 weeks. Often, patients are prescribed neuroleptic and nootropic drugs, symptomatic treatment, and a course of vitamin therapy.

Treatment for drugs in Medicon is carried out by qualified specialists, according to licensed methods, which significantly increases the chances of achieving successful results.

The therapeutic course includes psychological correction, work on the “12 steps” program in groups of codependents, methods of Genstald therapy.Special attention in the drug treatment center “Medicon” is paid to the rehabilitation of patients and the prevention of a possible breakdown. Psychological consultations, classes with a family psychologist and in groups of codependents help a person overcome psychological dependence on Tramadol, fully returning to a normal, sober life.

Factcheck | Dariga Nazarbayeva: Tramadol acts like a drug

On November 8, Deputy of the Senate of Parliament Dariga Nazarbayeva voiced an inquiry addressed to the Minister of Health Yelzhan Birtanov.The senator appealed to the minister with a request to exclude pharmacies from the list of small business entities, where planned and unscheduled inspections are prohibited, and to strengthen the administrative responsibility of pharmacy owners for the over-the-counter dispensing of drugs. Nazarbayeva explained the urgency of the issue by the cases of illegal sale of such a medicine as Tramadol to teenagers.

“Drugs that are highly addictive are freely sold in Kazakhstani pharmacies. They act like drugs. One of them is the drug Tramadol.Basically, this drug is bought by young people 14-18 years old. According to drug addiction doctors, Tramadol is similar in structure to the drug morphine. Taking this drug in large doses leads to a feeling of intoxication, and subsequently Tramadol causes addiction, withdrawal symptoms, changes in the human brain, destroys the liver, ”the senator said.

Let’s look at each of the statements separately.

Statement: Tramadol acts like a drug

Verdict: Half Truth

The analgesic mechanism of action of “Tramadol” has not been thoroughly studied, but it is reliably known that the drug acts in two different directions.

First, it does indeed activate opioid μ (mu) receptors located in the brain, spinal cord and gastrointestinal tract. It is believed that they are predominantly involved in the modulation of pain sensitivity.

Secondly, the drug also re-uptakes serotonin and norepinephrine in nerve cells, which actually activates non-opioid analgesic systems . The fact of the presence of a non-opioid component was proved, for example, by the fact that naloxone – a substance that neutralizes all the effects of opioids – was able to suppress the effect of Tramadol only partially (about 30%).

The analgesic effect of each individual mechanism is rather weak, however, synergistically, they provide a good result for the relief of moderate to moderately severe pain. The World Health Organization also notes that taking Tramadol alone usually fails to provide adequate pain relief.

Statement: Tramadol is structurally similar to morphine

Verdict: Manipulation

As an analgesic, Tramadol is more equivalent to codeine than morphine, as evidenced by the structural similarity of the two drugs.Both have a 3-methoxy group on the phenolic ring and undergo O-demethylation as a metabolic step.

Tramadol Codeine

It should also be noted that the dimethylaminomethyl portion of Tramadol resembles the methylated ring nitrogen of morphine and codeine, but apart from this small circumstance, there are no other structural similarities between Tramadol and morphine.

Tramadol Morphine

Moreover, the analgesic activity of Tramadol is approximately 10% of the activity of morphine if it is administered by injection, or 20% if it is taken orally.In this regard, “Tramadol” is classified as a relatively safe pain reliever – the drug has a lower potential for dependence and abuse compared to morphine.

In addition, it has been proven that in therapeutic doses, Tramadol is less than morphine capable of depressing respiration. Tramadol also often cannot serve as a substitute for morphine in opium addiction for patients with low to moderate levels of dependence, which indicates a fundamental difference between the two drugs.

Statement: Taking Tramadol in large doses leads to a feeling of intoxication

Verdict: Half Truth

The administration of therapeutic doses of the drug can also lead to narcotic intoxication.Tramadol has a number of side effects: drowsiness, sleep disturbance, headache, nervousness, twitching of body parts, muscle tension, mood changes, heartburn, indigestion, dry mouth.

In other cases, more serious side effects may occur: seizures, hives, blisters, rash, difficulty breathing or swallowing, swelling, hoarseness, agitation, hallucinations, fever, sweating, tremors, loss of coordination, nausea, diarrhea, constipation, loss of appetite, dizziness, changes in heart rate, menstrual irregularities, decreased libido.

At the same time, the symptoms of a Tramadol overdose can be even more dangerous. They, according to WHO, are in many ways similar to signs of an overdose of other opioid analgesics and in addition to them may include the consequences of an excess of serotonin and norepinephrine – depression of the central nervous system, coma, tachycardia, cardiovascular collapse, convulsions, respiratory failure up to respiratory arrest.

Fatal intoxications are recorded relatively rarely and are mostly associated with large overdoses, accompanied by taking other drugs or drinking alcohol.

Statement: “Tramadol” causes addiction, withdrawal, changes in the human brain, destroys the liver

Verdict: True

Addiction to Tramadol can indeed develop if taken in pill form. Withdrawal symptoms include anxiety, agitation, sweating, insomnia, hyperkinesia, tremors, paresthesia, and gastrointestinal symptoms.

However, at the same time, experts note that the potential for the development of dependence on “Tramadol” is quite low and can take place only in the case of daily use of the drug for several weeks or months.In many cases, dependence on Tramadol is due to a patient’s pre-existing history of substance or drug abuse.

“Several studies have shown that the incidence of dependence on Tramadol can vary from country to country and even within different regions of the same state, which may be related to the availability of the drug, its prescribing practices and the availability of other psychoactive substances for drug abusers “, – note in the WHO.

Long-term uncontrolled use of any opioid drugs (including Tramadol) leads to changes in the brain. Such drugs create artificial endorphins, and over time, the brain can completely rely on them, ceasing to produce its own, which will only exacerbate the developing addiction.

Reception of “Tramadol” in therapeutic doses was not associated with cases of clinically expressed liver diseases, however, an overdose of the drug can lead to acute liver failure.

Global context and Kazakhstan

WHO emphasizes that the abuse of Tramadol is on the rise in North and West Africa and the Middle East. The volumes of drug seizures during 2007-2015 are only increasing. Although Tramadol is recognized as a potent analgesic, its manufacture and distribution is not subject to international regulations.

The UN Office on Drugs and Crime argue that states do not want to “spoil their image” by disclosing to the world community accurate data on the amount of psychotropic substances that their population needs.Therefore, many countries independently established control over the circulation of Tramadol within their borders, making it impossible to leave it without a prescription or even banning it (as, for example, Ukraine and Belarus did).

However, the high level of abuse is still due to “unregulated prescriptions and the availability of the drug in pharmacies and on the black market,” the UN explains.

For 10 months of 2018, 52 administrative penalties were imposed on Kazakh pharmacies for the non-prescription sale of Tramadol for a total amount of 11 million tenge .The domestic Ministry of Health, together with the Ministry of Internal Affairs, is considering the issue of including the drug in the list of “narcotic drugs, psychotropic substances, their analogues and precursors used for medical purposes and under control.”

In addition, to control the activities of the retail network of pharmacies, the department plans to switch to “mandatory electronic dispensing of all prescription drugs” from 2020. The ministry also hopes to amend the Entrepreneurial Code, which will allow unhindered verification of pharmaceutical entities.

“In order to properly regulate the pharmacy business by the state, there is a need to include inspections of entities in the field of circulation of medicines, medical devices and medical equipment in the special order ,” Minister of Health Yelzhan Birtanov said to Senator Dariga Nazarbayeva.

The announced norm will be reflected in the new edition of the code “On the health of the people and the health care system.”

Contribute to the fight against disinformation!

Tramadol with or without paracetamol (acetaminophen) for cancer pain


It is impossible to draw unequivocal conclusions about the effectiveness or harm of tramadol, in monotherapy or in combination with paracetamol, in the treatment of cancer pain.


One in two or three people with cancer will experience moderate to severe pain. The pain tends to get worse as the cancer progresses.

Tramadol hydrochloride is an opioid analgesic available since 1977. In 2016, tramadol, alone or in combination with paracetamol, was available as oral and injectable formulations from nearly 90 pharmaceutical companies.Oral forms include formulations designed for immediate release and for modified release over a longer period of time. Rectal preparations are also available.

In this review, we attempted to assess how well tramadol worked, how many people had side effects, and how serious they were – for example, whether they were so severe that participants stopped taking tramadol.

Characteristics of research

In November 2016, we found 10 studies with 958 adults and no studies with children.The studies were often small and compared different tramadol preparations with different comparators and did not report important outcomes well enough. This made it difficult to determine whether tramadol was as effective, worse, or better than any other drug used to treat cancer pain.

Main results

No definite conclusions can be drawn about any outcomes in any comparisons. Tramadol may not be as effective as morphine.

Quality of evidence

We rated the quality of all available evidence as very low. This means that research does not provide a reliable indication of the possible effects of tramadol.

Get rid of tramadol addiction, addiction treatment

Tramadol is a drug that has a strong – up to six hours of action – analgesic effect that occurs 20 minutes after ingestion. It is prescribed for people to reduce pain after surgery, for elderly people with poor health.A feature of tramadol is that addiction to it occurs immediately, at the first intake. It is prohibited for free sale. Its activity is similar to codeine and morphine, but weaker.

Tramadol addiction is extremely dangerous. With a short use, a breakdown begins, which can be endured beyond human strength. However, when starting treatment with tramadol, there is a quick effect. A month is enough for the patient to stop taking the drug with the help of experienced doctors. But it will take years to forget about it.If a person starts to use the drug again, it is impossible to save him from certain death.

What signs cause the need to start urgent urgent treatment

If the close circle notices that a person is addicted to pills, you need to convince him to urgently see a doctor to get rid of tramadol addiction. Usually, the drug begins to be taken after suffering pain or in the company of peers. Signs of taking tramadol:

  • having used a drug, a person is in euphoria, ending with a breakdown, depression, detachment from reality;
  • pressure drops;
  • drowsiness;
  • Loss of appetite and interest in life.

Where to go for tramadol addiction treatment

The Kiev clinic “Recovery” successfully treats patients who use the drug and are addicted to it.

Treatment for tramadol begins with a consultation, which is completely anonymous. In a conversation and according to symptoms, the narcologist determines the degree of addiction and conducts treatment, which begins with a system for cleansing the body of tramadol breakdown products that cause withdrawal. After the removal of toxins, the patient’s condition improves and rehabilitation begins, during which a psychiatrist works with him, using various methods of returning the addict to reality, including hypnosis.

Specialists of the drug treatment center “Recovery”, along with modern methods, use their own developments, increasing the effect of treatment of addiction to tramadol.

Subsequently, the patient will still visit the doctor for consultations on adaptation in society, but without drugs.

Along with a competent individual approach to each patient, the clinic has created comfortable conditions for living and treatment. Call now and very soon you will be free from addiction.

90,000 Tramadol addiction treatment – Tramadol addiction treatment in Astrakhan at the Vybor clinic

Addiction to tramadol is as serious as to any other drug and
ignoring the problem can end badly.

It is very important to seek help on time so that you can get rid of addiction in a short time and not
allow serious consequences.

To date, there are a fairly large number of drugs that are
freely available and can be easily purchased at any pharmacy.

Tramadol as a narcotic drug

The problem is that many of these drugs are addictive when used regularly.
, and not only moral, but also physical. These drugs include tramadol.

Tramadol was not initially marketed as a drug; it is used in medicine to treat
certain pathologies. Tramadol belongs to analgesics and if you neglect the recommendations for
application can be addictive and even addictive.

This drug has a fairly quick effect, and the effect of the drug is quite
long lasting. In terms of activity, this drug is second only to morphine. The drug is being taken
orally and has long been included in the list of dangerous, potent drugs.

Signs of Tramadol Addiction

A person who has exceeded the dose of the drug, after one or two uses, experiences a narcotic
intoxication and becomes addicted. Due to the action of tramadol in the human body, activation occurs
opioid receptors.

The condition of tramadol users is similar to the condition of people using opium

The user feels:

  • a sharp uplift in the mood,
  • decreased response,
  • drowsiness,
  • breathing slowdown.

Added to the almost instantaneous dependence on tramadol is the constant need to increase the dose.
Tramadol addicts feel pain and aching joints if they stop using the drug.Also
there is a deterioration in the work of the gastrointestinal tract. Increased irritability is noted,
nervousness and feelings of apathy.

Consequences of use

If a person manages to overcome the physical craving for drugs, then even after 15 years the state
dependencies may come back. In order for the human body to completely cleanse itself of traces of the drug, it will take
more than 20 years. According to statistics, about 70 percent of drug addicts return to
addiction.Re-returning to tramadol use ends up for the addict
lethal outcome.

Home addiction treatment

You will not be able to overcome addiction on your own. In the case of long-term use of tramadol, only professional help is needed. Indeed, in addition to psychological problems, a person also acquires physical health problems, including:

  • kidney disease,
  • problems with the cardiovascular system,
  • dementia development,
  • epilepsy,
  • memory problems,
  • liver cirrhosis,
  • different forms of hepatitis and much more,
  • problems with the kidneys and other vital organs.

Even after giving up drug use, a person will experience in addition to psychological
suffering the strongest torment of a physical nature. There was a state of convulsions, muscle pain and interruptions in
breathing, refusal to eat, fever and vomiting.

Thus, a person can overcome addiction to tramadol only with the help of professionals,
who will carry out all the necessary procedures for detoxifying the body, a number of psychological manipulations and
help you adapt to your new drug-free life.The addict’s rehabilitation procedure should take place in
special institutions in order to remove a person as much as possible from their usual way of life and previous contacts.

Overcoming tramadol addiction

Addiction treatment should take place exclusively in a hospital, since at home, a lethal outcome is possible. Getting rid of addiction is time-consuming, so no one will be able to give a deadline in advance. The course of treatment itself is carried out in three stages.