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Tramadol Withdrawal: Learn the Symptoms, Timeline, Detox, and Treatment

Tramadol is a non-narcotic painkiller and a synthetic analog to codeine. Prescribed to treat moderate-to-severe pain, Tramadol is a significantly less potent opioid compared to other prescription opiates such as oxycodone or hydrocodone, so it is considered to have less potential for dependency and abuse. In the wake of the opioid abuse epidemic, Tramadol has made a name for itself as the “safer” option for prescription pain medication. 

However, Tramadol can become addictive and lead to withdrawal symptoms if abused. Many people who take Tramadol for pain get addicted to its psychoactive effects, which can alleviate mild symptoms of depression. This secondary side effect can lead people to take higher, unsafe doses for a stronger euphoric effect, which can cause seizures and other life-threatening health problems. 

Ironically, Tramadol’s reputation as a safe alternative to more addictive prescription medications can make it that much more dangerous. Someone could easily begin to misuse it under the impression that they will not get addicted because it doesn’t have the same negative associations surrounding it as Oxycontin or Vicodin. 

Because of its lower risk of fostering dependency, Tramadol is classified as Schedule IV controlled substance, which means it is less regulated and less difficult to obtain in comparison to its stronger counterparts, which raises the risk of potential overdose for those who abuse it.

Tramadol also poses a risk as a gateway opioid. People who abuse it could build up a tolerance that could lead them to seek out stronger, more dangerous drugs in search of a more fulfilling high. Many who abuse Tramadol combine it with other drugs, including antidepressants, which can have deadly consequences.

What Are the Symptoms of Tramadol Withdrawal?

Tramadol works slightly different from other opioid drugs because even though it does activate the brain’s opioid receptors, it also blocks the reuptake of neurotransmitters like serotonin, which is what gives it its antidepressant-esque effects. Because of this, Tramadol doesn’t affect the brain in the way other opioids do. While Tramadol withdrawal can take two different forms: typical, which most resembles the common symptoms of opioid withdrawal, and atypical, which comes with a unique range of psychological symptoms.

Statistically, only about 10 percent of people who detox from Tramadol experience the symptoms of an atypical withdrawal, with the other 90 percent experiencing traditional physical symptoms, such as:

  • Flu-like symptoms (fever, chills, muscle aches, runny nose)
  • Nausea and vomiting
  • Dizziness
  • Tremors and muscle spasms
  • Diarrhea
  • Abdominal cramps

The mental symptoms of typical opioid withdrawal that usually linger after the physical symptoms have lessened or disappeared include:

  • Anxiety
  • Insomnia
  • Depression
  • Inability to concentrate
  • Emotional numbness

An atypical Tramadol withdrawal is marked by psychological symptoms not usually associated with opioid withdrawal and can include:

  • Intense paranoia
  • Extreme anxiety and panic attacks
  • Numbness and tingling aka “pins and needles” in the hands and feet
  • Disorientation
  • Depersonalization (a dreamlike feeling of detachment from the body)
  • Hallucinations

Even though this set of withdrawal symptoms is relatively uncommon, it’s always safer to be prepared. This is just one of many reasons why we recommend undergoing Tramadol detox in a medical detox treatment center, where you’ll be monitored by trained medical professionals who are prepared for situations like atypical Tramadol withdrawal.

What Are the stages of the Tramadol Withdrawal Timeline?

Opioid withdrawal has two main phases: early withdrawal and late withdrawal.

  • Begins as soon as the drug leaves the bloodstream. For opioids, this is typically within about 12 hours of the last dose.
  • The flu-like symptoms begin within the first 24 to 48 hours.
  • Over roughly the next three to seven days, the rest of the physical symptoms will also manifest and hit their peak.
  • Psychological symptoms will also begin to appear at this point.

  • After a week or so, the physical symptoms will have lessened or dissipated completely.
  • In the meantime, the psychological symptoms will hit their peak discomfort levels.
  • Even as the other mental symptoms finally cease, feelings of depression and anxiety will most likely persist for weeks after, though they will weaken over time.

During detox, it is fairly common for doctors to administer doses of antidepressants to help patients cope with the worst of their withdrawal symptoms. However, this should generally be avoided with Tramadol, as mixing Tramadol with antidepressants significantly heightens the risk of seizures.

It can also cause what’s known as Serotonin Syndrome, which is when too much serotonin builds up in the body. Serotonin Syndrome symptoms can range from muscle spasms and tachycardia to seizures, coma, and even death.   

Overall, the majority of the Tramadol withdrawal symptoms will last anywhere between five to 10 days, though, previously mentioned, certain psychological symptoms may persist past that point.

While many different factors contribute to the length and severity of the withdrawal symptoms, the most common determinators of how your withdrawal timeline will vary are:

  • How long you’ve been using Tramadol and how much of that time was spent abusing it
  • How much Tramadol you’ve been taking
  • Whether or not you were abusing Tramadol in conjunction with other drugs or alcohol
  • How you were taking Tramadol (i.e., if you were injecting, smoking, or snorting it)

Why Should I Detox?

While it’s apparent why some drugs like heroin require a detox rather than a sudden “cold turkey” stop, someone might wonder if detoxing from a drug like Tramadol is necessary. However, an immediate and total cessation of the use of a substance your body has become dependent on throws it into shock and can exacerbate withdrawal symptoms. This can make the process unnecessarily more painful, and while suddenly stopping the use of Tramadol is rarely life-threatening, it can sometimes lead to organ damage.

Even disregarding the dangers of going cold turkey, forgoing detox greatly lessens the likelihood that you will be able to successfully stop using, as the withdrawal symptoms can become so severe that relapse is almost a certainty.

Seeking treatment specifically at a detox center also means that the medical staff are more knowledgeable and prepared for withdrawal situations than other doctors might be. For example, because Tramadol is considered so safe, many general practitioners will not offer a regimen for tapering off it for a detox that will best minimize withdrawal symptoms. A medical detox center is always your best and safest bet.

What Is the Next Treatment Step?

Once someone has completed their detox treatment, it is highly recommended that they enter recovery treatment. For those who choose to detox without continuing to ongoing treatment, the potential for relapse is high, with rates ranging from 65 to 80 percent just one month after being discharged from a detox center. On the other hand, those who choose to continue to the next phase of addiction recovery are up to 10 times more likely to make it to the six-month mark post-recovery still drug-free.

While each treatment plan is individualized to a certain degree for each person’s needs, most will involve a mix of some of the following:

  • Exercise, nutrition, and other health-supportive treatments (especially immediately following your detox)
  • Cognitive therapy
  • Family therapy
  • Individualized sessions on managing mental conditions that can contribute to addiction behaviors
  • Support groups

Start Your Journey to Recovery Today

If you or a loved one has been struggling with drug or alcohol addiction and is ready to take the first step to sobriety with a medical detox, Ocean Breeze Recovery is here to get you connected with everything you need to recover successfully.

We offer a variety of top-notch facilities with medical professionals ready to provide you or a loved one with expert support and care. Our admissions professionals are available round the clock, so call us today at 844-554-9279. You can also connect with us online.

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(June, 2014). Tramadol Update Review Report. World Health Organization. Retrieved January, 2019 from

(October, 2018). Tramadol. Drug Enforcement Administration. Retrieved January, 2019 from

Sansone, R, (April, 2009). Tramadol. US National Library of Medicine. Retrieved January, 2019 from

(February, 2012). Drug-Free Housing for Substance Abusers Leaving Detox Linked to Fewer Relapses. Johns Hopkins Medicine. Retrieved January, 2019 from

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