Need help: Tapering Tramadol

[Sendonis]

Hi guys,

I have been taking fairly large quantities of Tramadol in the last 2-1/2 months. It's to the point where all I want to do is stop taking it. I have to take way too many to get any sort of good feeling and I just don't feel like myself anymore. I'm sure people have heard this 100s of times. Regardless, I am looking for some detailed dosage information for tapering and a time frame for it. I know there are a few people on here that have had serious withdrawals from Tramadol and if any of those people could shed some light for me it would be great. I have about 100 tabs left and am ceasing to use them recreationally. Currently, I can take approximately 400mg per day and feel fine (no WD symptoms). From 400mg, what should I taper to? How long should I stick to each one of the doses down the ladder? At what point do I go cold turkey? I would love to CT and just suffer through it, but I have to many obligations and no way to put my life on hold for 2 weeks while I lay around miserably. I have gone through minor opiate wd's before but apparently tramadol is much more drawn out...I was on the couch for a few days feeling like crap but nothing more. If anyone can please help me I would appreciate it very much. I am very much, 100%, bent on stopping the tramadol use and will try to stick to documenting in this post what I go through to hopefully help other people out.

[jdub]

take as little as you can to feel decent. It probably won't be too comfortable but that is the best way to get off shit.

[Sendonis]

How do I know when to taper down even more though? And once I am tapered down to the point of barely taking anything, will there still be semi-severe WD symptoms?

[nick]

How do I know when to taper down even more though? And once I am tapered down to the point of barely taking anything, will there still be semi-severe WD symptoms?

Use the search to find Oxycontinuously's thread on tapering.It's the best taper method and gives the best chance of success.

Much luck.

[Saint]

How do I know when to taper down even more though? And once I am tapered down to the point of barely taking anything, will there still be semi-severe WD symptoms?

A few months ago I switched from (years of) methadone to about 350 mgs tramadol daily. That switch was a drawn out bitch in itself but methadone should be out of my body so now it's time to cut down on the tramadol - a little bit anyway.

Well, I thought it would be a big chunk of cake compared to those hundred heroin and methadone WD's I went through in my life - so I jumped from 350 mgs to 75 mgs tramadol within three days last week.
This is definitely not a good idea.
The first day was ok.. the second one I got sick. Way too sick to make it to work. I asked Lortabitha and Eerased for some advice and searched the net (Bluelight has tons of info on this!) and concluding I think that one shouldn't taper over 50 mgs a week max.

Tramadol is quite a 'boring' drug imo (I have never gotten the slightest sort of buzz from it anyway but just took it to get off methadone) but it still gives you withdrawals! (Life is so unfair, boohoo).
All the more reason to quit I guess.. although it has helped me tremendously getting off methadone and I'm more than happy about that.

As for that stupid fast taper I tried this week: I was in so much pain (not only from the withdrawals, I have a painproblem as well) that I had to go back up to 200 mgs a day. And that's still not 100% cutting it but I'm slowly getting there.
But I am definitely going to take things slow in the future and would advice you to do the same.

Why suffer if you can do a slow taper? I asked my doc for the drops instead of the capsules so I can go down with 25 mgs a week, or every other week even. You can also combine the 37.5 ultracet and the 50 mg ultram tabs to taper slow.

Maybe 25 mgs a week is a bit too slow for you (bear in mind that I have a long heroin/methadone history + a painproblem so it should be way easier for you. I hope so anyway..

Worst wd symptoms were - and still are: stomachproblems.. got a very painful bloathed stomach and am either constipated or the exact opposite all the time. Stomach hurts as fuck, like someone poured acid inside. I do have IBS so maybe that's the cause of my gutproblems being worse than usual.
Other symptoms are little sleep (got lorazepam for that), some sweating and RLS and a general yuckie, anxious & totally lethargic feeling. I have been lying on the couch for almost a week now and it sucked.
But I cut the trams down with 150 mgs in one week so at least I got something out of it..

But.. always look on the bright side: methadone withdrawals are even worse and take about ten times longer as well!! Also, you said you've only used them for 2 1/2 months and that you feel ok on 400 mgs already.. so it probably won't be too tough on you. Just taper, don't jump off!

My goal is to have cut back to 100 mgs a day by the end of august/september and then, who knows.. maybe just stay there.. maybe switch to another med.. all depends on my painlevel.

Anyway, I'm farting out of my mouth for way too long already.. My advice is: take it slow, 25 to 50 mgs every 5 to 7 days. Longer even if you don't feel stabilised yet. Finally jump from 25 mgs or even less and you'll be ok.

[Sendonis]

Thanks so much man. I was reading about the tapering your dose 1/3 per 3 days and it just doesn't sound right for tramadol. Maybe traditional opiates, but not these ones. I am going to start going down 50mg a week and see what happens. I have a supply of them so I guess you are right, there is no reason to go through unnecessary suffering. I really appreciate all that you have written. It really puts what I need to do into perspective and how long it may take. I really can't let any of that discourage me. I'm only 21 years old, in very good health, and have never done any of the harder stuff except for maybe snorting an oxy here and there about a year ago. I have no access to anything else and when I get off of tramadol for good I'm never looking back. It's not like other opiates where it just feels like a drug. It has changed my way of thinking and I am too reliant on it mentally to be in a good mood and want to interact with people. Anyway, thanks for the support and all of the advice. If anyone has anything to add I am more than happy to read it.

[Saint]

You're young and healthy and luckily not into the harder stuff. I think you will be fine.
So take it easy and you'll get there. There's probably others with some sound advice here.
Good luck man!

[Sendonis]

Well just getting through day 1 haha. Thought I would post that I am starting at 200mg total doses/day for 4 days. I spread dosing out 4 times daily in even, exact, 4 hour intervals. I will not be cheating on this since my will is so great to get off the tram wagon. Every four days I will be decreasing my dose by 50mg until I am down to only 50mg/day. At that point I am planning on going to 25mg for 4 days, then 15mg for 4 days, then 5mg for 4 days, and hopefully to nothing. I am still kind of wondering what kind of WDs can be expected when I am off them altogether out of curiosity...Possibly just some mentally depressed type issues? I have a script for Lexapro but it apparently is one of the more expensive SSRIs and I no longer have a doc or insurance. I may bite the bullet and buy 1 script anyway though if it is necessary. As for an update on how a feel on 50mg 4xs daily...I pretty much feel normal. Maybe a bit warmer than usual, and I had some really wierd, vivid dream last night. Aside from that, the usual worn out type feeling that I'm sure everyone on here is familiar with when they don't get the normal dose of the DOC. Anyhow, will keep this updated. Still looking for anymore personal experiences people may want to share. Thanks

[roxi*stardust]

Thanks so much man. I was reading about the tapering your dose 1/3 per 3 days and it just doesn't sound right for tramadol. Maybe traditional opiates, but not these ones. I am going to start going down 50mg a week and see what happens. I have a supply of them so I guess you are right, there is no reason to go through unnecessary suffering. I really appreciate all that you have written. It really puts what I need to do into perspective and how long it may take. I really can't let any of that discourage me. I'm only 21 years old, in very good health, and have never done any of the harder stuff except for maybe snorting an oxy here and there about a year ago. I have no access to anything else and when I get off of tramadol for good I'm never looking back. It's not like other opiates where it just feels like a drug. It has changed my way of thinking and I am too reliant on it mentally to be in a good mood and want to interact with people. Anyway, thanks for the support and all of the advice. If anyone has anything to add I am more than happy to read it.


First and foremost Tramadol is not an opiate. It is very closely related to SSRIs, closer to SSRIs than opiates. What you will experience w/d wise will be more like the w/d from SSRIs and the mental part of the opiate w/d. I am be no means down playing the w/d from Tramadol but the majority of what you are going to experience is going to be psychological and not like the hard core physical w/d you will have from a traditional opiate like morphine, oxycodone, or even hydrocodone. I suggest you read up on tapering off SSRIs. When I was one an SSRI for depression and my doctor tapered me off they simply had me skip a day. In other words take your dose everyday except one day the first week the skip two days the next week then on and on like that.

[Mayo]

Other symptoms are little sleep (got lorazepam for that), some sweating and RLS and a general yuckie, anxious & totally lethargic feeling. I have been lying on the couch for almost a week now and it sucked.



Sounds like opi-type w/d to me. SSRI w/d for me were electric shocks in the brain and severe emotional swings. Tramadol is an opioid albeit atypical and acts on both serotonin and noradrenalin too. Appears to be a w/d to avoid for sure, I hope the taper works out.

[Indy]

Tramadol is definitely an opioid.

[Saint]

Tramadol is definitely an opioid.

Yep, liver metabolises it in morfine and it attaches to the mu-receptor (but less so than morphine, just gives a 'high five' to the mu as Inspaktah Dek so nicely put it). It also has light anti-depressive qualities so you're withdrawling from an opioid AND an anti-depressive.
Keep us updated Sendonis and don't go down too fast...

About the wd-symptoms. This is what they say on the net:

Ultram Withdrawal symptoms include:

difficulty sleeping
agitated
hallucinating
dizziness
depression
diarrhea
nausea
lethargy
sweats
body aches body much worse than before taking the drug
irritability
increase in tremor
tearing, sneezing
For me the nausea, stomachproblems, insomnia, sweating and a week of sneezing was about the worst of it (and feeling achy and a little depressed but not VERY depressed, a slight depression/lethargy might hit you once you're off it altogether maybe but I don't think it will be too hard after a slow taper).

[roxi*stardust]

Here is what I learned about Tramadol from school, work, and CE. This information I am posting is directing from pharmacology books, Ultram package inserts, and past CE class notes that I have. All of it can be found on the internet with Google. Pleas skip past the Wiki articles and drugs dot com. Those sites are giving basic consumer info. They put things in terms that people understand, even though they might not be fully correct.

Tramadol is a centrally acting synthetic analgesic (notice that doesn't say narcotic analgesic or opioid analgesic). It's mode of action is not completly understood but at least two complementary mechanisms appear to be at work. One is binding of the parent compound (Tramadol) and the M1 metabolite to the mu receptor and inhibition of the reuptake of norepinephrine and serotonin. It's opioid activity is due to both the low affinty binding of the parent compound (Tramadol) and the higher binding affinity of the O-demethylated metabolite M1 to the mu receptor. In animal models the M1 metabolite is 6 times more potent than the parent compound (Tramadol) in producing analgesia and 200 times more potent in mu receptor binding.

Tramadol induced analgesia is only partially antagonized by the the opiate antagonist Naloxone in laboratory tests. This suggests the existence of another mechanism of action. This was demonstrated by the discovery of a monoaminergic activity that inhibits noradrenaline (norepinephrine) and serotonin (5-hydroxytryptamine; 5-HT) reuptake, making a significant contribution to the analgesic action by blocking nociceptive impulses at the spinal level (This is very important when considering it's opioid classification or lack of)

A single 100mg dose of Tramadol is the equivalent to 1000mg of Acetaminophen in producing analgesia.

Tramadol appears to have weak activity at the mu receptor.

Tramadol is a centrally acting analgesic. Structurely not an opiate, but it exhibits some opioid characteristics. Like opioids it binds to the mu receptor, although very weakly (it's binding affinity is 10 times less the codeine and 6000 times less than morphine). Like codeine, Tramadol is metabolised via the CYP2D6 isoenzyme of cytochrome P450 to an active metabolite which binds the mu receptor. Patients who metabolise drugs poorly via CYP2D6 (7% of Caucasians) may get much less benefit from it (and codeine) due to reduced formation of the active metabolite.

Tramadol, a centrally-acting analgesic, exists as a racemic mixture of the trans isomer, with important differences in binding, activity, and metabolism associated with the two enantiomers. The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS, which inhibits pain transmission in the spinal cord. The (+) enantiomer has higher affinity for the OP3 receptor and preferentially inhibits serotonin uptake and enhances serotonin release. The (-) enantiomer preferentially inhibits norepinephrine reuptake by stimulating alpha(2)-adrenergic receptors

After oral administration, tramadol demonstrates 68% bioavailability, with peak serum concentrations reached within 2 hours.

Tramadol should not be administered to patients receiving monoamine oxidase inhibitors, and administration with tricyclic antidepressant drugs should also be avoided.

So sometimes Tramadol is called an atypical opioid but that doesn't mean it is an opioid chemically or in structure. From purposes here, in this discussion, if you feel better calling Tramadol an opiate or opioid, by all means go ahead. But don't pass along bad information. I have TONS more information, if anyone would like to see more just say the word.

Tramadol is definitely an opioid.

Sorry Indy but you are definately incorrect.

[Mayo]

The Ortho-McNeil PI sheet calls tramadol a centrally-acting synthetic opioid analgesic, has morphine-like properties
and it acts on at least one opioid receptor type. If Ortho-McNeil repeatedly calls it an opioid in its literature, why is Indy wrong in calling it an opioid?

[Saint]

It sure feels like an opioid coming off of it... RLS, no sleep, sneezing, sweating, insomnia the whole abacadabra.

[roxi*stardust]

The Ortho-McNeil PI sheet calls tramadol a centrally-acting synthetic opioid analgesic, has morphine-like properties
and it acts on at least one opioid receptor type. If Ortho-McNeil repeatedly calls it an opioid in its literature, why is Indy wrong in calling it an opioid?


Well I have the package insert and it does not say Centrally acting synthetic opioid analgesic. It says:
Tramadol is a centrally acting analgesic. There is no dispute that it acts on the mu receptor, did you read all the facts I posted? I didn't make those up. I have been in this business for 10+ years. I have to get a certain amount of continuing education classes/credits to keep my certification. I got CE credits for a discussion about Tramadol. Here is a screenshot:
2902

[Mayo]

Well I have the package insert and it does not say Centrally acting synthetic opioid analgesic. It says:
Tramadol is a centrally acting analgesic. There is no dispute that it acts on the mu receptor, did you read all the facts I posted? I didn't make those up. I have been in this business for 10+ years. I have to get a certain amount of continuing education classes/credits to keep my certification. I got CE credits for a discussion about Tramadol. Here is a screenshot:
2902

Interesting. My PI sheet for ultram ER says centrally acting opioid analgesic lol.
It also says not to chew the pill or you risk a large release of the 'opioid' which may cause death from resperatory collapse.

Oh well. I've never taken it, hopefully wont ever need to cuz that means I be hurtin.

[roxi*stardust]

Interesting. My PI sheet for ultram ER says centrally acting opioid analgesic lol.
It also says not to chew the pill or you risk a large release of the 'opioid' which may cause death from resperatory collapse.

Oh well. I've never taken it, hopefully wont ever need to cuz that means I be hurtin.

ROTFL, "you risk a large release of the opioid", LOL. :D Some of the facts I have say that codeine is 10x stronger acting on the mu receptor. There is so much info out there on Tramadol that it doesn't surprise me a bit that they are different. I think the truth is that it mechanism of action is unknown. They also say the risk of abuse is extremely low, which we know is not true.

[OxyContinuously]

yup i agree w/ Roxi*
tramadol works, as she was telling us, more as an anti-D than as an opiate...i would be more comfortable labeling it as "an atypical analgesic w/ opioid-like properties" interesting to note though, it is a centrally acting pain med, as opposed to a peripherally active one such as acetaminophen for example. go figure!

[roxi*stardust]

yup i agree w/ Roxi*
tramadol works, as she was telling us, more as an anti-D than as an opiate...i would be more comfortable labeling it as "an atypical analgesic w/ opioid-like properties" interesting to note though, it is a centrally acting pain med, as opposed to a peripherally active one such as acetaminophen for example. go figure!


Thanks for backing me up on this OxyC. Definately atypical. A cenetrally acting analgesic w/ opioid-like properties. Structurally it is not a opioid and Tramadol induced analgesia is only partially antagonized by Naloxone yet it has a very weak affinity for the mu-receptor (suggestive of a different mechanism of action). Those three things in and of themselves pretty much disqualify it from being truely classified as an opioid. Then there is also it's action on serotonin, norepinephrine, and monoamine oxidase, this makes Tramadol's true mechanism of action unknown. It seems all play some type of role is relieveing pain but most authorities believe the blockade of noradrenaline (norepinephrine) and serotonin at the spinal level is what produces it's analgesic effect. Considering it's weak mu activity (10x less than that of codeine), it is highly unlikely that the mu receptor activity has little if anything to do with it's analgesic effects.

[OxyContinuously]

Thanks for backing me up on this OxyC. Definately atypical. A cenetrally acting analgesic w/ opioid-like properties. Structurally it is not a opioid and Tramadol induced analgesia is only partially antagonized by Naloxone yet it has a very weak affinity for the mu-receptor (suggestive of a different mechanism of action). Those three things in and of themselves pretty much disqualify it from being truely classified as an opioid. Then there is also it's action on serotonin, norepinephrine, and monoamine oxidase, this makes Tramadol's true mechanism of action unknown. It seems all play some type of role is relieveing pain but most authorities believe the blockade of noradrenaline (norepinephrine) and serotonin at the spinal level is what produces it's analgesic effect. Considering it's weak mu activity (10x less than that of codeine), it is highly unlikely that the mu receptor activity has little if anything to do with it's analgesic effects.

exactly right! i was going to say the thing that really convinced me otherwise of tramadol's "classification," i guess, would be that it acts on serotonin and nor-epinephrine...alot of our newer anti-D's also act on nor-epinephrine and serotonin such as Cymbalta,, and if u go through it's indications, you'll see that even as an anti depressant primarily, Cymbalta, for some people, has been helpful with neurological pains like fibro, or multiple sclerosis...

so that would lead me to conclude that tramadol's principal method of action resides in its ability to block nor epinephrine and serotonin from being re-absorbed by the neuron...it's mu affinity is negligible

[Cherry's Jubilee]

It sure feels like an opioid coming off of it... RLS, no sleep, sneezing, sweating, insomnia the whole abacadabra.

This is true. I took Tramadol for about a month years ago for an injury when I was only using other opiates sporadically. I never felt high, never felt anything at all, so it didn't remotely occur to me that I'd get sick when I ran out. I wasn't even upset about running out, it was like running out of aleve--oh well...

Holy fuck! The next day in class I was freezing, shaking, eyes watering, sneezing and the RLS and insomnia and shit lasted for 2 days until I finally got some oxy. WEIRD. Very bad withdrawals for absofuckinglutely nothing.

[reddragon3668]

This may be a crude comparison, but it reminds me of the various pod species that will keep you out of withdrawal but won't get you high. I'm not sure if they would produce withdrawal effects once stopped, similar to that of Tramadol?

After reading the info you posted, Roxi, it sounds like Tramadol might be a good analgesic for people like me with spinal/nerve pain. I've never tried it before, but I think I am going to ask my PM doc to throw a bit of it into my mix just to see what it will do. Surely it couldn't hurt, and since its not an "opioid" per se, it should mix well with the Opana and Oxy I take, right? Couldn't hurt... hell, I love opiates as much as the rest of us, but pain relief is precious to me and I don't give a damn where it comes from. I'd eat the shingles off the top of my house if I knew they'd make me feel better. I'd much rather enjoy a "high" without pain, ya know?

Thanks for the info, Roxi!
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[Sendonis]

Thanks for all the responses guys. Going on day two. So far with my spread out doses @ 50mg every 4hrs. for 4 times/day, the only real symptoms I am feeling from WD are lethargy (albeit very little) and a running nose and sneezing way more than I usually do. For what tramadol does, the WD symptoms definitely aren't worth it. I've WD'd from oxy before, but at least you actually feel awesome from that heh. Anyway, I can definitely deal with 200mg a day, can't wait for 2 more days to pass so I can go down to 150mg a day. I really want to get off this shit so I can just use something else recreationally here and there. Anyone think it would be a good idea to bite the bullet and get my Lexapro script filled for when I come of the trams?

[Mayo]

... Anyone think it would be a good idea to bite the bullet and get my Lexapro script filled for when I come of the trams?

Only if you think you will be seriously depressed. SSRI's even lex can have unpleasent SE, don't forget. And its very expensive w/o insurance.
Doctor could have given you a script for celexa, alot cheaper and essentially the same, just a bigger dose really.

I would not take a prescription antidepressant if I were you unless your depression was very debilitating, suicidal, unbearable basically.
Do you suffer from major depressive disorder? If so, then yes I would take it for chronic depression too.

SSRI's can be a bitch to get off too, not trying to scare you, just a reminder.

[roxi*stardust]

Only if you think you will be seriously depressed. SSRI's even lex can have unpleasent SE, don't forget. And its very expensive w/o insurance.
Doctor could have given you a script for celexa, alot cheaper and essentially the same, just a bigger dose really.

I would not take a prescription antidepressant if I were you unless your depression was very debilitating, suicidal, unbearable basically.
Do you suffer from major depressive disorder? If so, then yes I would take it for chronic depression too.

SSRI's can be a bitch to get off too, not trying to scare you, just a reminder.


Mayo is right. I would only start an anti-D if I was truly in need of one. All of the things Mayo mentions are potential problems, including getting off them. But if you believe what lead you to abuse the Tramadol was depression then this maybe an option for you, especially if the Tram was alleviating your depression and you feel it is/will worsen without taking the Trams. Another anti-d to consider is Wellbutrin. It works on several different neurotransmitters including serotonin, norepinephrine, and dopamine. Seems to cause less sexual side effects, it is much less likely to induce mania in bi-Polar patients and has been show especially effective in treating dual diagnosis of depression and substance abuse (opiate, cocaine, and amphetamine addiction specifically)

[Indy]

In my opinion if it binds to opioid receptors it's an opioid. Or at least acts as an opioid on the body. It relieves withdrawal symptoms from other opioids, and even has cross-tolerance. If that isn't indicative of an opioid i don't know what is.

For instance, when i was taking vicodin mainly, i had a decent but not too high tolerance. Tramadol kept me well, but it took me WAY more to get high than it took before i had a tolerance. I hadn't had tramadol in over a year at that point, but i had a tolerance to it. the hydro was the only other opioid i had been taking.

"Tramadol is a synthetic 4-phenyl-piperidine analogue of codeine. It is a central analgesic with a low affinity for opioid receptors. Its selectivity for mu receptors has recently been demonstrated, and the M1 metabolite of tramadol, produced by liver O-demethylation, shows a higher affinity for opioid receptors than the parent drug".
http://www.ncbi.nlm.nih.gov/pubmed/9190321

So not only does it have affinity for opioid receptors, it's a synthetic analogue of codeine, and it's metabolite M1 is an even STRONGER opioid, so even if the "parent drug" as the study so nicely puts it, isn't an opioid (which it is) it is most certainly a prodrug for a stronger opioid.

I just don't get how it ISN'T an opioid. Just because it's centrally acting doesn't mean it isn't one, in fact if anything that's one of the criterion for BEING an opioid.

EDIT: You said "there is no dispute that it acts on the mu receptor". An opioid, by definition, is:
"a synthetic drug (as methadone) possessing narcotic properties similar to opiates but not derived from opium"

Now the study i showed said it has a weak affinity for the opioid receptors, with a HIGHER affinity specifically for the mu receptor. Logic dictates that in that case it causes an opiate-like action, no?

edit AGAIN cause i keep forgetting stuff: Why would the monograph that comes with the drug say it's an opioid if it's not. Isn't that misinformation? You're the medical professional, aren't there laws about just making shit up about a drug and telling it to the patients as fact?

[Thebane]

Sorry Indy but you are definately incorrect.

Sorry if I'm being slow here, but are you saying Tramadol has no opioid buzz? (or opiate if you want to be less technical) I've never tried Tramadol but I assumed from all the posts here it would at least help with withdrawals (from pods in my case).

[roxi*stardust]

In my opinion if it binds to opioid receptors it's an opioid. Or at least acts as an opioid on the body. It relieves withdrawal symptoms from other opioids, and even has cross-tolerance. If that isn't indicative of an opioid i don't know what is.

For instance, when i was taking vicodin mainly, i had a decent but not too high tolerance. Tramadol kept me well, but it took me WAY more to get high than it took before i had a tolerance. I hadn't had tramadol in over a year at that point, but i had a tolerance to it. the hydro was the only other opioid i had been taking.

"Tramadol is a synthetic 4-phenyl-piperidine analogue of codeine. It is a central analgesic with a low affinity for opioid receptors. Its selectivity for mu receptors has recently been demonstrated, and the M1 metabolite of tramadol, produced by liver O-demethylation, shows a higher affinity for opioid receptors than the parent drug".
http://www.ncbi.nlm.nih.gov/pubmed/9190321

So not only does it have affinity for opioid receptors, it's a synthetic analogue of codeine, and it's metabolite M1 is an even STRONGER opioid, so even if the "parent drug" as the study so nicely puts it, isn't an opioid (which it is) it is most certainly a prodrug for a stronger opioid.

I just don't get how it ISN'T an opioid. Just because it's centrally acting doesn't mean it isn't one, in fact if anything that's one of the criterion for BEING an opioid.

EDIT: You said "there is no dispute that it acts on the mu receptor". An opioid, by definition, is:
"a synthetic drug (as methadone) possessing narcotic properties similar to opiates but not derived from opium"

Now the study i showed said it has a weak affinity for the opioid receptors, with a HIGHER affinity specifically for the mu receptor. Logic dictates that in that case it causes an opiate-like action, no?

edit AGAIN cause i keep forgetting stuff: Why would the monograph that comes with the drug say it's an opioid if it's not. Isn't that misinformation? You're the medical professional, aren't there laws about just making shit up about a drug and telling it to the patients as fact?

You saw the Package insert I attached. Just because something acts on the mu receptor doesn't mean it is an opiate. I am not disputing that it does act on the mu receptor, although rather weakly. There are alot of substances that appear to act on the mu receptor that aren't opioids. Kratom is one, yet it isn't an opiate/opioid, it only appears to act on the mu receptor.. Your quote above that I bolded. Keep that in mind. Now read this quote from one of my prior posts:


Tramadol induced analgesia is only partially antagonized by the the opiate antagonist Naloxone in laboratory tests. This suggests the existence of another mechanism of action.


Ok so if Tramadol has a weak binding affinity for the mu receptor yet Naloxone only partial antagonizes it. Naloxone displaces opiates/opioids from the mu receptor. The only excpetion is Bupe which has a stronger affinity than Naloxone. Tramadol does not have a high affinity, in fact it has an extremely low affinity, 10x less than that of codeine and 6000x less than that of morphine. It is not displaced because it is not an opioid.

Tramadol is a centrally acting analgesic. Structurely not an opiate, but it exhibits some opioid characteristics. Like opioids it binds to the mu receptor, although very weakly (it's binding affinity is 10 times less the codeine and 6000 times less than morphine). Like codeine, Tramadol is metabolised via the CYP2D6 isoenzyme of cytochrome P450 to an active metabolite which binds the mu receptor. Patients who metabolise drugs poorly via CYP2D6 (7% of Caucasians) may get much less benefit from it (and codeine) due to reduced formation of the active metabolite.



You can see in the above information, directly taken from a pharmacology research paper that it isn't just the Tramadol that binds the mu receptor, since it is a racemic mixture. It's active metabolite, O-demethylated metabolite M1 binds 200x more potently than Tramadol itself.


Tramadol, a centrally-acting analgesic, exists as a racemic mixture of the trans isomer, with important differences in binding, activity, and metabolism associated with the two enantiomers. The analgesic properties of Tramadol can be attributed to norepinephrine and serotonin reuptake blockade in the CNS, which inhibits pain transmission in the spinal cord. The (+) enantiomer has higher affinity for the OP3 receptor and preferentially inhibits serotonin uptake and enhances serotonin release. The (-) enantiomer preferentially inhibits norepinephrine reuptake by stimulating alpha(2)-adrenergic receptors.


So what does all this mean. It means that while Tramadol and it's M1 metabolite do show weak activity at the mu receptor, Tramadol itself is not structurely an opioid, much like may other substances including Kratom. Do you consider Kratom an opioid?

Now regarding the monographs you are given at the pharmacy. They contain information that is written for non-medical professionals to understand. They are not always right. The package inserts provided to RPhs and doctors contain the information like this, pharmacology, mechanism or action, metabolism, etc. You will not find this type of info in a drug monograph from you local Walgreens. That information is not well understand by the general population, putting there would only cause confusion. They put what they think the general population will read and understand.

[roxi*stardust]

Sorry if I'm being slow here, but are you saying Tramadol has no opioid buzz? (or opiate if you want to be less technical) I've never tried Tramadol but I assumed from all the posts here it would at least help with withdrawals (from pods in my case).


Please read my ENTIRE posts. NO ONE, including myself, is disputing the fact that Tramadol has some effect on the mu-receptor. All I am trying to say is that Tramadol is technically not an opiate/opioid structurely and it not antagonized by Naloxone even though it has a very WEAK affinity (10x less than codeine and 6000x less than morphine). Structurely not an opiate, but it exhibits some opioid characteristics and only partially antagonized by Naloxone. The prior disqualifies it from technically being an opiate/opioid. Much like Kratom, which also is not an opiate/opioid.

[roxi*stardust]

yup i agree w/ Roxi*
tramadol works, as she was telling us, more as an anti-D than as an opiate...i would be more comfortable labeling it as "an atypical analgesic w/ opioid-like properties" interesting to note though, it is a centrally acting pain med, as opposed to a peripherally active one such as acetaminophen for example. go figure!

[Indy]

Well maybe when i'm high i'll dispute this well but i'm too sober so i'll just say that the merriam webster dictionary says that an opioid is anything that.....well whatever i quoted before. tramadol does that, ergo it's an opioid.

[roxi*stardust]

Well maybe when i'm high i'll dispute this well but i'm too sober so i'll just say that the merriam webster dictionary says that an opioid is anything that.....well whatever i quoted before. tramadol does that, ergo it's an opioid.


According to that definition everything that has any effect at the opioid receptor is an opiate/opioid. Kratom, Naloxone, Naltrexone.



Tramadol is a centrally acting analgesic. Structurally it is not an opiate, but it exhibits some opioid characteristics. Like opioids it binds to µ receptors, although very weakly (binding affinity is 10 times less than codeine and 6000 times less than morphine).2 (http://www.australianprescriber.com/magazine/27/2/26/7/#2#2) Like codeine, tramadol is metabolised via the CYP2D6 isoenzyme of cytochrome P450 to an active metabolite which binds to µ receptors. Patients who metabolise drugs poorly via CYP2D6 (about 7% of Caucasians) may get less benefit from tramadol (and codeine) due to reduced formation of the active metabolite. Tramadol is also metabolised by CYP3A4 so its activity is reduced by drugs which induce CYP3A4.

The analgesic effects of tramadol are not completely reversed by the opioid antagonist naloxone. This suggests that tramadol has additional mechanisms of action. Tramadol inhibits reuptake of serotonin and noradrenaline and this probably contributes to its analgesic effects.



A low abuse liability is reported for tramadol, an analgesic drug centrally acting through either opioid or nonopioid mechanisms. In this paper, we evaluated the effects of the repeated administration (7 d) of different doses of tramadol (10,20, and 80 mg/kg, intraperitoneally) on the opioid precursor prodynorphin biosynthesis, in comparison with morphine (10 mg/kg, intraperitoneally), in the rat central nervous system (CNS). Northern analysis showed that morphine and tramadol produced different effects. While morphine caused a down-regulation of prodynorphin mRNA levels in all investigated areas (hypothalamus, hippocampus, and striatum), tramadol did not cause any significant change in the striatum, and did not decrease prodynorphin biosynthesis in the hypothalamus and in the hippocampus, at nontoxic doses (10 and 20 mg/kg). The highest dose of tramadol (80 mg/kg) decreased prodynorphin mRNA levels in the hypothalamus and the hippocampus but not in the striatum. These data give some information on tramadol effects at molecular level in the CNS. They indicate that the alterations of prodynorphin gene expression caused by tramadol and morphine show a different pattern that may be related to the different abuse potential of the two analgesic drugs.




Tramadol is a synthetic analgesic who’s mode of action is not completely understood. It has been shown to exhibit some of the same effects as other opiate pain medications but there is no consensus in either the medical or the recreational community whether it is a true opiate/opioid. As of now it is not scheduled in America and is relatively easy to get prescribed. Tramadol while not be considered a “true opiate” has been shown to be addictive and has potential to cause withdrawal symptoms



Chemical Names. trans-(+/-)-2-[(dimethylamino)methyl]-1-(3-methoxyphenyl) cyclohexanol.
Classification. Non-opiate synthetic analgesic.
Primary Uses. Analgesic (Off-label for diabetic neuropathy and restless leg syndrome).
Other Names. Ultram, Ultracet

Tramadol is a fully synthetic, centrally acting analgesic with a low binding affinity for the mu-opioid receptor. Some sources call it an opioid, others claim the opposite. Due to its dissimilarity to other opioids, it acts via methods other than the opioid pathways. Tramadol affects the GABAergic, noradrenergic, and serotonergic systems in the brain. The opiate overdose remedy, naloxone, only partially reverses analgesic effects, pointing toward non-opiate activity.


Actions
Tramadol is a centrally acting synthetic analgesic of the aminocyclohexanol group with opioid like effects. It is not derived from natural sources, nor is it chemically related to opiates. Tramadol is a non-selective pure agonist at mu, delta and kappa opioid receptors with a higher affinity for the mu receptor. Other mechanisms that may contribute to its analgesic effect are inhibition of neuronal re-uptake of noradrenaline and an enhancement of 5HT release.


Pharmacology
Tramadol is a centrally acting analgesic. Unlike other centrally acting analgesics eg morphine and codeine, tramadol has a dual mechanism of action at therapeutic doses: it possesses opioid agonist properties and modifies transmission of pain impulses at the spinal level by inhibition of monoamines (noradrenaline and serotonin re-uptake. Tramadol is a racemic mixture; the (+) enantiomer has a weak affinity for the μ opioid receptors and in inhibiting the re-uptake of serotonin whereas the (-) enantiomer preferentially inhibits the re-uptake of noradrenaline. A recent study has demonstrated the safety of both of the enantiomers and the racemate in patient with severe postoperative pain receiving up to 600mg i.v. per day of each respective substance. The enantiomers act in a complimentary and synergistic fashion to produce analgesia, mainly by inhibiting pain transmission in the spinal cord. Although tramadol has an affinity for opioid receptors, this affinity is 6,000 times weaker than that of morphine.
Tramadol has a major advantage over the other opioid analgesics because it has less effect on respiratory and cardiovascular functions at therapeutic doses. These are particularly useful properties in the treatment of pain in the elderly. Care should be taken not to exceed the maximum dose and tramadol should not normally be used in patients with epilepsy because of its effects on the re-uptake of serotonin.
Tramadol has a low potential to cause physical dependence or abuse, approximately 1 in 6,000.

All information above is from MEDICAL sources, not Wiki or Merriam Webster.

[OxyContinuously]

a lot of things can exhibit "opiate like effects" btw....doesn't mean it's an opioid....

salvinorin A tweaks the kappa opiate receptor i believe (jacky help me out on this my brotha ;-) but salvia is clearly as far away from an opiate as one can get...

i think the main issue with determining the "opiate-ness" of anything, is its ability to tweak good 'ol mu...now, a drug that fills up that receptor completely is called a "full agonist" example: methadone

still others only partially fill mu up-- they're partial agonists. example: pentazocine

and then others really have very very weak affinity for mu...tramadol is listed by Merck (not Wiki or some Mickey Mouse bullshit like that) to have approximately 10 percent the binding affinity at the mu receptor than codeine does...what does that tell you?

well, it tells me first and foremost that the "relief" a patient experiences whilst on tramadol has very very little to do with it's mu affinity...

tramadol works on serotonin, but more specifically nor-epinephrine....Serotonin we all know about...nor adrenalin, on the other hand, is weird, b/c not only is it a neuro transmitter, but it also helps to relieve certain types of pain...the serotonin released explains the "good mood" and the nor adrenalin explains the pain relief...

the activity of tramadol at mu is negligible, but it IS there so as a result, trams can and do relieve WD and for some, u can get a "kick" from trams if ur tolerance is low enough

so is tramadol an opiate? Nope.

but it is "opiate-esque" in nature.

let's put it this way: if tramadol did nothing for serotonin or nor epinephrine, u can bet ur bottom dollar it would be totally USELESS.

enjoy

[Sendonis]

Hey guys. Day 3 of the tapering and I still feel fine. After reading peoples' posts about anti-ds, I think I am going to steer clear. I don't find myself a depressed person now, nor did I before I started taking all the trams. The only thing tramadol did for me mentally is put me in a 'better' mood than I was in before I took it. I have been reading about it being difficult to get off an SSRI as well. There's really no reason to trade one problem for another and so on. Regardless, tomorrow, depending on how I am feeling I may cut out another 50mg. It would be the 4th day. I don't think I would have any problem doing that either. Also, I checked out prices on Lexapro...It's like $90+ for 30-60 tabs w/o health insurance. What a fuckin rip. Anyhow, I don't have a doctor at this point either so I am just going to come off clean for a while. I find all of the posts from roxi, Oxy, and Indy very interesting as well. Thanks for explaining what tramadol really is. So, more updates to come on the tapering....Thanks for the support.

[Mayo]

Hey guys. Day 3 of the tapering and I still feel fine. After reading peoples' posts about anti-ds, I think I am going to steer clear. I don't find myself a depressed person now, nor did I before I started taking all the trams. The only thing tramadol did for me mentally is put me in a 'better' mood than I was in before I took it. I have been reading about it being difficult to get off an SSRI as well. There's really no reason to trade one problem for another and so on. Regardless, tomorrow, depending on how I am feeling I may cut out another 50mg. It would be the 4th day. I don't think I would have any problem doing that either. Also, I checked out prices on Lexapro...It's like $90+ for 30-60 tabs w/o health insurance. What a fuckin rip. Anyhow, I don't have a doctor at this point either so I am just going to come off clean for a while. I find all of the posts from roxi, Oxy, and Indy very interesting as well. Thanks for explaining what tramadol really is. So, more updates to come on the tapering....Thanks for the support.

That's great! I hope it keeps going well, you sound happy so far. Thanks for letting us know how its going.

[roxi*stardust]

Hey guys. Day 3 of the tapering and I still feel fine. After reading peoples' posts about anti-ds, I think I am going to steer clear. I don't find myself a depressed person now, nor did I before I started taking all the trams. The only thing tramadol did for me mentally is put me in a 'better' mood than I was in before I took it. I have been reading about it being difficult to get off an SSRI as well. There's really no reason to trade one problem for another and so on. Regardless, tomorrow, depending on how I am feeling I may cut out another 50mg. It would be the 4th day. I don't think I would have any problem doing that either. Also, I checked out prices on Lexapro...It's like $90+ for 30-60 tabs w/o health insurance. What a fuckin rip. Anyhow, I don't have a doctor at this point either so I am just going to come off clean for a while. I find all of the posts from roxi, Oxy, and Indy very interesting as well. Thanks for explaining what tramadol really is. So, more updates to come on the tapering....Thanks for the support.


That's great Sendonis, glad to hear it's going fairy smoothly. Anti-D are difficult to go off but when tapered properly it is usually a smooth transition. Have you been experiencing and type of dizziness or "electric shock" feeling in you head since you started tapering? I am asking because this is a common complaint when people taper from SSRIs. Sometimes you will hear it refered to as brain shivers. I am wondering if the reason so many people find Tramadol w/d so unpleasant is because the combination of the mu-receptor acitvity and noradrenaline reuptake and Serontonin Reuptake inhibition all happeneing at once. Almost like w/d from an opiate and an SSRI all at once.

[Nate]

Best of luck!!

[Sendonis]

Gettin through day 4 now... Yesterday I forgot to take one of my 50mg doses (the noon one). Instead, I just took it as soon as I remembered, probably about 2pm, then took my normal one at 8pm. So basically, yesterday I went through the day with 150mg. No probs so far. In fact, I woke up this morning, getting ready to take my daily 8am dose and forgot about that one until 9:30am! I find myself really not thinking much about the trams at all, which I guess is a good thing. So, I ended up tapering 2 days early and feel fine for the most part. I will end up taking a total of 150mg today, and the next 2 days and see how I feel from there. I feel that my plan is still going right on track. It seemed like it was going to be much more difficult from reading other peoples' posts. Still the biggest WD symptom I have been having is a bit of lethargy and dizziness if I get up too quickly from a seated or layed down position (see below for details).

roxi - The only dizziness I have experienced is a bit of abnormal light-headidness when I get up quickly from sitting or laying down. Generally I can jump up from sitting down and not have to worry about fainting haha, but I definitley feel woozy for 10 seconds or so if I get up to quickly for now. Aside from that I haven't had any abnormal dizziness. Honestly I don't think I have been getting any electric "shock" type feelings in my head either. I do know what you are talking about however, and have had that feeling before. If anything, the only thing remotely close to that symptom so far that I have experienced has been very mild and is usually felt when I get up too quickly as stated above when I am light-headed.

Hopefully this documentation will help people in the future for tapering trams. I know I was rather nervous before I started since I really didn't know what to expect. It's pretty hard to find taper/quitting advice for tramadol online. The few sites that I have found have been so convoluted that it's hard to see what experience the person is going through.

Thanks again for the support everyone, more updates to come.

[Saint]

Wow, wish it was that easy for me! I guess my 25 year opiate addiction + chronic pain is to blame with having a lot of difficulties tapering the tramadol.
Although not as horrible as methadone wd's I didn't come any further than 200 mgs yet (coming from 350) and I am in PAIN. So I'm gonna have a talk with my doc first. Maybe there is an option in between tramadol and methadone that handles my pain without the side effects from done...
Anyway, good luck. Hope it'll be smooth sailing for ya!

[roxi*stardust]

Gettin through day 4 now... Yesterday I forgot to take one of my 50mg doses (the noon one). Instead, I just took it as soon as I remembered, probably about 2pm, then took my normal one at 8pm. So basically, yesterday I went through the day with 150mg. No probs so far. In fact, I woke up this morning, getting ready to take my daily 8am dose and forgot about that one until 9:30am! I find myself really not thinking much about the trams at all, which I guess is a good thing. So, I ended up tapering 2 days early and feel fine for the most part. I will end up taking a total of 150mg today, and the next 2 days and see how I feel from there. I feel that my plan is still going right on track. It seemed like it was going to be much more difficult from reading other peoples' posts. Still the biggest WD symptom I have been having is a bit of lethargy and dizziness if I get up too quickly from a seated or layed down position (see below for details).

roxi - The only dizziness I have experienced is a bit of abnormal light-headidness when I get up quickly from sitting or laying down. Generally I can jump up from sitting down and not have to worry about fainting haha, but I definitley feel woozy for 10 seconds or so if I get up to quickly for now. Aside from that I haven't had any abnormal dizziness. Honestly I don't think I have been getting any electric "shock" type feelings in my head either. I do know what you are talking about however, and have had that feeling before. If anything, the only thing remotely close to that symptom so far that I have experienced has been very mild and is usually felt when I get up too quickly as stated above when I am light-headed.

Hopefully this documentation will help people in the future for tapering trams. I know I was rather nervous before I started since I really didn't know what to expect. It's pretty hard to find taper/quitting advice for tramadol online. The few sites that I have found have been so convoluted that it's hard to see what experience the person is going through.

Thanks again for the support everyone, more updates to come.


Glad to hear everything is going smoothly for you. Thanks for answering my question about the "brain shivers". I was very curious what type of w/d symptoms one would experience when the only drug they are currently using is Tramadol. I wondered how much of the w/d would be mu-receptor related and how much Serotonin and Noradrenaline(Norepinephrine) related. Sounds like you have a mix of both. The dizziness is definately the Serotonin and Noradrenaline. The lethargy is a combination both.

[Saint]

Gald to hear everything is going smoothly for you. Thanks for answering my question about the "brain shivers". I was very curious what type of w/d symptoms one would experience when the only drug they are currently using is Tramadol. I wondered how much of the w/d would be mu-receptor related and how much Serotonin and Noradrenaline(Norepinephrine) related. Sounds like you have a mix of both. The dizziness is definately the Serotonin and Noradrenaline. The lethargy is a combination both.

Like I said in previous post: I got plain old opiate-WD-s: sneezing, insomnia, lethargy, the runs, RLS and nausea for a week. I'm wondering whether it could be some delayed effect of quitting methadone 4,5 months ago? My longtime history of opiate addiction must have something to do with the fact that I was getting wd's from tramadol that bad since Sendonis doesn't get them..

No brainzaps for me either when ging from 350 to 75 mgs. After 6 days I went back up to 200 though because of the pain.

[Sendonis]

Well, to update everyone on my progress... I have been on 150mg/day for the last 4 days. Today I have gone down to 100mg/day. I am taking 25mg every 4 hrs. basically 4 times daily. So far I feel fine, even with only 25mg this whole morning since 8am. I am definitely not as 'chipper' as I was when I was using it heavily everyday, but that's understandable. I am going to probably stay on 100mg for 4 days then go down to 50mg so long as I feel ok. I have to say though, near the end of my heavier usage times, I was feeling much more irritable than happy from taking a lot of them. It was almost like oxy rage but most of the day. Not a very fun thing...No other withdrawal side effects have come up. My runny nose went away and I haven't been getting as light headed when I stand up fast from sitting or laying. So...Thanks for reading and updates to come tomorrow! Just to give people an example oh how easy the tapering is (physically), I drove two 8 hour drives from Southern Cali to northern and back to So Cal to visit some family with no problems. So far so good!

[Saint]

How much do you take now? How're you feeling? I tapered from 350 to 175 mgs but am taking it very, very slow since I have to work every day. I want to be off this shit by november. Right now I only have some nausea and insomnia/RLS. Nothing too bad. I guess you have to decrease with small amounts, then it's doable.

[Sendonis]

Hey guys, I got an update for everyone, well mainly Saint since he's trying to get off these too. I am down to 50mg per day! 25mg in the morning and 25mg at night. (This is day 3 at that dosage level.) The most severe symptoms I have been having are the wierd little brain jolts when I am up walking around. They are becoming much less frequent however. In about 2 weeks I have gone from approx 800mg per day (near the end) to 50mg! As people will probably recall, I started tapering with 200mg since I was pretty comfortable at that particular minimum. I do feel inclined to try and take a bunch like I used to, just to get some sort of head change, but I haven't cheated yet and don't think I could even if I wanted to. I would be kickin myself in the pants for weeks if I slipped up now and just feel way too guilty in general if I screwed up out of boredom. Regardless, the taper is going much better than I thought it would. I am still working full time and it hasn't really gotten me down to badly. More or less the worst part I would have to say is mental depression a bit. I'm sure it will get worse when I stop taking them altogether for a while but for now I just seem to be a bit bummed out before work and stuff in the mornings and have a hard time dragging myself to get ready. It's not severe enough to where I can't talk myself out of the situation though and try to get some steam to get goin. Anyway, if anyone has any other questions or something they want to ask about tapering these feel free. Tomorrow I will most likely drop my dose to 25mg/day for a few days and just go down from there. Thanks for readin!

[Papa Verine]

It's great to hear this. Ideally, we'd all taper down like this instead of CT'n it all the time but you know how that goes. Self control anyone?

Good luck with the rest of your taper. Remember, if you're feeling bad, you don't have to taper so fast. Don't feel bad if you backstep to the previous dose for a little longer. "Slow and steady wins the race".

[Sendonis]

Thanks for the advice! Self control has really never been an issue for me until I felt bound to take these things everyday to feel right. The main thing I am trying to prove is to myself; it is that I don't need to take these things every single day. I would literally get to work and realize I hadn't remembered the bottle or my morning dose and my whole day would go to shit. It would put me into a bad mood and by the end of the day I would feel like I was getting the flu. I think I already said it but I really just want to be able to use stuff for recreation here and there (probably not these fucking tramadol though haha). By the way, Saint if you look at the end of page three there is an update on where I am at with this.

[Saint]

Thanks for the advice! Self control has really never been an issue for me until I felt bound to take these things everyday to feel right. The main thing I am trying to prove is to myself; it is that I don't need to take these things every single day. I would literally get to work and realize I hadn't remembered the bottle or my morning dose and my whole day would go to shit. It would put me into a bad mood and by the end of the day I would feel like I was getting the flu. I think I already said it but I really just want to be able to use stuff for recreation here and there (probably not these fucking tramadol though haha). By the way, Saint if you look at the end of page three there is an update on where I am at with this.

Well that sounds good. Congrats! I have tapered down to 150 mhs a day ,yself. It isn't fun but nowhere near as horrible as it was with methadone.. Main problem is no sleep and foggyness/sneezing/lethargy. But I'm still working. So far so good...

btw: I'm a girl ;-)

[Sendonis]

Saint, sorry about the assumption that you were a guy. Haha, I'll make sure it doesn't happen again. Good to hear you aren't going through too, too much pain at the moment. I do hope the symptoms improve though for you. My lethargy has finally gone away for the most part. I am assuming I am through most of the opiate-like w/d symptoms (if there would have been any). I guess really now I just have to deal with the anti-d w/d symptoms if there will be any when I drop off completely. This is my last day for 50mg and tomorrow I am going to 25mg. I am still a bit curious whether or not I will experience uncomfortable w/d symptoms when I am down to 0. Thanks for the support and I hope your tapering gets better! Keep me posted as I will be doing the same. I am also kicking around the idea of dropping off to 0 after 3-4 days of 25mg per day. Anyone have feedback on that?

[Cherry's Jubilee]

I am also kicking around the idea of dropping off to 0 after 3-4 days of 25mg per day. Anyone have feedback on that?

I'd probably try to even go a little lower for a week or so if possible. Or maybe try 25mg every other day for a few days? In my experience, the lower you go--even if it doesn't see like much--the less likely you are to feel any discomfort that might lead to relapse. You're doing a really good job! Keep it up. Good luck.

[Papa Verine]

I'd probably try to even go a little lower for a week or so if possible. Or maybe try 25mg every other day for a few days? In my experience, the lower you go--even if it doesn't see like much--the less likely you are to feel any discomfort that might lead to relapse. You're doing a really good job! Keep it up. Good luck.

I was going to say the same... 25mg every other day, or even try to break them down to 12.5 for a week...

[Sendonis]

Alright, so I have finished my regiment of 50mg for 4 days and I am now on 25mg. I am taking 12.5mg morning/night. If anyone is wondering how I am measuring the pills out....I got a different kind the last time I had a refill and it turns out they are great for breaking up into smaller pieces. They are small tablets with an indentation in the center which makes it easy to break up 4 pieces of a 50mg pill easily. I will also take your guys advice and go down to a smaller taper here near the end but continue it instead of dropping straight off. Not sure exactly what increments they will be in but I will figure that stuff out in the next few days.

[Saint]

Going down to 125 mgs a day coming tuesday.. So far so good. I am taking this very, very slow. From now on I will go down by 12,5 mgs every week only. So at least a few months to go.

Whenever I go down with 25 mgs it took about 36 hours for the first withdrawalsymptoms setting in. Most annoying thing for me is a weird fultime nausea and RLS. That will usually last about 3 days and then it gets better. Then I will take 2 days 'rest' and after that go down another 25 mgs. I do take a low dose benzo (10 mgs serax and 1 mg lorazepam for sleep, cut that down a little too) and am in no hurry to get this over with since I have a stressfull, fultime job. So, one day at a time.
Still, it's doable and definitely not as horrific and longlasting as methadonewithdrawals..
Good luck Sendonis & keep us updated.

[Sendonis]

So I decided to jump to 0mg early as I forgot to take a dose the other afternoon. I have been completely free of the tramadol for about 36 hours now. I don't feel the need to take anymore as of this point and feel pretty much the same as I did when I was on a low dose of 12.5mg for that one day. I think this will probably mark the end of my tapering 'experiment'. I would have to say it was/is extremely successful. I couldn't have asked for less discomfort really at all either, especially not after hearing some peoples' horror stories about coming off of it. I would also highly recommend this form of detox (the taper method) if you can at all bring yourself to do so, and to not go CT. I have to admit that it does take a rather large amount of willpower. I had thought about cheating on my plan on several occasions but talked myself out of it everytime. Mentally I feel like myself again as well. It feels really good to not have to worry about taking the trams to feel 'right'. I still have yet to see what the long term depressive effects may be on my mindset, if there will be any at all. I guess I will just have to cross that bridge when I get there however. My use from now on will be on a recreational basis for any and all things that I might try. I am really going to try not to get wrapped up in something like this again unnecessarily. Thanks for all the comments and info guys. It helped get me through this a lot! Saint, good luck with the rest of your taper as well. Keep us updated!

[Cherry's Jubilee]

So I decided to jump to 0mg early as I forgot to take a dose the other afternoon. I have been completely free of the tramadol for about 36 hours now. I don't feel the need to take anymore as of this point and feel pretty much the same as I did when I was on a low dose of 12.5mg for that one day. I think this will probably mark the end of my tapering 'experiment'. I would have to say it was/is extremely successful. I couldn't have asked for less discomfort really at all either, especially not after hearing some peoples' horror stories about coming off of it. I would also highly recommend this form of detox (the taper method) if you can at all bring yourself to do so, and to not go CT. I have to admit that it does take a rather large amount of willpower. I had thought about cheating on my plan on several occasions but talked myself out of it everytime. Mentally I feel like myself again as well. It feels really good to not have to worry about taking the trams to feel 'right'. I still have yet to see what the long term depressive effects may be on my mindset, if there will be any at all. I guess I will just have to cross that bridge when I get there however. My use from now on will be on a recreational basis for any and all things that I might try. I am really going to try not to get wrapped up in something like this again unnecessarily. Thanks for all the comments and info guys. It helped get me through this a lot! Saint, good luck with the rest of your taper as well. Keep us updated!

I am SO happy for you and really proud of you too.

You are so lucky to be where you are right now--CLEAN, with the accomplishment of having the self-control to taper yourself off under your belt and emerge virtually unscathed, with the knowledge of the power of opiates and the ease with which you can become sucked right in and dependent, and the conviction to prevent that from happening in the future. If you can keep all that knowledge intact and in the forefront of your mind you may be one of the lucky few who can chip occasionally, "recreationally," and notice the red flags of addiction well before you're hooked. NEVER become complacent though. You have to stay vigilant, always, because you're more susceptible. God, I would KILL to be where you are...

Good job Sedonis! You're an inspiration. You can do it too Saint!

[Sendonis]

Cherry, thanks for all the kind words and support! Just thought I would take a quick second to update my status. I have been off the trams for 4-1/2 days now. So far no more symptoms have appeared and I still feel fine. Looks like I got off of the pills very, very easily compared to others. I'm not sure exactly what attributed to that the most. Regardless, it is rather apparent (I would assume at least) that things aren't getting any worse or even uncomfortable.

[Saint]

I am SO happy for you and really proud of you too.

You are so lucky to be where you are right now--CLEAN, with the accomplishment of having the self-control to taper yourself off under your belt and emerge virtually unscathed, with the knowledge of the power of opiates and the ease with which you can become sucked right in and dependent, and the conviction to prevent that from happening in the future. If you can keep all that knowledge intact and in the forefront of your mind you may be one of the lucky few who can chip occasionally, "recreationally," and notice the red flags of addiction well before you're hooked. NEVER become complacent though. You have to stay vigilant, always, because you're more susceptible. God, I would KILL to be where you are...

Good job Sedonis! You're an inspiration. You can do it too Saint!

Thanks Cherry's.. However I'm starting to doubt if I'll ever succeed. I went down from 350 mgs to 100 over a few weeks but last week has been a total nightmare. Pain, pain, pain. No sleep.. maybe 2 hours a night max and at 7 o clock having to go to the office again for a nine hous workday.

Somehow the same thing happened as when I came off methadone: once below a certain amount (with methadone it was below 5 to 10 mgs) it's like my body gets stuck in some weird kinda physical stress(?)mode: I can't shit anymore AT ALL (sorry, don't want to be groce), absolutely no movement whatsoever going on inside and my whole gut starts to blow up and hurt like hell. I get severe headaches and tingling legs and it gets so bad (with the no sleeping) that it drives me up the wall.

I feel godawful shitty. And it was the same when tapering done.. now with tramadol.. fuck, I'm doubting if I'll ever get off this stuff. I'm even craving methadone again. At least I could sleep on that shit..
And (weirdly!) on high doses, like over 40 mgs, I had normal bowelmovements. It's at the lower doses beneath 15/25 mgs that problems begin.
Anyway, I decided to stay on 150/175 mgs a day for now. So that's about 200 mgs less than I used to take but still.. 100 mgs doesn't cut it for now..
Don't know where this is gonna end. Trouble is I really have to work and the whole thing is wearing me out. I'm exhausted and totally numb.

I'm seriously starting to doubt whether my body will ever recover from 25 years of methadone/dope-use.. I can't fucking believe this is happening after being off done for 5 months!

Anyway, I'm gonna take a break for now and try to taper further - but really slow - later..