Tag: tramadol

Tramadol Carries Addiction Risks Too, Study Finds

A new study has found that tramadol, a less powerful opioid painkiller, carries the same risks of addiction as other opioids.

As doctors have become more vigilant about the addiction risks of opioids like oxycodone and morphine, they have turned to tramadol, perceived as less powerful and thus safer. However, a new study has found that tramadol carries the same risk of addiction as other opioids, CBC reports.

“What we know now is there really is no safe opioid, and tramadol is not a safe alternative,” lead study author Cornelius Thiels told CBC. “Tramadol essentially has a similar risk of long-term dependence or long-term opioid use compared to other opioids.”

Thiels led a team of researchers from the Mayo Clinic who examined whether people who were prescribed tramadol were still filling opioids prescriptions more than 90 days after surgery. Long-term use of opioids is associated with a vastly increased risk of addiction.

The study, published in the British Medical Journal, concluded, “People receiving tramadol alone after surgery had similar to somewhat higher risks of prolonged opioid use compared with those receiving other short acting opioids. Federal governing bodies should consider reclassifying tramadol, and providers should use as much caution when prescribing tramadol in the setting of acute pain as for other short acting opioids.”

“We found that people who got tramadol were just as likely as people who got hydrocodone or oxycodone to continue using opioids past the point where their surgery pain would have been expected to be resolved,” Molly Jeffery, one of the researchers, said.

Tramadol is classified differently by the federal government, but study authors call for this to change.

“We found that tramadol, a drug that is scheduled at a lower risk level than other common short acting opioids (Schedule IV versus Schedule II for hydrocodone and oxycodone), has a similar or somewhat greater risk of prolonged opioid use after surgery,” they wrote. “Although all factors related to the safety of a drug must be considered, from the standpoint of opioid dependence, the Drug Enforcement Administration and FDA should consider rescheduling tramadol to a level that better reflects its risks of prolonged use.”

The study is important since use of tramadol has increased in recent years.

“Tramadol has seen a surge in use in the past few years, likely due to its perceived benefits, including what physicians may consider a favorable side effects profile and the widespread assumption that it is safer and less addictive than other short acting opioids,” study authors wrote. “As a result, tramadol is now among the most commonly prescribed opioids in the US, and it is frequently used by surgeons for the treatment of postoperative acute pain.”

View the original article at thefix.com

16 May 2019
How to stop taking tramadol
Interested in quitting tramadol?

If you’ve been taking tramadol for a while, you won’t be able to simply stop taking tramadol. Why? Because when you use tramadol for a long period of time, your body starts developing a tolerance to tramadol which can develop to dependence on the drug. And when you get off tramadol, the presence of withdrawal symptoms manifest. In fact, withdrawal from tramadol can be dangerous and even provoke seizures.

So what is withdrawal from tramadol like? How long do tramadol withdrawal symptoms last? Learn what to expect and how to stop taking tramadol below. Then, ask your questions about tramadol at the end.

Can I just stop taking tramadol?

Yes. And no. You can stop taking tramadol whenever you would like to. But you can only quit tramadol cold turkey if you’ve been using tramadol for a short period of time. It is NOT ADVISABLE that you suddenly just stop taking tramadol if you’ve been using tramadol for extended periods of time.

Tramadol is an opiate pain killer and can result in uncomfortable and dangerous withdrawal symptoms if your body has become physically dependent. Withdrawal symptoms can include; seizures, insomnia, vomiting, and anxiety. In order to understand the full extent of tramadol withdrawal symptoms, it is a good idea to get help from a doctor. A doctor can tapper your use of tramadol slowly and over time until you’re no longer using tramadol. Tapering also helps alleviate the harsh effects of withdrawal.

What happens when you stop taking tramadol?

When you stop taking tramadol you go through a period of withdrawal. Why? With time, your brain and body adapt to the presence of tramadol in the system to the point that you integrate tramadol into the functioning of the body systems. As you continually take tramadol, your body then becomes dependent on it and without the presence of tramadol, your body manifests adverse effects trying to compensate. This “rebound” effect is characteristic of any drug withdrawal period as your body learns to cope with the new chemistry and function normally. Withdrawal is a way for the body to regain homeostasis. Withdrawal from tramadol begins about a few hours after the last dose of tramadol has worn off. Even if you don’t have an addiction to tramadol, you can experience these symptoms when you stop taking tramadol.

Side effects stop taking Xanax

You can develop a physical dependence on tramadol after only taking tramadol for a few weeks. Withdrawal effects may be more severe and intense the longer you are taking tramadol. some common side effects that occur when you stop taking tramadol can include the following:
- cough
- chills
- excessive sneezing
- depression
- hallucination
- insomnia
- nervousness
- numbness in the extremities
- panic attacks
- runny nose
- sweats
- tingling
- uncontrollable shaking
Stop taking tramadol suddenly

Never stop taking tramadol suddenly. If you stop taking tramadol suddenly, you run the risk of seizures, hallucinations, and losing concsiousness. It is better to work with a doctor and have your tramadol dosage slowly and gradually tapered. Doctors may substitute other medication that can help with any side effects you may be facing because of withdrawal.

Stop taking tramadol cold turkey

Opioids like tramadol can be painful to quit. Tramadol has also been shown to cause atypical withdrawal symptoms such as convulsions and seizures which can put you in danger if no one is watching you. Always let a doctor know about your intentions to quit tramadol before altering you medication or stopping on your own. You can only stop cold turkey if you haven’t been taking tramadol for a long time or if you experience a high tolerance for tramadol without adverse effects or the signs of dependency. Anytime you present withdrawal symptoms from tramadol, you shouldn’t stop taking tramadol cold turkey.

How do I stop taking tramadol?

The best way to quit tramadol is to work with a doctor and have him or her gradually taper you off the medication. Tapering tramadol doses helps your body regulate and can decrease the intensity of tramadol withdrawal symptoms. The timeline you and your doctor come up with will help you wean yourself off of the medication as you observe symptoms. In fact, it is helpful to schedule regular doctor appointments and make check-ins as you stop taking tramadol so that the prescribing doctor can make adjustments, if needed. If you have developed an addiction tramadol while taking this pain killer, seeking outside help is even more important. General tapering guidelines for opiates such as tramadol include the following recommendations:

1) The method of tapering will be dependent on the presence of other physical and mental conditions present.

2) In general, tapering opioids consists of a reduction by 10% daily, 20% every three to five days, and 25% a week.

3) It is never advisable to taper by 50% daily anytime during the tapering process.

How to stop taking tramadol safely

Tramadol is a popular opiate prescribed because it is considered a schedule III medication. That is, it has a lower potential for dependence and abuse. Tramadol should be safer than other drugs to quit. However, as mentioned before, the safest way to stop taking tramadol is to consult a doctor and follow instructions for quitting. While you are trying to quit taking tramadol, you can treat your withdrawal symptoms with over-the-counter medications or home remedies to help the ease symptoms of tramadol withdrawal. Other medications might be prescribed if withdrawal proves to be severe.

How to stop taking tramadol questions

Still have questions about stopping tramadol? Please leave us your questions, comments, or experiences about quitting tramadol below. We respond to all questions personally, and will try to have you an answer or reply ASAP.

Reference Sources: NCBI: tramadol
Daily Med: tramadol hydrochloride
Utah Department of Health: Prescribing Opioid Guidelines

View the original article at addictionblog.org
8 May 2019
Does Tramadol show up on drug tests?

Yes – sort of.

While Tramadol isn’t going to show up on standard drug tests that, say, a new employer would usually have you take, Tramadol will show up on a toxicology screening specifically designed for prescription drug detection. More on drug testing for Tramadol here…but if we don’t answer your question, please leave it for us at the end.

Why order a drug test for tramadol?

There are a few different reasons why you might be tested for Tramadol. The first is medical. Dangers of Tramadol including serious side effects, drug interactions, or overdose may require medical testing. If you’re admitted to a hospital and they suspect an overdose or need to find out what medications you’re taking, they’ll run a screen. You might also need to be screened for legal purposes. For example, if you’ve been convicted of taking the pain medication to get high off Tramadol without medical supervision. In other words, positive drug testing for Tramadol without a prescription puts you at risk of legal consequences.

Types of Tramadol drug tests

A blood test, Toxi-Lab A, can determine if there is Tramadol in your system or not. However, the test will not be able to show the level of the drug. The result will simply be a positive or negative. Tramadol can also be detected using special urine or hair tests, but there must be some reason or suspicion that Tramadol is in your system for these tests to be ordered.

Tramadol cutoff levels

In hair tests, Tramadol can be detected at low levels – those which would appear in normal use as prescribed by a doctor. In one study, a concentration as low as 0.176 ng/mg was enough to show up on the test. Anecdotal evidence suggests that urine tests are not as effective, since Tramadol leaves the system fairly quickly.

Positive drug testing for tramadol

If you have a prescription for Tramadol, it shouldn’t be a problem if it shows up on a drug test. If you test positive to Tramadol and you have a prescription for the drug, it should be easy enough to explain to employers, doctors, and anyone else who might request a drug test. However, in several states Tramadol is considered a controlled substance, so if you’re using it without a prescription, you may get into some legal trouble.

If you test positive and you’re using Tramadol illegally, there will likely be repercussions. The exact legal status of Tramadol depends on where you live, so if you’re concerned about it showing up on a drug test, find out what your local laws are.

Questions about Tramadol drug testing

Do you still have questions about Tramadol showing up on drug tests? Please leave us your questions about Tramadol drug testing here. We try to respond to all questions with a personal and prompt reply.

Reference Sources: Determination of tramadol in hair using solid phase extraction and GC-MS
NIH Clinical Center Test Guide
Missouri State Highway Patrol: Toxicology information

View the original article at addictionblog.org

8 May 2019
What are tramadol withdrawal symptoms?
Thinking about detox from tramadol?

Dependence on tramadol symptoms can vary from restlessness to abdominal discomfort to seizure. Learn what are tramadol withdrawal symptoms, how long they last and how they can be treated here. Plus, a section at the end for your questions about tramadol.

Why do Tramadol withdrawal symptoms occur?

How long does tramadol stay in the body? About a day, or two. So, when your body detoxes from tramadol after your last dose, you go through withdrawal. Why?

The biggest reason withdrawal symptoms occur when you stop taking tramadol is because tramadol is part of the opiate family. Although tramadol is technically an opioid (a man made opiate), it acts like an opiate on the brain and central nervous system. Opiates have a naturally high dependency rate and people taking forms of this drug become physically dependent on tramadol relatively quickly. These reasons affect how tramadol is prescribed and for how long.

Because of this high dependency rate, withdrawal is likely to occur in anyone who gradually comes off tramadol as well as those who suddenly decide to stop taking tramadol. Withdrawal symptoms are more likely for people who choose to go off of tramadol suddenly or who stop taking tramadol cold turkey. However, it is interesting to note that tramadol is one of the safest opioids that doctors prescribe and comes with a lower risk of developing tramadol drug addiction.

What are symptoms of Tramadol withdrawal?

There are two types of Tramadol withdrawal symptoms: typical opioid withdrawal symptoms and atypical opioid withdrawal symptoms. The first set of withdrawal symptoms for tramadol are typical of opioid drugs which result in flu-like symptoms such as restlessness and tramadol cravings. It has been reported that this first type of withdrawal shows up in about 90 percent of the population who are taking Tramadol. The second set of tramadol withdrawal symptoms is considered rather atypical but nevertheless occurs in about 10 percent of the population. Such symptoms include; hallucinations, paranoia, extreme anxiety, panic attacks, confusion and numbness and tingling in the limbs.

Other symptoms of tramadol withdrawal may include the following:
- abdominal distress
- dysphoria (unease or dissatisfaction with life)
- insomnia
- muscle cramps
- restlessness
- seizures
- Serotonin syndrome
- sweating
- trouble sleeping
Tramadol withdrawal symptoms: How long?

How long the symptoms of tramadol withdrawal last varies by person. Those who stop using tramadol can expect to feel the effects of the withdrawal up to at least 24 hours after the last time they took tramadol. This is the most likely timeline. In other cases, however, it has been said that tramadol withdrawal can take several days before acute symptoms dissipate. Those who have developed a dependency with tramadol have a harder time, as withdrawal symptoms can linger and be more intense.

Tramadol withdrawal symptoms treatment

One of the key ways to treat withdrawal symptoms of tramadol is to first slowly reduce medication intake and taper off tramadol while also supporting symptomatic reactions to the withdrawal. It is important to be careful with over the counter and prescription medications used to help with the symptoms and that they do not interact negatively with the tramadol. Avoiding the use of alcohol and other drug are important for not only inhibiting dependency but also to alleviate potential withdrawal symptoms. Slow tapering helps with anxiety and restlessness. However, all cases of tramadol withdrawal should be supervised by a medical professional.

Tramadol withdrawal symptoms questions

Do you still have questions about withdrawing from tramadol? Please leave us your tramadol questions below. We are happy to respond to you personally, and will try to answer your questions ASAP. And if we don’t know the answer, we will refer you to someone who does.

Reference Sources: PubMed: Withdrawal syndrome after longterm treatment with tramadol
DEA Office of Diversion Control: Tramadol
FDA: Ultram Drug Warning
PubMed: Tramadol Dependence in a Patient With No Previous Substance History
The American Journal Of Psychiatry: Withdrawal Syndrome After Delayed Tramadol Intake

View the original article at addictionblog.org
3 May 2019
How much tramadol is too much?

How much is too much tramadol? It depends.

While it’s difficult to overdose on tramadol, you can experience serious health problems at relatively low doses of the medication. This is especially true if you’re not taking tramadol as directed (crushing, injecting, or snorting tramadol hcl), or haven’t taken tramadol before. In this article we explore the various prescription strengths of tramadol, the maximum recommended daily dosage, and fatal dose of tramadol. And we invite your questions about tramadol use at the end. We try to answer all tramadol questions personally and promptly…and if we can’t, we will refer you to someone who can.

Tramadol strengths

The available strength of tramadol depends on the specific formulation you are taking and if it’s mixed with other medications, or not. Tramadol is available in an immediate-release tablet which lasts from 4-6 hours. The extended-release version of the medication is only taken once daily.There’s also a version of tramadol combined with acetaminophen, a non-narcotic painkiller.

1. Generic immediate release tramadol – Generic tramadol tablets are available in 50 mg doses.

2. Generic controlled release tramadol– The controlled-release version of tramadol comes in 100mg, 200mg, and 300mg strengths. Strengths over 100mg are only for those with a tolerance to the medication.

3. Brand name tramadol formulas – Tramadol is available in an immediate-release, 50 mg form under the name Ultram. Other brand names include Ryzolt and Ultram ER come in the 100-300 mg doses. Tramadol is also found in Ultracet, combined with acetaminophen, at a dosage of 37.5 mg.

How much tramadol is safe?

The safe amount of any narcotic depends on a person’s individual tolerance to opioid medications. Tramadol is always started at a smaller initial dose of 100 mg per day. In patients who’ve experienced more exposure to the drug, safe doses may be as high as 450 mg a day. However, this is a determination that needs to be made by the prescribing doctor, and may change over time as a tolerance to the effects of the tramadol develops. Similarly, how long tramadol stays in your system is affected by opioid tolerance, individual metabolism and dosing regimen.

Immediate release tramadol

People who haven’t taken tramadol before will start out with a low, immediate-release dose. They’ll be prescribed 50 mg tablets to be taken every 4-6 hours for pain – but they may be instructed to only take half the dose, starting at 25 mg for the first few days, so that they don’t take more than 100 mg in one day.

After using tramadol for some time, doctors will adjust the dosing regimen for each person individually. These tramadol dosing changes take personal medical history into account, especially as it pertains to analgesic pain medications. The current daily dose, degree of opioid tolerance of the individual, and their general health will all be considered when a doctor starts thinking about increasing tramadol dosage.

Controlled release tramadol

The starting dose for controlled release tramadol is usually 100 mg a day. This provides continuous, around-the-clock pain relief for people with chronic pain. This may be increased to 200 or 300 mg a day as time goes on.

If someone has taken a different narcotic for pain before trying tramadol, a higher initial dose may be needed. A tolerance to one opiate medication can result in a heightened tolerance for other, similar medications. The doctor will have to determine the equivalent dose of tramadol for the current dose of any other narcotic that a patient has been taking.

How much tramadol can you take at once?

In its immediate release form, no more than 100 mg of tramadol should be taken every 6 hours. Those who have never used the medication before should start on a much lower dose of tramadol, however, because 100 mg may be too much. Furthermore, only one extended release tramadol tablet should be taken at any given time. The maximum dose of extended release tramadol it’s safe to take is 300 mg, because that’s the largest dosage the drug comes in. Taking two of these pills at once could cause very serious side effects, most notably seizures.

How much tramadol to overdose?

The amount of tramadol that causes an overdose depends on personal tramadol or opioid/opiate dependence. In individuals without a tolerance, of course, it will take less tramadol to overdose, but the amount is still fairly high. In general, doses greater than 450 mg in one day can cause serious health problems, including seizures and serotonin syndrome. It’s very important to follow your doctor’s advice when taking tramadol, because taking any more than prescribed has the potential to cause serious adverse effects.

Toxic levels of tramadol in the system

Levels far below the toxic dose – starting around 500 mg – can easily cause seizures and other serious health issues. But you can overdose on tramadol taking any type of formulation of the medication. And methods of abusing tramadol make overdose more likely. Specifically, crushing extended release tramadol and either snorting it, or dissolving it in water and injecting it, greatly increases your risk of overdose. When taken orally, tramadol is slowly released into the bloodstream over the course of a full day. But high doses of tramadol or snorting or injecting immediate release tramadol can result in near immediate effect of tramadol on the brain and can cause overdose, especially if more than two pills are taken at a time.

How much tramadol is fatal?

While taking more than the recommended dosage of tramadol probably won’t kill you, as mentioned previously, this practice has some serious health risks. Overdosing on tramadol is more difficult than many stronger opioid medications – fatalities have been reported at doses between 2.65 and 8.2 g, 5-18 times the recommended maximum daily dosage. So although it would be difficult for an adult to take enough tramadol to be fatal, it’s very easy to exceed the maximum safe dose of 450 mg a day.

How much tramadol should I take?

You should take the amount of tramadol prescribed to you by your doctor. Never take more than recommended by a medical professional, and only take this oral medication as directed. Keep in mind that tramadol show in drug tests that are specific to synthetic opiates, and that tramadol use can be tracked and recorded by your prescribing doctor.

How much tramadol questions

Do you still have questions about tramadol use? Please leave us your tramadol questions below. We will be happy to answer you with a personal and prompt response, or refer you to someone else who can.

Reference sources: Toxnet: Tramadol
FDA MedWatch: Tramadol hydrochloride tablets
Medline Plus: Tramadol

View the original article at addictionblog.org

2 May 2019
Stop Illegally Selling Opioids Online, FDA Warns

Over the summer, the FDA has issued similar warnings to 70 websites.

The Food and Drug Administration issued a warning this week to the operators of 21 websites that the administration says sell mislabeled and illegal opioids to Americans.

The websites, which are run by four companies, have been “illegally marketing potentially dangerous, unapproved, and misbranded versions of opioid medications, including tramadol,” according to a press release issued by the FDA on Tuesday (August 28).

“The illegal online sale of opioids represents a serious risk to Americans and is helping to fuel the opioid crisis. Cutting off this flow of illicit internet traffic in opioids is critical, and we’ll continue to pursue all means of enforcement to hinder online drug dealers and curb this dangerous practice,” FDA Commissioner Scott Gottlieb said in the news release.

Over the summer, the FDA has issued similar warnings to 70 websites.

“The FDA remains resolute in our promise to continue cracking down on these networks to protect the public health,” Gottlieb said. “We have more operations underway, and additional actions planned. We are also working closely with legitimate Internet stakeholders, including leading social media sites, in these public health efforts.”

People who buy their opioids online can often wind up with expired, counterfeit or contaminated pills, according to the FDA. Some of the pills are marketed under one name, but are really just pressed fentanyl, a dangerous synthetic opioid. On CNBC’s Squawk Box, Gottlieb said that online sales are making the ongoing opioid crisis worse.

“As we see doctors prescribe fewer opioids, we’re fearful that more and more of the new addiction is going to shift to illicit sources, and a lot of those illicit sales are taking place online,” he said on Tuesday.

The four companies that received warnings on Tuesday were CoinRX, MedInc.biz, PharmacyAffiliates.org and PharmaMedics. They have 10 days to respond to the FDA’s letter, outlining the specific actions that they will take to avoid selling illegal opioids to Americans. If the companies do not respond they may face legal action.

On Wednesday, Gottlieb said that the FDA will continue to aggressively pursue companies and practices that make opioids too easily available.

“The reason that we find ourselves with a crisis of such proportion is that as a medical profession, we’ve been one step behind its sinister advance,” he said in a press release.

“Collectively, we didn’t take all the steps we could, when we could, to stop the advance of this crisis. We shunned hard decisions. As a profession, providers were too liberal in our use of these drugs well past the point where there were signs of trouble, and the beginning of a crisis of addiction. I’m committed to making sure that we don’t perpetuate these mistakes of the past. And so, when we see this crisis taking new twists and turns, we’ve acted swiftly.”

View the original article at thefix.com

31 August 2018
Vets Believe That Some Pet Owners Injure Their Animals To Get Opioids

A new study reveals that 13% of veterinarians believed a client had intentionally injured a pet or made them ill in order to be prescribed a drug.

A small research study in Colorado had disturbing results: the study found that 13% of veterinarians believe that people are using their pets to obtain opioids—by making them appear to be injured, or by actually injuring the animal.

Gizmodo interviewed the author of the study, Liliana Tenney, a public health researcher at the University of Colorado Anschutz Medical Campus. Tenney is concerned about the lack of training and education for veterinarians regarding their responsibilities in the opioid crisis.

“In conversations with these doctors, they often ask: ‘Well, what do we do? We need to treat pets who are in pain but we also need to know how to identify and handle suspicious behavior,’” she said. “But there’s not a lot of resources or training right now to direct these veterinarians.”

According to Gizmodo, almost three-quarters of vets reported that their veterinary medical school training on opioids was mediocre, poor, or non-existent. Sixty-four percent said that following veterinarian school, they had no further training on the issue.

Newsweek reported that in the survey of 189 vets; 13% reported that they believed a client had intentionally injured a pet, made them ill, or made them appear unwell, in order to be prescribed a drug. Tramadol is the most common opioid stocked by veterinary practices.

The emailed survey also revealed that 45% of the vets knew of someone at work or a client who was abusing opioids, and 12% said they knew of a staff member that was giving out opioids.

Lee Newman, director of the Center for Health, Work & Environment at the Colorado School of Public Health, told Newsweek, “There were also reports of diversion of drugs within the veterinary practices. Doctors [of animals] can prescribe the full range of opioids that are prescribed and administered to humans.

“In fact, veterinarians have the ability to prescribe, administer, carry, stock, and dispense narcotics in clinics, depending on the pain needs of their animal patients.”

The survey results indicate that veterinarians have been dramatically undereducated about their role in drug monitoring. Sixty-two percent believed they had a role in preventing opioid abuse, and 40% were unsure if opioid abuse was an issue in their communities.

To address this gap, Liliana Tenney, along with her team, has built an online education course for veterinary providers. Tenney and others are also working on building a better surveillance program within Colorado, where the survey was conducted.

View the original article at thefix.com

15 August 2018