Does Tramadol Help with Opiate Withdrawals?

Yes, Tramadol can help with opiate withdrawals, especially if you used <10 bags of heroin or opium a day before detox. More on Tramadol's efficacy, what symptoms it treats and how opiate withdrawal side effects are lessened here.

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Reviewed by: Dr. Manish Mishra, MBBS

ARTICLE SUMMARY: Yes, Tramadol is effective as a detox medication. Tramadol helps reduce the severity of withdrawal symptoms in people coming off heroin and its by-products. Why are doctors excited about this potential? And can Tramadol really help manage symptoms of withdrawal from opiates like heroin? We explore here.


What does withdrawal from opiates feel like?

Opiate withdrawal feels like a really, really bad flu. Acute cases of withdrawal begin with anxiety and craving, reaching a peak between 36 and 72 hours, and decreasing substantially within 5-7 days.

Is detox painful or dangerous?

Yes, detox is uncomfortable. However, opiate withdrawal is rarely life-threatening. Still, withdrawal from these types of narcotic drugs on your own can be very hard and relapase is frequent. Instead, medical treatment during withdrawal leads to successful tapering and drug elimination, often involving medicines, counseling, and support.

Withdrawal does not need to be painful. Medical detox includes the use of prescription medications to address uncomfortable symptoms as they appear. Why suffer through detox on your own when you can benefit from professional help in a safe environment?

How long does withdrawal last?

To be honest, withdrawal duration can vary in time and intensity. In fact, there are many factors involved in the length of time you spend in withdrawal, including your:

  • age
  • dosage and amount of opiates you take
  • general health
  • length of use
  • level of dependency

In general, a typical opiate detox lasts for 10-20 days depending on the drugs in your body.  According to the WHO’s Clinical Guideline for Withdrawal Management,  short-acting drugs like heroin trigger symtpoms 8-24 hours after last use; withdrawal duration is from 4-10 days. Long-acting opioids like methadone bring on symptoms 12-48 hours after last use; withdrawal duration is from 10-20 days.

More generally, withdrawal symptoms usually begin 6-12 hours after your last dose, persist for 1-3 days (peaking at 72 hours after last dose), and gradually become less intense over the course of 5-7 days.  Still, protracted withdrawal symptoms (PAWS) may persist for a few months beyond the period of acute withdrawal.

What medicines are used during withdrawal?

The World Health Organization lists 15 medications that can be used to address symptoms of withdrawal during opiate detox. These include medicines that adress common symptos such as:

  • anxiety
  • diarrhea
  • insomnia
  • nausea
  • vomiting

Still, other medications are used to address opiate cravings and dependence. The top three medicines currently in clinical use include:

  1. Buprenorphine
  2. Methadone
  3. Naltrexone

Clinical trials are continually ongoing to identify new medicines that can help withdrawal. You can check out current research and investigate your options at the National Institute of Drug Abuse website for opiate withdrawal medications.

Why do doctors use Tramadol for detox?

  1. Low potential for abuse
  2. More efficient than other medications
  3. Less side effects than other medications

1. Tramadol is considered a low-risk pain killer

Tramadol can get you high. But compared with other medications, Tramadol seems to have low abuse potential. In fact, Tramadol is a Schedule IV analgesic painkiller medication, which means that it is viewed as a drug with minimal potential for abuse. Still, products that contain tramadol hydrochloride such as Ultracet and Ultram can be addictive.

2. Tramadol is superior for managing some withdrawal symptoms

Many medications have been used to treat opiate and opioid withdrawal symptoms in the past few decades. Aside from new methods of withdrawal such as rapid opiate detox, these medicines have been tested and are generally thought to be safe. Each has its clinical strengths and limitations.

But in clinical trials, Tramadol has been shown to (slightly) better manage opioid withdrawal syndrome. Further, doctors and researchers testing Tramadol in comparison with other medications have found that Tramadol is more efficient in controlling opioid withdrawal symptoms such as depression, irritability, anxiety and drug cravings. Other medicines currently used to treat opiate withdrawal include:

  • clonidine
  • LAAM
  • levomethadyl
  • naloxone
  • naltrexone
  • methadone
  • parenteral buprenorphine
  • propoxyphene
  • sublingual buprenorphine

3. Tramadol has less severe side effects than other medications

In addition to lower dependency potential and efficiency in controlling the uncomfortable symptoms of withdrawal, Tramadol also comes with less side effects than other medications. People who take Tramadol experience relative lack of respiratory depression and toxicity, less sweating and drowsiness than with other medications such as methadone. Furthermore, Tramadol effects psychomotor tasks involving speed, coordination, pattern recognition, and set shifting tasks less than other drugs used to treat withdrawal.

Is Tramadol effective for withdrawal?

Yes, tramadol is effective as an opiate withdrawal aid.

In a 2017, the Journal of the American Medical Association printed a study of a randomized clinical trial looking at tramadol as a viable option during detox.  Results of this trial suggest that the extended release version of tramadol is more effective than clonidine and comparable to buprenorphine in reducing opioid withdrawal symptoms during a residential tapering program. Indeed, tramadol is viewed as an effective method to manage opioid withdrawal symptoms.

Tramadol is especially useful in cases of low dosage of opium or heroin use. More specifically, tramadol compares favorably to other drugs used during detox in the management of acute withdrawal from less than 10 bags per day of heroin. If you use more than this amount, tramadol may not help you during withdrawal.

We Invite Your Questions Here

More tramadol questions? Please leave them here. We love hearing from our readers. And we will try to respond to all real life questions personally and promptly.

Reference sources: Efficacy of Tramadol Extended-Release for Opioid Withdrawal: A Randomized Clinical Trial.
NIDA Director’s report summary 2011
Tramadol versus buprenorphine for the management of acute heroin withdrawal: a retrospective matched cohort controlled study
Tramadol versus methadone for the management of acute opioid withdrawal: an add-on study
Opioid Antagonists, Partial Agonists, and Agonists/Antagonists: The Role of Office- Based Detoxification
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Manish Mishra, MBBS serves as the Chief Medical Officer of the Texas Healt...

All of the information on this page has been reviewed and verified by a licensed medical professional.

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