Tramadol, AKA Ultram, is one of the misunderstood medications in the world. In 1962, when Tramadol was first invented in Germany, the researchers were looking to create a synthetic opioid that would do the same job as a natural opioid without the addiction problem, and they succeeded.
The trick was to create the pain reliever inside the body. It could be a bit complicated for non-medical professionals to understand, but in this article, we shall give it a try to explain things in layman’s terms. It’s important to remember that a lot of medical professionals won’t agree with the way we are going to explain it.
How Opioids Work in the Body
Natural opioids come from the opium flower. It contains a substance called M1 (morphine 1). M1 stimulates the opioid receptors in the brain (Which already exist in the brain) and has the ability to alter the perception of the brain, wherein the brain gets the pain signals but translates them differently.
In this altered state, the patient naturally feels numb, very sleepy, and of course a chemical high. The issue is that once the brain gets used to this altered state, it wants to return to it.
Unmistakably, in almost 95% of the cases, taking opioids for 2 weeks can develop dependency in a patient. That is why, after an opioid treatment, the patient is immediately recommended support groups, rehabs, and therapies.
What Makes Tramadol Different
To understand Tramadol, we need to go back a little.
Let’s understand the opioid receptors. These exist in our brain because our body produces some opioids itself. We know them as endorphins (Endogenic Morphine). Endorphins are released after physical exercises, before bedtime, and after sex.
Endorphins are natural morphine that is good for our body. We need them to relax and sleep. Natural opioids like Oxycodone contain ready-to-use M1. That’s why it is fast acting and powerful.
On the other hand, Tramadol is a synthetic opioid. It does not contain ready-to-use M1. It needs to metabolize in the body by two liver enzymes called CYP2D6 and CYP3A4.
Once metabolized into M1, Tramadol starts to take effect. That’s why Tramadol may be a little slow acting at first. However, the benefit is that it takes a more natural route to produce M1, which is similar to producing Endorphins.
So, now the question is,
Is Tramadol Really Addictive?
“Yes” would be the shortest answer, and the reason is in the amount. If our body naturally produces 1 unit of M1, introducing Tramadol 50 mg will bring up the level to 5. Taking 40 mg of Oxycontin will increase the level to 10, and morphine, the kind they inject in the hospitals brings the M1 level to 15-20 (depending on the amount injected).
Tramadol Addiction and Symptoms
While it may take a long time to get dependent on Tramadol, some symptoms manifest. Following are examples of a few:
- Anxiety:Patients who are running out of Tramadol show anxiety towards it. They may panic if only 5-4 pills are left and would insist on buying more immediately.
- Paranoia: Patients may show paranoia towards his/her stock of Tramadol, “Someone is stealing meds from my cabinet”.
- Overeagerness: They are very eager to take their next dosage and sometimes, take them earlier than the designated time.
- Visiting Multiple Doctors: This is kind of a sure sign that the patient is addicted when they visit multiple health professionals in order to get more prescriptions.
It is always best to consult a doctor. If you have been prescribed Tramadol for a certain medical condition by your doctor, keep him informed of your feelings. The doctor would know when a treatment is turning into an addiction.
Here are the following steps that we recommend:
Step 1- Come Out
Addiction is viewed as a criminal act in our society and that is the biggest problem. It harms more than it does good. Addiction is not criminal at all so please come out and be open about it with your family and friends.
This step not only confronts the problem directly but also helps in the recovery process. If recovery takes long, you will need assistance from your loved ones to keep you in check and motivate you to get better.
Step 2- Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy or CBT uses a combination of therapy sessions and rewarding social activities. Addiction is deeply connected to the reward center of our brain.
Whatever substance (Cigarettes, alcohol, or drugs) we are addicted to, we take them as a form of reward. “I’ve done a good job so I should reward myself with a cigarette”, is the general attitude.
CBT targets this and tries to change the person into thinking that a good job is a reward on its own and that additional substance is not required. It may take a while, but it really works.
Step 3- Detoxification
Unless someone uses Tramadol continuously for 6 months or more and is seriously dependent, the chemical detox is an overkill.
Step 4- Support Groups
This may as well be the first step. Support groups are an excellent solution. As mentioned earlier, our society criminalizes addiction and therefore, it is difficult to open up to people who don’t understand what the patient is going through.
Support groups solve that problem. People can share their thoughts and feelings with others who had similar experiences. It also is a long-term solution and prevents patients from falling back into their old habits.
In the beginning, we mentioned that Tramadol is a misunderstood medication. It was first an OTC (Over-The-Counter) drug. Then in 1995, FDA conducted a trial and found it to be addictive.
However, According to Harvard Health Publishing the FDA trial had an issue medical professionals call “Confounding“. Many of the participants in that trial had had a history of substance abuse and addiction. Some also had preexisting liver and kidney issues.
Therefore, it is not clear if the data gathered at that time was conclusive. Yet, since Tramadol does act like an opioid, there’s always that possibility.