According to ProHealth, people with a moderate level of pain are experiencing symptoms that can’t be ignored for more than a few minutes, but if they put their minds to a task, they could be able to get that task done despite the pain. While it’s useful for people who may not understand what pain really means, it may not describe the experience of people who live in pain each day.
Moderate pain that drags on can leave people feeling too ill and exhausted to handle everyday tasks. Their relationships may suffer. They may struggle to keep a job. They may not be able to focus on the future.
These symptoms are real, and painkillers are made to alleviate them. Tramadol is one such painkiller.
Tramadol is a synthetic medication, made in the controlled environment of a laboratory. The World Health Organization reports that a dose of tramadol is one-tenth as strong as a dose of morphine, making it a good choice for people with moderate pain. Someone like this might be incapacitated by morphine. With tramadol, they can get the relief they need.
Tramadol works on the same receptors used by morphine. These opioid receptors are located both in the brain and in the body.
An opioid receptor and an opioid fit together like an electrical plug and an electrical outlet. When they are connected, energy is created and transferred. To the person who takes the drug, that energy feels like euphoria and happiness.
Typically, a drug’s ability to produce euphoria is connected to its ability to spark an addiction. At one point, researchers didn’t believe that tramadol could cause an addiction. But the way they studied addiction potential was flawed, and that led to an inaccurate result.
Research from MedPage Today suggests that tramadol studies involved drug injection. When people injected the drug, they didn’t have the same reaction they felt when they injected heroin. That led researchers to believe tramadol had a low abuse potential.
But when researchers gave people oral doses of tramadol, the same sense of euphoria was present. That insight means that tramadol must be processed a little differently than heroin, but when it is taken properly, it can trigger a huge sense of euphoria.
A rush of euphoria triggers the brain’s reward system. In essence, the brain tries to remember and replicate the situation that was so wonderful. When that brain mechanism kicks in, people can use drugs compulsively. Even if their active minds simply do not want to use drugs, their brain cells may call out for drugs. When that happens, it can be very hard to stop without help.
People who have addictions may not speak about them openly. Even their doctors may not know that they’re struggling with an abuse issue. As a result, researchers often focus on how many people visit the hospital when they’re trying to determine the scope of a drug use problem. The data generated by tramadol is troubling.
The Substance Abuse and Mental Health Services Administration reports that the number of emergency room visits involving the use or abuse of tramadol rose 250 percent between 2005 and 2011. It’s likely that some people included in this figure didn’t intend to take tramadol. A child who takes a parent’s pills and would be included in this statistic. But the steep climb does seem to suggest that there are many people who abuse it, and there are many people who need help because of their substance abuse.
Even though people with an addiction may not discuss the issue openly, they may show signs that family members can look for and address when they appear. The Journal of the American Academy of PAs reports that people intoxicated on tramadol may appear:
When the drugs wear off, these people may seem depressed or upset. They may be dealing with deep cravings for drugs, and they may seek out those drugs at any cost.
People who alternate between these moods could be dealing with a substance abuse issue. Calls for privacy in order to take drugs or frequent trips to the doctor with complaints of pain could other signals that an addiction is at play.
An athlete in recovery from a tramadol addiction told the U.S. Anti-Doping Agency that his addiction was obvious to those around him and that he caused his body damage that was visible. He described spending his days waiting to take another dose, and he mentioned losing relationships due to his drug use.
Seeing someone struggling with an addiction isn’t easy, and talking about the issue can be even harder to do. But leaving the addiction in place can cause equally terrible consequences for the person and the family.
People who have an addiction to tramadol are fighting a battle against the body. Each dose makes the body more accustomed to the presence of the drug, and that means small doses may stop having any effect at all. In order to experience the euphoria the addicted person wants, the dose must get bigger.
At very high doses, which are common in people who have an addiction, tramadol can cause an overdose.
In a case study published in Forensic Science International, researchers describe a young man who developed organ failure after taking a large dose. The man was taking no other drugs, so the death was caused only by tramadol. People who keep taking the drug will keep facing this risk.
An overdose of opioids, like Vicodin, can be reversed with the use of the medication naloxone. Tramadol is different. In addition to boosting levels of dopamine in the brain, tramadol can boost the production of serotonin throughout the body. Serotonin is involved in a variety of different body functions, and when levels get too high, the drug can cause seizures.
Research published in the journal Clinical Toxicology suggests that naloxone alone can increase the risk of seizures in someone experiencing a tramadol overdose. Adding in another medication can lower that risk, but naloxone alone is dangerous.
In addition to the risk of illness or death caused by overdose, ongoing abuse of tramadol can lead to law enforcement action. In 2014, the U.S. Drug Enforcement Administration deemed it a Schedule IV drug. That means people must have a prescription to get the drug, and there are penalties for possession without a prescription.
People with an addiction may stockpile the drug to keep that addiction alive, and since criminal charges are based on the number of drugs people have, that stockpile could result in a lengthy prison sentence.
Dealers may keep tramadol at the ready for their clients, but they may charge outrageous prices for the drugs they sell. Users may have no idea if the drugs they’re buying are pure or if they contain contaminants. Each dose could be both expensive and deadly.
While people addicted to opioids like OxyContin have medications available to help them with cravings, there is no such specialized medication for tramadol. Some doctors use a combination of medications to help their patients deal with symptoms, but there is no targeted drug that can ease the brain and body damage an addiction can cause. Relief just isn’t that simple.
Often, people addicted to tramadol enroll in programs that combine Eastern and Western techniques to help people strengthen their skills so they will be able to face the urge to relapse with strength and serenity.
In therapy sessions, people can unpack the reasons they started abusing tramadol. They might discuss the triggers that seem to make cravings stronger, and they might learn how different techniques could be used to mitigate those cravings. Addiction therapy sessions tend to be solution-focused. The therapist and the client work together and collaborate on a roadmap that leads to long-term healing.
People may participate in meetings that follow a 12-step model. Here, they have the opportunity to study literature about addiction written by people who also have addictions. They can also hear stories and get support from people who have addictions.
These methods are designed to help people pay attention to their energy, breathing, and sense of inner peace. Often, they contain components that can be put to use in times of stress. For example, someone with a background in yoga may be adept at belly breathing while dropping the shoulders down and back. When this person feels tense and senses their shoulders creeping up, a quick yogi breath can settle the tension.
Addictions are chronic disorders, according to the National Institute on Drug Abuse, and they’re characterized by periods of sobriety followed by occasional relapse. That means treatment is rarely a one-time affair. People often need to stay in touch with treatment for months or even years after the addiction developed, and they may need to go back for follow up care after a relapse.
A relapse to addiction does not mean the therapy did not work. Relapse is part of the healing process. People who go back to treatment, unpack what caused the relapse, and work on skills to combat it are on the right path.
(July 2018) What the Pain Scale Really Means. ProHealth. Retrieved from from https://www.prohealth.com/library/what-the-pain-scale-really-means-34982
(June 2014) Tramadol: Update Review Report. World Health Organization. Retrieved from from http://www.who.int/medicines/areas/quality_safety/6_1_Update.pdf
(December 2013) Killing Pain: Tramadol the 'Safe' Drug of Abuse. MedPage Today. Retrieved from from https://www.medpagetoday.com/painmanagement/painmanagement/43554
(May 2015) The CBHSQ Report. Substance Abuse and Mental Health Services Administration. Retrieved from from https://www.samhsa.gov/data/sites/default/files/report_1966/ShortReport-1966.pdf
(July 2009) The Risk of Tramadol Abuse and Dependence: Findings in Two Patients. Journal of the American Academy of PAs. Retrieved from from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.568.4804&rep=rep1&type=pdf
(February 2017) Tramadol: Why Some Athletes and Experts Want It Banned. U.S. Anti-Doping Agency. Retrieved from from https://www.usada.org/tramadol-why-some-athletes-and-anti-doping-experts-want-it-banned/
(February 2008) Fatal Intoxication Due to Tramadol Alone: Case Report and Review of the Literature. Forensic Science International. Retrieved from from https://www.sciencedirect.com/science/article/pii/S0379073807006263
(August 2018) Is Naloxone the Best Antidote to Reverse Tramadol-Induced Neuro-Respiratory Toxicity in Overdose? An Experimental Investigation in the Rat.Clinical Toxicology. Retrieved from from https://www.ncbi.nlm.nih.gov/pubmed/29148295
(July 2014) Rules: 2014. U.S. Drug Enforcement Administration. Retrieved from from https://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0702.htm
(January 2018) Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). National Institute on Drug Abuse. Retrieved from from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/what-drug-addiction-treatment