Tramadol Addiction and Abuse in Washington State and Finding the Right Treatment Options

There is no doubt that Tramadol abuse and addiction have both contributed to the opioid epidemic in Washington State.

This drug is highly addictive, and yet, many people do not realize the need for detox and rehab to help them recover. This is a prescription medication that has a high risk of abuse, which is something a lot of people are not aware of.

Opioid addiction has become a serious problem in the United States, and Washington State has felt the impact of it. The latest numbers from 2020 list Tramadol as the 32nd most prescribed medication out of a list of 300 drugs. Considering how dangerous narcotics like this one can be, it is clear that doctors are still prescribing it; perhaps in high numbers.

A lot of people opt for Tramadol over what they deem to be “more addictive drugs,” such as Vicodin or Oxycodone. But the reality is that this one carries risks of its own. People still abuse it and get addicted to it. Fortunately, there is hope in the form of quality drug treatment in Washington State.

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What Is Tramadol?

Also known as Ultram, Tramadol is a synthetic opioid that has a similar mechanism of action to morphine.

Tramadol binds to opioid receptors in the central nervous system (CNS) to provide pain relief for moderate to severe pain. This prescription painkiller should not be prescribed to children younger than 12 years of age. 

Tramadol comes in various forms. In the US, it’s possible to find this prescription medication in the following forms: 

  • Capsule, Extended Release
  • Suspension
  • Tablet
  • Tablet, Extended Release
  • Capsule, Extended Release, 24 HR 

The recommended dosage for this prescription pain pill is 50 to 100mg for immediate-release tablets. Patients should only take the dosage prescribed every 4 to 6 hours as needed. The maximum dosage that a person should take in a day is 400mg. This prescription medication can be taken with or without food. When taken orally, the effects of this medication should kick in within 1 hour.

Compared to other opioids, Tramadol has a fairly young history. This drug was first synthesized by a German drug company in 1962. The effects of Tramadol was tested extensively 16 years before the drug was approved for commercial use. It was first brought to the foreign market under the name Tramal in 1977. 

Even though many countries around the world used Tramadol, this prescription opiate was not available in the US until 1995. This opioid was first approved for an analgesic for treating mild to moderate cancer pain. 

Since then, Tramadol has become a fairly popular opioid because it comes with fewer side effects than other opioids and is also fairly inexpensive to manufacture. In 2018, a dose of Tramadol cost only $0.05 at wholesale prices.

Like with other opioids, Tramadol works by binding to μ-opioid receptors in the central nervous system (CNS). This results in an artificial influx of various neurochemicals, like dopamine and serotonin. These neurochemicals induce a sense of euphoria and relaxation. 

This prescription drug is also a serotonin-norepinephrine reuptake inhibitor (SNRI), which means that it can achieve a lot more. This drug can also be used to regulate mood disorders and can also treat symptoms of ADD, anxiety disorders, menopausal symptoms and more.

Although Tramadol does not have a high affinity for opioid receptors in the CNS, its metabolite is desmetramadol. This metabolite is responsible for most of the euphoric effects that can be achieved by Tramadol. 

Desmetramadol has a 700-fold higher affinity for opioid receptors than Tramadol. It has a high intrinsic activity, and a potency that is equal to that of morphine. This is also one of the major metabolites that most drug tests look for.

How is Washington State Handling the Overprescribing of Opioids Like Tramadol?

For many years, doctors in WA State – as well as elsewhere in the United States – have largely been overprescribing opioid drugs. In the not-so-recent past, it was common to go to the doctor, complaining of pain, and leave with a prescription for Tramadol or a similar drug. This problem is largely to blame for the opioid epidemic we are currently facing today.

The Washington State Department of Health has carefully clarified the opioid prescribing rules for the practitioners in our state. The following is a summary of the rules:

  • There is no set regulatory limit on the daily dosage of opioids that can be prescribed.
  • The CDC recommends that when starting a patient on opioids, the doctor should choose the lowest possible dose that they believe will be effective.
  • Practitioners are instructed to use extreme caution before prescribing any type of opioid drug.
  • Doctors are required to consult with pain specialists prior to prescribing excessive dosages of opioids to chronic pain patients.
  • Patients on higher doses of painkillers will not be required to rapidly taper off or discontinue these drugs.

There are times when tapering off opioids is expected, and that is when a patient meets one or more of these conditions:

  • The patient has requested it.
  • The patient has declined in function or their pain level has decreased.
  • The patient is noncompliant with treatment.
  • The patient requires a different type of treatment.
  • There is evidence of either diversion, abuse or a substance abuse disorder.
  • The patient has a severe adverse reaction to the drug.
  • The patient overdoses on the drug.
  • The patient is using more of the medication at a time than is indicated on the prescription.
  • The patient increases their dose without consulting their physician and the result is no improvement in function or pain levels.

Because these new prescribing rules have only recently been put into place, it is still too early to tell if they are effective. But the University of Washington’s Alcohol & Drug Abuse Institute offers some promising numbers.

  • The number of opioid-related overdoses was at its highest in 2009 when there were 10.8 for every 100 people.
  • That number immediately experienced a sharp decline the following year.
  • In 2010, there were 9.4 opioid overdoses for every 100 people in WA State.
  • While there have been some fluctuations, the numbers have remained more or less the same since that time.
  • Many deaths have involved more than one drug along with opioids; namely cocaine and methamphetamine.
  • The number of people obtaining prescriptions for Tramadol and other opioids has been decreasing steadily since 2011.
Tramadol Addiction

Signs and Symptoms of an Addiction to Tramadol

Signs and symptoms of an addiction to Tramadol may not always be obvious. Many prescription drug abusers are high-functioning addicts, which mean that they can carry on regular routines and keep up with most of their daily responsibilities. Many people may even refuse to believe that they are addicted because they still continue to go to work or care for their children. 

The Diagnostic and Statistical Manual of Mental Disorders uses 11 criteria to diagnose addiction. Those who are addicted to Tramadol will exhibit some of the following 11 signs and symptoms of addiction: 

  • Neglect responsibilities at home, work or school in favor of taking Tramadol
  • Have to take larger amounts of Tramadol than prescribed
  • Experience opioid withdrawal symptoms when attempting to quit
  • Continue to use Tramadol even in the face of negative consequences
  • Obsess over Tramadol and spend a huge chunk of time either trying to get, use or recover from abusing this medication
  • Avoid social, recreational or occupational activities in favor of doing drugs
  • Need to take larger and larger doses of Tramadol to achieve the same effects
  • Use Tramadol again and again even if it puts one in dangerous situations
  • Continue to use Tramadol despite facing physical or mental health issues as a result
  • Have a desire to cut down on Tramadol use, but being unable to
  • Experience Tramadol cravings 

The severity of the addiction will depend on the number of criteria that each drug user may meet. Those who meet two to three of the above criteria have a mild addiction while those who meet four to five of the above criteria have a moderate addiction. Anyone who meets more than six of the above criteria is severely addicted to Tramadol and need professional help to get sober.

Those who suspect that a loved one may be abusing Tramadol may find it difficult to determine whether their loved one meets any of the criteria defined by the DSM-5. Instead, they should look for these behavioral and emotional signs of abuse and addiction: 

  • Doctor shopping in an attempt to get more of the drug
  • Intense mood swings, like irritability, anger and depression
  • Compulsive use of Tramadol
  • Social and interpersonal problems caused by Tramadol use
  • Difficulties concentrating or poor cognitive functioning
  • The need to hide full or empty prescription bottles
  • Financial difficulties as a result of Tramadol use 

Those who suspect that a loved one may be abusing Tramadol should highly consider reaching out to an addiction expert. We can help loved ones figure out how to approach a family or friend about recovery. Our addiction specialists can also help loved ones learn how to be supportive during the recovery process.

There is a fairly fine line between abuse and addiction. Those who abuse Tramadol may not necessarily be addicted to this prescription drug. Abuse is best defined as the use of Tramadol in a manner that is not prescribed. This includes: 

  • Taking Tramadol in a larger dose or at a higher frequency than prescribed
  • Snorting Tramadol or injecting it instead of taking it as prescribed
  • Combining Tramadol with other drugs and substances in order to achieve a more potent effect 

Those who abuse Tramadol may not necessarily be addicted to it. 

Addiction is best defined as both tolerance and dependence. Tolerance means that the individual does not respond to the drugs in the same way anymore. Their body already expects the artificial influx and has made adjustments to accommodate it. To achieve the same results, the individual will need to take a larger dose. 

Dependence, on the other hand, happens after tolerance in most cases. It means that the individual’s body now expects the drug and needs it. Without it, the chemicals within the body become imbalanced. The individual will experience both cravings and withdrawals.

Side Effects of Tramadol Abuse

Anyone who takes Tramadol, whether properly as prescribed or not, will experience some side effects. This is due to the fact that this drug binds to both opioid receptors in the CNS, and raises serotonin and norepinephrine levels within the body. 

The type of side effects, as well as the severity, experienced will vary from one individual to another. Some common side effects include: 

  • Agitation
  • Constipation
  • Dizziness
  • Difficulties sleeping
  • Dry mouth
  • Fever
  • Hallucinations
  • Headaches
  • Hives, blisters or rashes
  • Lack of coordination
  • Loss of appetite
  • Nausea
  • Profuse sweating
  • Rapid heartbeat 

If side effects persist, those taking Tramadol should consider speaking with a doctor. This may mean that the drugs are not suitable for that individual. Fortunately, there are many other alternatives and options on the market.

Another common side effect of taking Tramadol is known as serotonin syndrome. This happens when too much serotonin accumulates in the body. Those who take Ultram are more likely to experience serotonin syndrome because this drug causes a rise in this particular neurochemical.

Serotonin syndrome comes in varying levels of intensity. Mild forms of this syndrome will usually disappear on their own. However, severe forms of this syndrome can lead to deadly consequences. Some common symptoms include: 

  • Agitation or restlessness
  • Changes in blood pressure or body temperature
  • Confusion
  • Diarrhea
  • Dilated pupils
  • Goosebumps and shivering
  • Headaches
  • Loss of muscle coordination
  • Loss of consciousness
  • Nausea or vomiting
  • Profuse sweating
  • Rapid heart rate
  • Tremors or seizures 

Anyone who suspects that they are experiencing serotonin syndrome should seek medical help immediately. During our assessments and testing, we can help diagnose this syndrome and help patients get the help that they need.

Tramadol Withdrawal Symptoms

One of the main reasons why so many drug users fail to recover from a Tramadol addiction is because they can’t stand and tolerate the opioid withdrawal symptoms that come with quitting.

Withdrawal symptoms for opioid abuse tend to be quite brutal. They are tremendously difficult to bear. 

Tramadol withdrawal symptoms will often overtake one’s entire body. Drug users will wish that they never tried quitting in the first place. Common Tramadol withdrawal symptoms include: 

  • Body pains
  • Confusion and disorientation
  • Depersonalization
  • Diarrhea
  • Hallucinations
  • High anxiety and panic attacks
  • Intense paranoia
  • Muscle pains
  • Nausea and vomiting
  • Numbness and prickling in the extremities
  • Gastrointestinal pain 

Some of these withdrawal symptoms are atypical, so they don’t happen when withdrawing from other opioids. The reason why Tramadol has atypical withdrawal symptoms is because it also acts on serotonin and norepinephrine receptors. 

One of the main atypical symptoms of Tramadol withdrawal is psychosis, or hallucinations. Many studies have looked into this withdrawal symptom and how it can be treated.

Although Tramadol is a fairly weak opioid, withdrawal symptoms will usually begin within hours of reducing this prescription drug use. Symptoms usually linger on for several weeks even when the individual is seeking professional addiction treatment. 

The Tramadol timeline is as follows: 

  • Days 1 to 3.  This is when the onset of most of the general withdrawal symptoms will begin. Most recovering addicts will report experiencing the following symptoms: feelings of pins and needles, profuse sweating, nausea, heart palpitations, anxiety and nervousness, insomnia and drug cravings.
  • Days 4 to 7. This is when the symptoms start to peak. Most users will also report experiencing more intense drug cravings, disorientation and confusion.
  • Days 8 to 14. Most physical symptoms will usually begin to die down by this point. Psychological symptoms, however, may persist. These symptoms include depression, anxiety and irrational thoughts. 

The withdrawal timeline will vary slightly for everyone. It may be based on one’s biological makeup or the length of the drug abuse. Our experts will carefully monitor each patient to ensure that he or she is progressing as expected. 

Some patients may experience post-acute withdrawal syndrome (PAWS). These psychological symptoms can last up to 18 to 24 months after one has stopped taking Tramadol.

Tramadol requires a prescription. Due to this reason, many people are under the misconception that this drug can’t be too dangerous. Unfortunately, that is not the case. Abuse or misuse of Tramadol can lead to fatal consequences, as was the case of a 12-year-old girl who took her grandmother’s Tramadol after mistaking it for ibuprofen. 

Although Tramadol is a fairly weak opiate, it can still cause tremendous harm and danger. Those who abuse this drug can easily get addicted, and overdoses are possible.

Tramadol Overdose Symptoms

Opioid overdose rates are skyrocketing all over America and are partly responsible for America’s life expectancy reduction. It’s possible to overdose on Tramadol even though it’s a weak opioid. Although this prescription medication does not have a strong bond with typical opioid receptors in the CNS, its analgesic effects are enhanced by its atypical effect on norepinephrine and serotonin neurotransmitters.

Tramadol overdose symptoms are similar to the overdose symptoms of all other opioids. Some common overdose symptoms to look out for include: 

  • Blue tint on fingernails and lips
  • Cold, clammy skin
  • Contracted pupils
  • Extreme drowsiness
  • Loss of consciousness
  • Muscle weakness
  • Seizures
  • Slowed breathing and heartbeat 

Those who overdose on Tramadol are more likely to experience seizures than with any other opioid. It’s important to note that it can be difficult to recognize an overdose. Many victims will simply look as if they are falling asleep. They will then stop breathing.

Fortunately for those who abuse opioids, there is an antidote capable of reversing the effects of opioids. This drug is known as naloxone. So far, it has saved many Americans, including celebrities like Demi Lovato

Naloxone will attach to the opioid receptors in the CNS and prevent any opioids from attaching to the surfaces. It will effectively stop an overdose in its tracks. This drug will also start to work within 2 to 5 minutes of being administered, and its effects can last for up to 90 minutes, which is long enough for the victim to receive medical help. 

Anyone looking for naloxone can find this drug at a pharmacy in Washington. Some pharmacies do not require a prescription. The instructions for administering this drug is on the package and is fairly straightforward.

Choosing Our Outpatient Drug Rehab Program at Northpoint the Evergreen in WA State

At Northpoint the Evergreen, we have worked with many people who were addicted to Tramadol. So many of them were surprised to have gotten addicted, and a lot of them were scared about getting treatment. Our outpatient treatment program fits their needs perfectly.

We work with clients who are both new to treatment and who have gone through an inpatient program elsewhere. Our program is able to address both types of needs because of its flexibility. For many of our clients, our intensive outpatient program provides them with the support they need during this challenging time. Not only does it give them a high level of care, but it fits well into their schedules.

During our IOP, our clients meet with their therapist and participate in group therapy sessions. Other therapeutic activities may be recommended as well. Our clients are treated as individuals, and they are given their own, personalized treatment plans. This method allows us to tailor our program to give them the support they need to be successful.

We have two locations in Washington State. Our facilities are in Seattle and Bellevue. We also accept many of the major health insurances in the state to keep our clients’ costs as low as possible.

Evergreen Addiction Rehab

Washington State Detox and Rehab for Tramadol Abuse and Addiction

We understand that recovering from a Tramadol addiction or abuse can be challenging. At Northpoint the Evergreen, our staff members have a great deal of experience working with clients who are addicted to opioids. They know the best methods to provide support, and our success rate is higher than average because of our personalized program.

Would you like to know more about Tramadol abuse and addiction? Do you want to talk with someone about our drug rehab program in Washington State? Please contact us today.

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