Tramadol Withdrawal Symptoms, Timeline & Detox Treatment

What is Tramadol?

Tramadol is labeled as a Schedule IV controlled substance by the Drug Enforcement Administration (DEA), meaning it has recognized medicinal use, but there is some potential for abuse and addiction.^2,3 Previously unscheduled, but more recently as a Schedule IV drug, tramadol continues to be regarded as relatively safer and less addictive than other short-acting opioids, though research to entirely support this is lacking.⁴ However, because of this reputation of a superior safety profile, as well as some unique therapeutic benefits relative to other painkillers, tramadol is one of the most commonly prescribed opioids in the United States—frequently used by surgeons for postoperative acute pain.⁴ In fact, one cohort study found that nearly 75% of the more than 500,000 patients in the study received tramadol as their discharge prescription.⁴ Unfortunately, an estimated 0.5% (or about 1.7 million people) aged 12 or older misused prescription tramadol products in 2020.⁵

Tramadol has a somewhat unique mechanism of action amongst the prescription opioids. In addition to its activity at opioid receptors, tramadol acts on monoamine reuptake systems to directly inhibit both norepinephrine and serotonin reuptake—increasing their activity in a manner thought to augment its pain management properties.^4,6

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The U.S. Food and Drug Administration (FDA) places warnings on the labels and in the prescribing information for Ultram, one of the common brand name tramadol formulations, stating that tramadol exposes users to the risks of addiction, with a potential for misuse similar to other opioids.⁷ Tramadol use may result in the development of physical dependence, and dependent individuals are at risk of experiencing a serious withdrawal syndrome should the medication be abruptly discontinued.⁷

Drug dependence can develop even when a person takes a drug exactly as prescribed, although it becomes more likely should the drug be misused. The risk of tramadol dependence and misuse, including illicit diversion and nonmedical use of the drug, has been observed to be higher for those with a history of substance abuse or addiction.⁷

Withdrawal from certain prescription drugs can be uncomfortable—and even dangerous in some cases. Opioids, like tramadol, are no exception. With the help of American Addiction Centers (AAC), medical detox, treatment, and ongoing care are within reach and can help get you on the road to long-term recovery. Call one of our admission navigators at

Tramadol Withdrawal Symptoms

Many more traditionally prescribed opioids like oxycodone and hydrocodone increase sensations of relaxation and can produce a “high,” which is why some individuals take them for non-medical use.⁸ Tramadol works a little differently by not only activating opioid receptors in the brain but also by increasing activity of neurotransmitters like serotonin and norepinephrine throughout the nervous system.⁹ As a result of this unique pharmacological activity, people may experience two types of tramadol withdrawal: the more traditional opioid withdrawal syndrome in addition to a more rare, but somewhat atypical withdrawal syndrome.²

Tramadol Withdrawal Timeline

While there isn’t much documentation on the timeline for tramadol, withdrawal symptoms associated with shorter-acting opioids typically reach the most intense point within 36 to 72 hours after the individual discontinues use or drastically reduces how much they take.¹¹ Symptoms usually last for 5 to 8 days.¹¹

Of course, not everyone’s withdrawal experience is the same so it’s difficult to pinpoint when symptoms may start, how long they will last, or the severity of them. Similar to other drugs, opioid withdrawal is influenced by the frequency and duration of drug use, the amount taken, and the method of intake (snorting or injecting it, for instance).⁷ Other factors that may influence an individual’s withdrawal include a history of substance misuse or addiction, a co-occurring mental health condition—such as major depression—or the concurrent use of other substances, including alcohol or other painkillers.⁷

Tramadol Withdrawal Treatment, Detox, and Medications

Acute opioid withdrawal, though rarely life threatening, can be intensely unpleasant and present challenges to early recovery. However, opioid withdrawal can be effectively managed through medical detox, which can serve as an ideal starting point for more comprehensive substance use disorder treatment.¹¹

Medical detox offers a high level of care with around-the-clock monitoring by medical professionals. During detox, the body rids itself of the substance and other toxins and experiences withdrawal symptoms. The healthcare professionals help to manage these symptoms safely and keep you as comfortable as possible. Sometimes this is done with medications.¹³

The FDA has approved several types of medications for opioid use disorder treatment, with some of them—including methadone, buprenorphine, and lofexidine—being useful to manage opioid withdrawal.¹¹ With somewhat different mechanisms of action, some combination of these three medications can be used to ease withdrawal symptoms, manage drug cravings, and blunt some of the rewarding or euphoric effects of any other opioid drugs to be used while on treatment.¹¹

Tramadol Addiction Treatment

Detoxification is typically the first step in a more comprehensive treatment plan for substance use disorders. Medical detox alone is typically not enough to support long-term abstinence, so your treatment team will encourage you to continue with some form of treatment following successful withdrawal management.¹³