Anyone have experience with Tramadol?

In My Humble Opinion
1

My mom is in the hospital, having fallen and broken her pelvis in two places last Thursday. She’s an old lady with a lot of comorbidities, and her options for pain management are limited. In particular, she can’t take NSAIDs due to kidney issues, and they tried giving her some oxycodone, and it enormously exacerbated her cognitive issues, to the point where she couldn’t work with the physical therapist.

So her medical (geriatric) attending physician has decided to try a very low dose of Tramadol, in addition to the Tylenol. Based on what I saw today, this may be a win. And I’m not trying to second-guess the physician. But I’m the healthcare proxy, and I want to know what she’s getting into, and what I might need to watch out for.

2

My experience, not your mom’s: After my open-heart surgery, the doctors first had me on Percocet (acetaminophen and oxycodone). It caused mental side-effects like paranoia, so they put me on Tramadol. I took it for six weeks, and it was wonderful. It masked the pain, with no noticeable side effects.

3

As a physician who prescribes it, it has its uses. And cases like your mom’s certainly seem like reasonable cases to use it.

It does have opioid-like activity and is abusable, but its abuse rate is much lower that codeine, morphine, etc. And withdrawal from it is generally easily accomplished with a short taper.

4

I’m a big fan of tramado (Ultram)l. I actually respond very well to acetaminophen, but occasionally, I need something a little bit stronger, and I always ask for tramadol. If I take narcotics for more than three days, I start to get migraines, and on top on that, they make me constipated.

I have had tramadol for a number of things. I asked for it instead of narcotics after my c-section as my take-home drug. The doctor insisted on giving me two days of Percoset as well, but I did fine on the tramadol. I did take a 1/2 dose of Percoset to help me sleep the first chance I got to hand the baby off to DH and sleep for 4 hours. I also had tramadol for an ear infection once, I have had it a few times after dental procedures, and I had it after getting steroid injection for carpal tunnel syndrome (VERY painful for about 24 hours). I’ve had it a few other times as well. The longest I ever took it was about 4 weeks, when I was taking it along with a prescription NSAID for really bad whiplash (something I will NEVER make fun of again-- unbelievably painful).

My son we know is allergic to morphine, and we’ve never tried most other narcotics on him. He can take low doses of codeine, but he’s never had anything else. I don’t like having narcotics in the house, in case he should take something accidentally. Yes, I know tramadol is technically in the narcotics family, but both my doctor and my son’s say that tramadol rarely provokes an allergic reaction, even in people with known allergies to narcotics.

My son didn’t go into anaphylaxis when he got morphine after breaking his arm-- he got a raised rash around the injection site, then he started vomiting, about 1/2 hour after the injection, and vomited on himself, and here’s the weird thing-- all over his thigh where he’d vomited on himself, he got the same rash.

They started an IV for fluids, he was vomiting so much, and gave him steroids, an an antihistamine, and compazine through the IV. They gave him a benzodiazapine, too, because he was freaking out, and also because they were at that point afraid to give him anything besides Tylenol and ice packs for the pain. He fell asleep.

Anyway, after the rash was totally gone, they tested my son on a small dose of tramadol, then codeine, and he came home with both. We were supposed to give just tramadol as much as possible, and use the codeine only if the tramadol was not enough. The first day after, he got a couple of doses of codeine, and the second day, he got a dose at bedtime, but after that, it was just tramadol. He was on that for a week.

His fracture was displaced, so they had needed to pin it. They did it with imaging, so they didn’t need to make an incision, just drilled a hole, but it probably still was extra pain on top of the fracture. However, he handled it, and he was only 11.

5

I took tramadol for back pain. I was also taking nortriptyline for nerve pain. I experienced a lot of emotional lability which is apparently a known symptom of drug interaction with those two medications. We chose to stop the nortriptyline and the symptoms subsided. The back pain improved with the tramadol

So, tramadol plus tricyclic antidepressants may not be a good thing.

6

I tend not to use it quite as often as the bottle says I can, mainly because I will usually be taking something OTC as well-- Tylenol or naproxen. If I’m taking 2 or 3/day, and not the 4 I could be taking, I figure addiction is not much of an issue.

If I WERE taking 4/day, and still in a lot of pain, I’d call the doctor before I “self-prescribed” an extra pill or two. I’ve a feeling Puzzlegal would make sure her mother did the same.

Isn’t that how someone ends up rolling down the hill of addiction? Or are there people who really seek out tramadol with the intent of getting high?

I’ll confess-- my brain doesn’t really respond to narcotics by getting high. I get very sleepy if I’m already tired, but it’s a pretty ordinary sleepiness, and if I’m not tired, I might as well have taken an aspirin; I don’t become altered at all. So I can’t really compare tramadol to something like Percoset or Vicodin-- except to say that tramadol does not make me sleepy, even when I’m already tired.

7

Your non-addict seldom rolls down the hill of physical addiction, unless they truly need large doses of opioids for prolonged times. But that’s not the same as chemical dependency. People with the disease of chemical dependency lose control of their ability to take the med properly. Physical addiction can then result too. But it’s the compulsion to use that’s the problem. For someone without that underlying condition, abuse of tramadol is very infrequent. And yes, opioid addicts will seek out tramadol, both to change their mood and to reduce their symptoms of withdrawal from other opioids.

8

My own observations about tramadol is that people either love it, or hate it. I hope your mother has excellent results with it.

And Qadgop is correct - it does not have a high addiction potential, especially in people who are not predisposed to that in the first place.

9

I just don’t get drug abuse.

I have all the sympathy in the world for addicts and their families; I support employers who give leave for rehab, and choose insurance companies that cover it.

I drove a friend to AA meetings for a while once, when she wasn’t sure she’d go straight there and back, and waited just outside the door for her, three times a week, for a month.

I don’t judge people.

I still fundamentally don’t make the synapse leap.

10

You’re fortunate then.

It makes life a living hell for all involved if one doesn’t find recovery.

11

So what you’re saying is that some people are wired to be addicts, and the rest just aren’t?

That would explain why with the exception of a single post-surgery IV dose of Demerol, I’ve never had anything approaching a high, despite having had Norco/Vicodin, Percocet, Dilaudid (IV in hospital), and Tylox at various points for knee injuries/wisdom teeth over the last 30 years. Generally they did work for pain relief, and made me drowsy, but that was about it. And if the dosage was right, not even particularly drowsy.

And yet, I keep hearing about people describing them as making them feel good/high, etc… which is not at all congruent with my experience.

12

Consider yourself lucky.

Many of us addicts/alcoholics describe our first experiences with our drugs of choice as having finally discovered what was missing from our life. My first opioid experience (at age 14 with codeine for a horrible cough) certainly felt like that. Finally, all the anxiety, fears, sense of not fitting in went away. For a while.

13

I kind of get it… that IV dose of Demerol was insane. As in total, absolute euphoria and happiness for about 15 minutes.

It absolutely terrified me at 17, and it still does. I can totally see how if people feel like that on stuff like Vicodin (or any other drug), they get addicted very easily. I just don’t get that sensation from the limited selection of opioids I’ve taken. I mean, the closest I recall was the IV Dilaudid after my most recent knee surgery (5 years ago). I remember being out of pain and feeling pleasantly sleepy before I fell asleep. But that’s it.

14

This is how I found my first (and so far only) use of opioids… It wasn’t a “rush”, or a “high”… It was like discovering true peace for the first time.

Scares the shit out of me, to be honest.

15

Well, since my mother currently can’t roll over in bed, and only can take meds that someone hands to her, I am not especially concerned about abuse.

I’m a little concerned about physical addiction. She had a kidney removed many years ago, and had morphine in the hospital. It worked great. Until they took her off it, and she cried for two days. But she never sought it out after that.

It did seem to help today. At least, she managed to sit up for a while, and she wasn’t loopy. So that’s good.

16

People who are addicted to gambling, or have eating disorders, have also said the same thing.

Anecdote: When I was in college, I worked with a guy who told the story many times of the first and last time he ever did a line of cocaine. He didn’t even like it all that much (to him, he felt like he’d drunk about 2 pots of coffee) and after about 20 or 30 minutes, it wore off, and he had this overpowering urge to take it again. That this powerful urge to do something again that he didn’t even enjoy was a big old warning flag that he’d better stay the hell away from this stuff.

Those people you see on TV, usually attractive blonde females, who blame their heroin addiction on the 10 Percocets their oral surgeon prescribed for them after they had their wisdom teeth pulled were probably extra-hard wired for addiction. It seems that some people who have addictive tendencies can take it or leave it, like the guy I mentioned in the last paragraph, or other people who saw themselves heading in this direction and gave it up and other people will slide into hopeless addiction to SOMETHING, regardless of where they live, what happens in their lives, what drugs they’re exposed to, etc.

One of my IRL friends used to work in substance abuse treatment (and most of the time was the only non-active addict employed there!!!) and said that it was not uncommon for people to stop using drugs and alcohol, and some other compulsive behavior would take over. Both sexes were about equally likely to become hypersexual or religiously fanatic; men were more likely to gamble, and women were more likely to develop eating disorders.

17

Is codeine still used in the USA? And what about ibuprofen?
I assume that this thread is about analgesics that are stronger than anything I have ever had.

18

Yes. I have both codeine cough syrup and ibuprofen pain pills in my bathroom.

The standard cough suppressant is now dextromethorphan, but i had a very unpleasant reaction to it, so I’ve begged my doctors to give me codeine and they have. Actually, my current physician hasn’t, because i rarely use a cough suppressant and I’m still working on the bottle my last pcp prescribed ten years ago. I’m afraid it will be hard to get a new bottle what with the crack down on opiate prescriptions. But at the rate I’m consuming it i might have a lifetime supply.

Ibuprofen is an NSAID, and my mom can’t have it. Codeine is likely to cause the same problems as oxycodone.

19

Both my sister and my daughter described feeling that way about valium. They are both very anxious people. My sister was given a prescription once in college, and after taking one tablet she flushed all the others down the toilet because she felt SO good she knew she was at risk of abusing it. She said she didn’t feel high, she felt the weight of her anxiety lift.

My daughter had a similar experience with valium for dental work, but was only given one dose, so she didn’t have anything to get rid of.

I was given Versed once and hated it. We are wired differently.

20

IANA medical anything, but ISTM …

If she cried for two days she may have been in a bunch of pain. Which means they mismanaged the removal of the morphine she’d been on.

As opioids go, tramadol is not very potent, 1/10th the horsepower of morphine.

I do have experience with watching other people take tramadol daily for months and years with no problem from it.