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Treatment - Can Tramadol suppress effects of withdrawing from heroin?

Discussion in 'Opiate addiction' started by beena, Jan 19, 2010.

  1. beena

    beena Palladium Member

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    In 2008 I was on methadone for a time as a treatment for heroin addiction. She was assigned a keyworker who she told she also had access too, and used, morphine tablets (MST 30mg) and Tramadol Hydrochloride capsules (50mg). At the time I remember her keyworker telling her that Tramadol were virtually useless for treating heroin w/d because they were not an opiate but a weak opioid, which the keyworker said was a synthetic, man-made drug designed to simulate the effects of an opiate.
    I took what the keyworker said for granted and has therefore never seriously attempted to use tramadol when coming off heroin. It has never been an issue or a problem because I have always had the MST tablets to fall back on when she's had no heroin.
    Two weeks ago though SWIM's partner needed to use the MST tablets himself for a genuine medical condition, so I had nothing to fall back upon. I wasn't worried at the time because she had just had a three week break from drug-use and was effectively clean. She didn't think w/d was gonna be a problem, although she had just started using again sporadically (ie not every day and not as much as before). But then followed a period of heavy use, in which she was using as much as ever and this continued over several days. After which she experienced withdrawal symptoms. 24 hours after use she started to feel unwell. 48 hours after use and she was really feeling bad. It probably wasn't as bad as the w/d she's experienced in the past but it was bad enought.
    She chucked 200mgs of tramadol down her neck because there was nothing else in the house to use. She didn't expect anything much from them and she lay down in bed to try and sleep through the symptoms. She hadn't been able to sleep before taking the tramadol but about an hour after taking them, SWIM presumes when they kicked in, she fell asleep and had a comfortable, good sleep. When she woke up she felt much better than she had. She wasn't totally better or anything, but she's sure the tramadol did have some beneficial effect on her.
    This got her thinking about what her keyworker had said previously and she started to wonder if he had been correct. After all, his main supposition as to why tramadol wouldn't and couldn't work for treating w/d was that it was a synthetic, man-made opioid, but surely this is what methadone is too, isn't it? And methadone, of course, is specifically used for heroin treatment.
    Can anyone clarify for SWIM whether what the keyworker told her was right or was he mistaken? Can tramadol work for heroin treatment?
    Has anyone else used tramadol during w/d from heroin and did it work? Was it effective? I would be interested to hear from anyone who has knowledge about tramadol in relation to its efficacy for w/d treatment and/or anyone who has personal knowledge or experience of tramadol use for w/d. Thanks.
     
  2. OG Kush

    OG Kush Newbie

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    Not really because if you have been using heroin your tolerance will be too high for tramadol to be effective. Now if you have a low does oxy or hydro habit It can be somewhat effective but not perfect from my experience. Better than nothing but you will still have withdrawals.
     
  3. kasbeq

    kasbeq Palladium Member

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    Swim thinks that tramadol can be helpful for mild opiate withdrawals but would not help a lot for a full swing heroin withdrawal ( unless taken in dangerously large doses)

    For mild withdrawals is not recommended as tramadol in itself can cause withdrawal

    Tramadol is a centrally acting analgesic with a partial affinity for the opiate receptor (mu), having an analgesic potency estimated to be one tenth that of morphine. Whereas methadone is not partial but a full agonist.

    Having said that I do use tramadol, but at a later stage as means of parachute tapering.

    First seven days he uses methadone taper for H withdrawals ,and by day seven he reduces methadone to nil .
    Day 8 he uses tramadol (max 7 days) and reduces the amount every day .

    Yes there will be some discomfort but I find that this procedure works best for him.

    Initially he assesses how much methadone he needs for a “comfortable” withdrawal from his daily H use, by using a conversion of H to Meth table



    Heroin Use Methadone Dose
    0.25 g 10 mg
    0.50 g 15 mg
    0.75 g 22 mg
    1.00 g 30 mg
    1.50 g 45 mg
    2.00 g [COLOR=black]60 mg
    [COLOR=black]3.00 g [COLOR=black]90 mg




    [COLOR=black]So if You has assessed habit of 1 gram a day her starting methadone dose should be 30 mg

    [COLOR=black]The length of methadone use is 7 days ,so the reduction of daily methadone intake should be 30:7 = 4.5 mg (roughly)– reduction each day.

    [COLOR=black]After day seven he uses tramadol starting at 2 or or 3 times x 50 mg and reduces 25mg every day

    [B][COLOR=black]Warning : do not use tramadol and methadone together [/COLOR][/B][COLOR=black]

    [COLOR=black]Tramadol (Ultram®) is not considered an opioid, but in fact, it is. It is simply that it does not depend solely on its opioid quality for its pain relieving ability. As a result of its action, it effects methadone levels as a mixed agonist-antagonist. It should be avoided by those using methadone[/COLOR][/color][/COLOR][/COLOR][/COLOR][/COLOR][/COLOR][/COLOR]
     
    Last edited by a moderator: Sep 10, 2017
  4. pinksox

    pinksox Palladium Member

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    Interestingly, SWIM who, at the time, had been maintained on (3)60mg MS Contin and (3)10 methadone tablets daily for chronic pain which were always taken as written, came across a large cache of Tramadol and found her cat could switch to tramadol solely with no adverse "withdrawal" effects whatsoever...likely because it's opioid nature was still hitting those "right" receptors(or enough of them at least). Not even a hint of withdrawal symptoms. It wasn't however nearly as effective in managing her daily pain levels.

    That being said, it is generally considered ill-advised to exceed doses of Tramadol in excess of 400mg/day as the medication tends to considerably lower a person's seizure threshold. Due to genetic variability, this will effect some people more easily--and even at lower doses--than it will others.

    Since it hasn't really been effectively studied or trialed in humans as an opiate replacement therapy, I would have to say be careful, but as long as they're taking less than the 400mg daily/q 24*, and continuing to move downwards, then they're likely okay continuing. If they need in excess of that amount, then they'd likely choose to go the more via one of the more tried and true conventional routes as mentioned above. Her cat will say that when she did a CT opiate withdrawal many, many years ago, she happened to remember that a low recreational-level dose of dextromethorphan (DXM)could get her through the sickest of work days without dying and she tried that in her desperation and found it both helped ease some aspects of post-acute withdrawal but aided as a mood stabilizer as well. She was actually fascinated when she found DF and saw other swimmers had tried DXM and widely reported similar effects as well because places like DF weren't around, unfortunately, when the cat was going through her ordeal.
     
    Last edited: Jan 20, 2010
  5. Trapped_under_ice

    Trapped_under_ice Newbie

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    Yeah tramadol is a full opiate although not itself, it's a prodrug. It's slow to come on.

    My monkey read that for pain relief, tramadol is 1/60 as potent as methadone(both PO). But my monkey found that the actual rate is about 1:100 for a whole days coverage. It doesn't seem to cover some of the methadones peripheral effects so you would be better off using a combination of tramadol and clonidine. My monkey found that these two together can completely cover it.


    People think tramadol is not a real opiate. Yet another monkey in disguise.
     
  6. Helene

    Helene Gold Member

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    I am addicted to heroin (and is on a methadone script), a while ago she was scripted tramadol as part of her post-op pain relief after having her wisdom teeth out. She found that it interfered with the methadone's ability to keep swim from withdrawing. This isn't that rare an effect, and as Kasbeq said in his above post, tramadol shouldn't be used by those on methadone scripts for this reason

    I wouldn't advise using tramadol in an attempt to stave off heroin withdrawal, as the highest safe daily dose of tramadol (400mg) isn't really comparable to any but the smallest of heroin habits. This maximum dose is due to tramadol potential to trigger seizures, and so opiate tolerance does not have an effect on the doses that could be considered "safe".

    For more details on swim's own experience with tramadol (in the context of methadone and heroin addiction) have a look at these posts from the Tramadol Experiences Thread -

    https://drugs-forum.com/forum/showpost.php?p=724528&postcount=722
    https://drugs-forum.com/forum/showpost.php?p=732057&postcount=731

    And for further info on why its not a good idea to combine tramadol with methadone, see this thread here -

    Combinations - tramadol and methadone

    H
     
    Last edited: Jan 20, 2010
  7. Helene

    Helene Gold Member

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    Apologies for slightly off topic content:


    I'm a little bit puzzled by the above quoted conversion table. Where is this sourced from? The figures given for equivalent methadone doses seem to be very low to swim, based on both personal experience and all the other heroin > methadone conversions she has seen. Also, what ROA is this referring to? I know for sure that back when she was hitting up 3g a day of heroin 90mg of methadone wouldn't have touched the sides.

    H
     
    Last edited by a moderator: Sep 10, 2017
  8. kasbeq

    kasbeq Palladium Member

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    Swi Helene the above chart is from heroinhelper.com and its not for purposes of maintenance – but for using rapid methadone taper to withdraw from heroin.
    I did mention in his post that there will be slight discomfort , but not as bad as withdrawing cold turkey.
    Will try to attach more from this site – but unsure if I have the know how- to attach charts to forum post :

    Sorry unable to clear format but will attach link http://www.heroinhelper.com/sick/methadone_detox_part_2.shtml
     
    Last edited by a moderator: Sep 10, 2017
  9. Dickon

    Dickon Newbie

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    Interesting as the above may be, it should be discussed in another thread. As a final word this conversion table does seem to overlook the non-linearity of one morphine/methadone equianalgesia table where the conversion ratio of morphine to methadone varies from 3:1 at low doses to 20:1 at high doses. I would imagine this would be the same with heroin unless the non-linearity existed between equivalent doses of heroin and morphine.

    Now, back to tramadol....

    Echoing in part Helene above, high dose tramadol can cause seizures [or lower the seizure threshold] so a caution is in order about using "stupid" doses to try to suppress withdrawals [400mg is a maximum recommended daily dose]. Tramadol does have some opiate effects (it is not a partial agonist, but I believe it's effects at the mu opiate receptors are because of it's metabolism to M-1 (O-desmethytramadol)) alongside other effects such as reuptake inhibition of noradrenalin and serotonin.

    It would almost certainly provide relief if someone was on a very low dose of heroin, and tramadol itself can be addictive, and for some the withdrawal is particularly nasty. I started this thread about tramadol withdrawals a while back which might be worth looking at before attempting this: https://drugs-forum.com/forum/showthread.php?t=86797 .

    I'm not convinced this is the best idea, but possibly sensible doses over a short period may constitute some kind of a minimal taper or take the edge off.

    All the best

    Dickon
     
    Last edited: Jan 23, 2010
  10. Trapped_under_ice

    Trapped_under_ice Newbie

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    High doses will be futile anyway since it's dependent on the cytochrome CYP2D6 to produce it's most active metabolite. This enzyme is used up very quickly just like with codeine.

    Tramadol is a weak, crappy opiate. It seems like the current trend in medicine is to subtitute effective drugs that may be addictive, with crappy inefficient drugs that have less abuse potential.

    Assuming the trend continues, soon the hottest new prescription will be a glass of water. Guaranteed free of abuse potential!
     
  11. ruca

    ruca Silver Member

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    hi everyone!
    well this may be a dead thread nevertheless i was reading it trying to search for such answer and this is what my pet knows:
    first time he went on a rehab clinic ,and before an antagonist was prescribed to him he was prescribed for a week with tramadol,some kind of benzodiazepine to help him sleep,some drops to his heart pressure.this is the treatmentthat is still used in his country..maybe the tramadol is solely used to manage the pains of a not so hard,i d say mild use of heroine but in my pet s case they did work by then..even now everytime he uses h he manages the day after with a_largerdose of tramadol than the one he was prescribed down in the clinic..let s say then hid doc prescribed him like 50mg every 8 h and by now everytime he uses he manages the day after with a 300mg dose of tramadol,and the results are ok..he is aware that everyone reacts diferently to this substnce and he underlines that he is talking about a small and discontinued use of heroine..of course bupes are way better with better results but stil trams do the trick..also a somehow dose of codeine proved to help his day after,not togheter with trams,either one or the other do help with the disconfort of heroin use anytime he falls off the wagon and ,say he has to go to work,for instance,without showing the h use effects..

    this is my pets experience,may not work with everyone but with him even the depression of heroin discontinued use is managed by tramadol..have a try maybe it works and if you stay low on trams dose-400 max- you should be ok!
    hope my pet s experience helps someone
     
  12. Big Time

    Big Time Newbie

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    Re:O Demetyl tramadol

    Swim been eating aprox 5g/day for 3 Years of krypton that contains O Demetyl Tramadol. Now his stopped CT with Krypton And tryed tram as help to manage work 200mg every morning he manage work but feel like skit. Things changed now his gott too quit those too. Hi had WT from Krypton for 3 days he felt so bad he thought he would die. But now from eating Tram for three weeks he ecspected the same but no.
    SWim got som benso now but his whish too live is gone notting is interesting How long will it take till swim can feel joy in life again?
    Sorry for spelling and all but swim dont feel good
     
  13. &rew

    &rew

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    TBH for SWIM 100mg of methadone sounds fair for 3g of heroin. Not to get high but it'll help to remove acute WDs symptoms.

    /offtop off

    Tramadol suppresses heroin's withdrawing effects for sure. The proof is thousands of clinics that uses tramadol intensified by benzos for heroin detox in Russia. TBH that the only option to detox here. Other option is a cholino-blockade as a help from a free medicine which is burns out health a lot.

    In SWIM's favorite detox clinic patient comes on second day, gets 6 mg of clonazepam, 4 mg of loperamid, subclavian catheter, drip flask with tramadol and... "sleep well next 72 hours". After 72 hours passed, patient joins other tramadolo-benzo-crafts floating all over the clinic.
     
  14. beena

    beena Palladium Member

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    The reason SWIM originally posted this question was that a drug-worker in a rehab told SWIM (or SWIM's boyfriend - he was the patient), that tramadol were useless for w/d because it's a synthetic, ie man-made opiate and therefore doesn't have the same chemical make-up or structure as other 'true' opiates, therefore not helping with w/d ... at the time SWIM bought this but one-time when she had no gear and just tramadol in the house she put it to the test and found she did get some relief ... anyway, to cut a long story short, it was only after this I did some thinking and it occurred to her that this argument of the drug-workers is ridiculous because methadone of course is also a synthetic opiate and also the main substitute prescribed to heroin addicts for withdrawal! Very bizarre ... that said, I wouldn't suggest tramadol as a first or best option for w/d - mild w/d only really ... but in conjunction with something like morphine it can really help because of the anti-depressant qualities that tramadol also has (ie boosting or lifting your mood).
     
  15. kurrajong

    kurrajong Newbie

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    Ttramadol can really lift your mood.The effect comes on relatively slowly but is then potent enough.It makes one more sociable and happier,and the feeling is similar to opiates.
     
  16. Spucky

    Spucky Palladium Member

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    AW: Can Tramadol suppress effects of withdrawing from heroin?

    The problem we have with a Drug like Tramadol is the increased Risk of cerebral Seizures,
    a normal Withdrawal also increase that Level
    and we get as a Result a unknown/ not foreseeable Factor,
    and this is too Risky!

    The Potency of Tramadol is afair 0,1 of Morphine
    and People can do between 1-2,5mg a Kg maximal, every 9 Hours (therapeutic Dosage)

    Heroin (the real one aka DAM) Potency is 2-2,5 of Morphine (100mg Morphine is 40-50mg Heroin)

    If someone use 400mg Heroin a Day he will need a few gram of Tramadol

    Original question; Heroin is also a Semi-Synthetique Opiat/ Opioid
    and Methadone a real Opioid and that Stuff works very well!

    What he maybe tried to say was that the affinity (on the afair Mu-Receptor) of Tramadol is very low
    only 1/6000 of the Morphine!
     
    Last edited: Feb 4, 2011