Managing Tramadol Cravings and Avoiding Relapse
Cravings are quite common during recovery from tramadol addiction. But many people who experience cravings can manage them using a variety of techniques on their own or with the help of a therapist.
Tramadol Cravings Signs and Symptoms
Tramadol is an opioid medication that is used to treat moderate to moderately severe pain, as well as to manage some chronic pain conditions. Over time, tramadol has proven to be habit-forming, and some people develop an addiction to it.
Cravings are a normal part of recovery, and they are not unique to people recovering from tramadol addiction or from other substance use disorders. People who are on a diet often have cravings for specific types of foods. People also experience craving-like feelings when they can’t engage in certain activities that they love due to injury or environmental conditions.
Cravings don’t mean that something is wrong with the recovery program. Everyone in recovery will experience cravings at one time or another. In fact, most people will experience them many times, and some people experience intermittent cravings after years of abstinence. 1
Understanding cravings is the key to resisting them. Cravings are neither good nor bad – they just occur. People can experience cravings differently, but there are some similarities in how they are experienced (see the next section).
For someone who has never had a substance use disorder, craving a drug is similar to having a craving for a favorite food such as chocolate or pizza. The difference is that drug cravings are typically far more intense – and giving in to them is potentially far more destructive.
Symptoms of Cravings
Cravings are often experienced as strong urges to use tramadol. They can be physical, psychological or a combination of both: 1, 2
- Physical cravings: Some people experience cravings physically. For instance, it’s possible to have a specific feeling in the stomach, to suddenly experience the rush of taking the drug, or to taste or smell the drug. Any physical sensation associated with past drug use can be a craving.
- Psychological cravings: People may also experience cravings on a psychological level. For example, some people may not be able to get the notion of taking tramadol out of their minds. Others may describe their cravings as a “calling” to do the drug.
- Combination: Sometimes cravings are combinations of these physical and psychological feelings.
Onset of Cravings
As a general rule, most people can expect to begin experiencing cravings within 12 to 48 hours after discontinuing tramadol.1
The onset of cravings will differ, however, depending on the type and the amount of the substance that was abused. Drugs with shorter half-lives are often associated with a quicker onset of cravings.
The half-life of the drug refers to the length of time it takes for the amount of a drug in a person’s system to be reduced by half through normal metabolism of the drug.2 The general range for the half-life of tramadol is between 5 to 8 hours.2
Cravings can become increasingly powerful during withdrawal and detox because the body has learned to rely on the drug to function efficiently. Drugs that are capable of producing physical dependence result in the person’s system developing a new equilibrium that occurs only when the person has ingested a specific amount of the drug.2 Once the levels of the drug in the tissues decline to a certain point, cravings and withdrawal symptoms will set in.
Causes of Cravings
Cravings are also associated with cues from the environment. They are learned associations that follow many of the principles of classical conditioning and operant conditioning. 1, 2
For example, people who used tramadol when they became extremely stressed may experience very strong cravings to use tramadol when they are under stress again. People who used tramadol with certain people may experience cravings when they encounter these same people in the future. Any number of learned associations can trigger cravings.
Treatments for Tramadol Cravings
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- Cognitive behavioral therapy (CBT): is a form of psychotherapy that helps you identify irrational thoughts and beliefs in order to change your behaviors. Many people have a number of automatic thoughts that accompany cravings. CBT attempts to counter these automatic impulses by identifying and then challenging them.
- Mindfulness approaches: teach you to remain in the moment and concentrate on your thoughts, experiences and feelings without judging them. These strategies can minimize cravings by removing their power over you.
- Meditation: allows you to manage stress, control thoughts about drug use, overcome uncomfortable situations and become healthier in general.
- Inpatient treatment: Live-in or residential treatment options are best for those who need help with detox or who need to be removed from a potentially dangerous environment. Inpatient treatment typically lasts for a limited amount of time, such as 28 to 30 days, 60 days or 90 days.
- Outpatient: Treatment with a therapist on an outpatient basis allows you to live at homeand return to your daily routines. Some people transition to outpatient after inpatient tramadol rehab, while others use outpatient as their primary treatment. Outpatient therapy provides you with the opportunity to apply your new skills directly to your new, drug-free lifestyle.
- Group therapy: In group therapy, people with similar struggles are guided by a therapist. Group therapy has the advantage of allowing members to learn, support and teach one another.
- Individual therapy: This one-on-one work with a therapist offers intensive and targeted intervention.
- Twelve-step programs: Participation in a 12-step program is not a form of therapy, but instead is a social support group run by people with similar addictions. These groups can be extremely useful in dealing with cravings during recovery. You are assigned a sponsor, and you can call the sponsor if you experience a craving.
Medications Used to Curb Tramadol Cravings
Suboxone (buprenorphine and naloxone) and Subutex (buprenorphine) are used to treat cravings and withdrawal symptoms for other opiates and can be used to curb cravings for tramadol. 4
Tramadol itself can also be used to reduce cravings by having a physician use a tapering strategy. This means that the user takes ever-smaller doses of the drug at successive intervals until he or she no longer experiences significant withdrawal effects.
All medication-assisted treatment strategies should only be implemented under the supervision of a physician.
How to Stop Cravings Naturally
In addition to the strategies listed above for stopping tramadol cravings, you can use a number of other techniques to deal with cravings naturally. These include: 1, 2
- Distraction simply involves leaving the situation that is producing the craving and doing something else. Distracting activities might include taking a walk, running, breathing, practicing relaxation or playing a sport. Because cravings are time-limited, they will typically become less intense while you are engaged in a distracting activity.
- Talking about cravings, This strategy requires a support system that consists of either a therapist or other people in recovery who share similar experiences. Talking about cravings can also be beneficial because you can receive helpful advice from others who have dealt with cravings.
- Urge surfing is a technique in which you think of a time when you had strong cravings for your drug of choice but for some reason could not give in to them. 1, 3 If you stay with the feeling instead of giving in to it, you will probably find that the cravings pass. Urge surfing allows you to acknowledge the cravings, which helps you realize that cravings are just like other thoughts and feelings that come and go.
- Recalling negative effects of substance use. This is not an easy strategy to do, but it can effectively reduce the intensity and duration of cravings. Because cravings occur as a result of learned responses and physiological changes in the body, associating cravings with negative outcomes helps to reduce their importance in your mind.
Although these strategies are not guaranteed to eliminate cravings, they will likely reduce their intensity and frequency. The key to applying them is to be motivated and consistent. Giving in to cravings, even occasionally, will only make them more powerful.
Cravings and Relapse
Cravings are strongly associated with relapse. 1, 2 By understanding the signs of a relapse, you can be prepared to take action if you begin to slip back into drug-seeking behavior.
Some warning signs of relapse include:
- Discontinuing participation in a formal treatment program.
- Associating with former “drug buddies” or going to places where you used drugs.
- Beginning to think that it is OK to use tramadol occasionally.
- Isolating from support groups or family.
- Being dishonest.
- Neglecting to deal with triggers or stressful situations.
- Beginning to think that treatment and support are unnecessary.
- Romanticizing past drug use.
How Long Do Tramadol Cravings Last?
Cravings become less intense over time.
Most cravings are short-lived. They will typically peak and dissipate within an hour or less if you do not give in to them. Cravings may shortly reappear, but eventually you will notice longer gaps between them.
Further, cravings will become less intense over time. The initial experience of cravings will be very strong; however, after a few days or weeks, cravings will start to lose their urgency in most recovering people. 1, 2 For many, cravings will be strong for a short period and then taper off over the long run.
Find a Recovery Center for Tramadol Abuse
If you are concerned that you or a loved one may have an addiction to tramadol or may need help with tramadol cravings, please seek professional support by calling our helpline at 1-888-319-2606 Who Answers? . You can speak with a recovery advisor who will answer your questions and provide information on treatment options.
. Marlatt, G. A., & Donovan, D. M. (Eds.). (2005). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors (2nd ed.). New York, NY: Guilford Press.
. Doweiko, H. E. (2011). Concepts of chemical dependency (8th ed.). Pacific Grove, CA: Brooks/Cole Publishing.
. Ostafin, B. D., & Marlatt, G. A. (2008). Surfing the urge: Experiential acceptance moderates the relation between automatic alcohol motivation and hazardous drinking. Journal of Social and Clinical Psychology, 27(4), 404-418.
. Wikler, A. (2013). Opioid dependence: Mechanisms and treatment. New York, NY: Springer Science & Business Media.