I know some one with a chronic back condition that keeps re-occurring, in that I disc in his upper back fails and they have to operate through his neck (from the front, , I'll have to find out what the condition is) anyhow he has been on and off Tramadol, DHC and at points morphine patches for the last 3 years. Every time they fix it it just starts to get better and another one goes and they don't seem to know why.
He reckons the WDs haven't been to bad but he is also very careful to only ever take just enough to deal with the pain, which is always less than he is being prescribed. I assume the WD's are going to vary quite a bit from person to person, but I'd advise keeping any doses of the opiate based stuff as low as you can whilst still giving you some quality of life, he finds the Tramadol good for pain buy YMMV
I would also agree with the above there no way I'd take APAP daily, if your in tat much pain I can't see the point you may a well stick to the Tramadol straight your going to have to taper from it anyhow.
Can you CWE Tramadol?? assume so or you wouldn't have posted it, my mate gets Tramadol and DHC on its own
I'm on 150mgs of Effexor (Venlafaxine) and am way more functional that this guy, it may well have SNRI and other antidepressant qualities but the opioid effects see way to strong to make it really a viable alternative as an AD, but that is only from my very limited experience.