Opioids Using tramadol as a tool

[WellTram]

No need to apologize, thank you for your candor.

The beginning of your story sounds very familiar. I've always experienced life as unsatisfactory, a problem to be solved. Most of my past behavior can be characterized as resistance to the current reality and hoping for relief in the future.

A while ago, I ate a piece of hash which turned out to be more potent than I had anticipated. I was overwhelmed by fear, yet something in me decided to let go completely. I was ready and willing to die on the spot if necessary. That moment, the fear dissolved completely and I had an amazing trip. Interestingly, I lived the next couple of weeks in some kind of pseudo-enlightened state where everything seemed to just flow naturally.

Sadly, my normal state of consciousness returned after a while. Yet, after 20 years of stagnation I've started turning my life around, trying to use all the tools at my disposal. I'm awfully grateful to tramadol for providing relief and showing me what is possible, yet I recognize that looking the beast in the eye when it rears its ugly head is an equally important duty as the flip side of the coin.





So, I gather that any level of consistent, long-term use of tramadol will escalate towards addiction. I was going to ask whether incorporating month-long breaks would be a way to prevent this, but I guess the crux of the matter is that an external enforcement mechanism is necessary to prevent abuse.




Sounds like you're on to something. I found the following in A call to develop tramadol enantiomer for overcoming the tramadol crisis by reducing addiction:

They didn't separate isomers cause they wanted to make it as multimodal as possible and since both isomers are psychoactive they decided that racemic tramadol is the best one for pain - providing both serotonine reuptake inhibition, noradrenaline reuptake inhibition, serotonine release, mu-opioid binding and even its potent opioid metabolite still function as a noradrenaline reuptake inhibitor.
It is very monoaminergic in both reuptake inbibition, serotonine release and indirect dopamine release due to opioid mechanism and combination of every single one of these mechanisms provides the best analgesic effects for acute, chronic and due to monoaminergic properties for neuropathic pain.
Also, it has quite long half-life which is getting even higher when u take multiple doses theough the day.
Compared to codeine it is whole different beast and for me, very good cyp2d6 metaboliser 100mg of tramadol is actually considerably more potent and longer lasting than 10mg of morphine sulphate ( both tram and morphine oral consumption ) .

 

[MedicinalUser247]

Tramadol is a weak opioid agonist and more of a SNRI. It's been approved for the Treatment of Depression so ask your Psychiatrist about it.

 

[WellTram]

Tramadol is a weak opioid agonist and more of a SNRI. It's been approved for the Treatment of Depression so ask your Psychiatrist about it.

Where it was approved as a treatment for depression ? I know it has excellence online ratings it's actually the most effective antidepressant according to ratings online and it can be used for severe depression off-label but doctors ( EU ) are scared to prescribe more than 1 pill of 37,5mg for severe pain so i doubt any psychiatrist would even considere prescribing somebody tramadol before trying ssri, than bupropion and than structurally very look-alike venlafaxine first.
My psychitrist know i use it and instead of making junkie out of me he rather prescribed me meds to eliminate seizure risk and antidepressant which is not messing with cyp2d6 enzyme because most of them are.

But my friend told her psychiatrist that she was given tramadol for pain and her psychiatrist told her he would not treat her if she would take tramadol.

And it's opioid effects are actually still very underrated. For ultrarapid cyp2d6 metabolisers almost 25 percent of ingested dose is converted into o-desmethyltramadol which has potency almost as strong as oxycodone but half-life of 7-9 hours and additional noradrenaline reuptake inhibition effects.

My algesiologist told me that it makes no sense putting codeine and tramadol into one category of opioids because for efficient metabolisers tramadol is acrually much more potent ( M1 is weaker than codeines active metabolite morphine but created in much larger ammount ) and it also works 2,5times as long while having additional almost amphetamine-like effects.
She told me when they need to work long shifts they take 75mg and they are able to be functional for 12 hours.
While taking codeine makes them feel that warm, more classic opioid effect but only for a few hours.

 

[MedicinalUser247]

It was approved off label. It wouldn't hurt to ask.

 

[RUC4]

Say I decide to keep experimenting with tramadol. Are there rules I can set to improve the odds of doing it in a safe manner? I already keep track of the doses I'm taking. I was thinking of the following:

• No more than 3 50 mg doses per week
• No dosing on consecutive days
• After 3 weeks, take a week off
• No recreational use

I'm very interested in hearing from people here who have been in a similar position and have tried using tramadol longer-term.

i think this is the best plan i've seen in a long time. seems like you've covered all your bases. the only thing to have caution about is seizures on that stuff.

 

[DeathIndustrial88]

I used tramadol for 13 years.

Just like you, it was like some kind of switch gets flipped on in my brain & suddenly I feel alive & ready to take on the world.
Even a lot of other opioids don't do this to me.

Tramadol had me cleaning my house, working extra hours, exercising, being creative. I use to get so much done on tramadol.
I also felt more confident in my appearance & who I was as a person on it. It even made me more "romantic" and "sensual".

Unfortunately it wasn't my script, it was my mothers. And after she died, I lost access to tramadol altogether.

Then I spent another 9-10 years on buprenorphine, which is completely subpar compared to tramadol.

I was taking up to 400mg a day (usually stacked doses, spread out over an 1.5hr). It kept working for me pretty much every day. Sure, I built some tolerance & the "euphoria" dissipates a bit, but that antidepressant action was still there.

I do NOT believe the antidepressant properties come from it's VERY weak SNRI properties.
Because if it did, then Effexor or other SNRI's would have helped me, but they don't. In fact, SNRI's make me feel worse & give me serotonin syndrome-like symptoms (projectile vomiting, hand tremors, burning feeling inside the body).

I believe most of the antidepressant effects come from it's metabolite, O-desmethyltramadol. Which is a full agonist opioid.

Tramadol is also a weak TAAR1 agonist, so it also releases serotonin (similar to MDMA & methamphetamine, although much much MUCH more weakly).

It's also a weak NMDA antagonist, which means it can help prevent it's own tolerance buildup. And NMDA antagonism offers pain relief all on it's own. So it's a very unique opioid with unique actions at various receptors.

But once they scheduled tramadol in 2013-2014, they started tapering my mom slowly. So I started running out faster & faster, which lead me to using heroin from 2015-2020ish. And then I ultimately ended up on shitty buprenorphine for another 9 years.

So we're looking at 18-20 years now of me being on an opioid in some form.

Depression affects the same part of the brain as physical pain, so it makes sense that opioids would help depression.

I feel like nobody pointed out though, that dependence and addiction are NOT THE SAME THING.
Addiction is defined medically as "continuing to use something despite it causing harm to your life".
Dependence is defined as needing a medication to physically function & stay out of withdrawal.

So you may end up dependent, but this does not magically make you an "addict". If the drug helps you & you're able to access it, then it's actually doing the OPPOSITE of "addiction", by improving your quality of life.

A lot of people conflate addiction & dependence as the same thing when it's really not.

I'd give anything to get back on tramadol honestly. It really does have a unique way of boosting confidence & being stimulating, while retaining all the classic opioid effects as well (itching, miosis, sedation, nodding, pain relief, etc..).

 

[WellTram]

I used tramadol for 13 years.

Just like you, it was like some kind of switch gets flipped on in my brain & suddenly I feel alive & ready to take on the world.
Even a lot of other opioids don't do this to me.

Tramadol had me cleaning my house, working extra hours, exercising, being creative. I use to get so much done on tramadol.
I also felt more confident in my appearance & who I was as a person on it. It even made me more "romantic" and "sensual".

Unfortunately it wasn't my script, it was my mothers. And after she died, I lost access to tramadol altogether.

Then I spent another 9-10 years on buprenorphine, which is completely subpar compared to tramadol.

I was taking up to 400mg a day (usually stacked doses, spread out over an 1.5hr). It kept working for me pretty much every day. Sure, I built some tolerance & the "euphoria" dissipates a bit, but that antidepressant action was still there.

I do NOT believe the antidepressant properties come from it's VERY weak SNRI properties.
Because if it did, then Effexor or other SNRI's would have helped me, but they don't. In fact, SNRI's make me feel worse & give me serotonin syndrome-like symptoms (projectile vomiting, hand tremors, burning feeling inside the body).

I believe most of the antidepressant effects come from it's metabolite, O-desmethyltramadol. Which is a full agonist opioid.

Tramadol is also a weak TAAR1 agonist, so it also releases serotonin (similar to MDMA & methamphetamine, although much much MUCH more weakly).

It's also a weak NMDA antagonist, which means it can help prevent it's own tolerance buildup. And NMDA antagonism offers pain relief all on it's own. So it's a very unique opioid with unique actions at various receptors.

But once they scheduled tramadol in 2013-2014, they started tapering my mom slowly. So I started running out faster & faster, which lead me to using heroin from 2015-2020ish. And then I ultimately ended up on shitty buprenorphine for another 9 years.

So we're looking at 18-20 years now of me being on an opioid in some form.

Depression affects the same part of the brain as physical pain, so it makes sense that opioids would help depression.

I feel like nobody pointed out though, that dependence and addiction are NOT THE SAME THING.
Addiction is defined medically as "continuing to use something despite it causing harm to your life".
Dependence is defined as needing a medication to physically function & stay out of withdrawal.

So you may end up dependent, but this does not magically make you an "addict". If the drug helps you & you're able to access it, then it's actually doing the OPPOSITE of "addiction", by improving your quality of life.

A lot of people conflate addiction & dependence as the same thing when it's really not.

I'd give anything to get back on tramadol honestly. It really does have a unique way of boosting confidence & being stimulating, while retaining all the classic opioid effects as well (itching, miosis, sedation, nodding, pain relief, etc..).

I agree with you on everything u wrote, i didn't mention NMDA antagonism and TAAR1 agonism cause i wantet to make it sound more simple but i definitelly enjoy tramadol more than oxy, more than morphine, i know it's cause of my ultrarapid cyp2d6 metabolism (mostly) but for me tramadol is like hybrid of opioid and amphetamine.

Most of antidepressant effects are produced by it's active full mu opioid receptor agonist metabolite - i agree. The snri and sra effects of tramadol ( as a complex of its enantiomers and metabolites ) are mostly boosting effects of tramadol for supressing neuropathic pain. One may say it is also reason for it's stimulating effects but i experienced a lot of stimulation on hydromirphone too and if I am right hydromorphone doesn't cause serotonine release and snri effects.

So, for some people with right metabolism and pain caused partly by nerve damage, tramadol is definitelly much more than weak opioid. It is multimodal painkiller with monoaminergic, nmda antagonistic properties metabolised into medium potency opioid ( M1 ) with half-life of almost 9 hours and that is for IR formulation.

One disadvantage is that because of all the cns activity it produces after ingestion too high doses send human brain into some state of neurologic overload resulting at epileptic seizures.
But responsible doses or doses higher than usual but complimented with anticonvulsant agents make tramadol absolutely unique painkiller, antidepressant, pro-social medication.

 

[RUC4]

I feel like nobody pointed out though, that dependence and addiction are NOT THE SAME THING.
Addiction is defined medically as "continuing to use something despite it causing harm to your life".
Dependence is defined as needing a medication to physically function & stay out of withdrawal.

super great point. they go hand in hand.

 

[DeathIndustrial88]

I agree with you on everything u wrote, i didn't mention NMDA antagonism and TAAR1 agonism cause i wantet to make it sound more simple but i definitelly enjoy tramadol more than oxy, more than morphine, i know it's cause of my ultrarapid cyp2d6 metabolism (mostly) but for me tramadol is like hybrid of opioid and amphetamine.

Most of antidepressant effects are produced by it's active full mu opioid receptor agonist metabolite - i agree. The snri and sra effects of tramadol ( as a complex of its enantiomers and metabolites ) are mostly boosting effects of tramadol for supressing neuropathic pain. One may say it is also reason for it's stimulating effects but i experienced a lot of stimulation on hydromirphone too and if I am right hydromorphone doesn't cause serotonine release and snri effects.

So, for some people with right metabolism and pain caused partly by nerve damage, tramadol is definitelly much more than weak opioid. It is multimodal painkiller with monoaminergic, nmda antagonistic properties metabolised into medium potency opioid ( M1 ) with half-life of almost 9 hours and that is for IR formulation.

One disadvantage is that because of all the cns activity it produces after ingestion too high doses send human brain into some state of neurologic overload resulting at epileptic seizures.
But responsible doses or doses higher than usual but complimented with anticonvulsant agents make tramadol absolutely unique painkiller, antidepressant, pro-social medication.

Probably the best description of tramadol that I've read!
It gets a lot of flack because it's low potency, but a lot of people mistake stronger potency for better effects. And while that can be true in some cases, it's not in every case. Fentanyl is more potent than heroin, but most people would prefer heroin because it feels a lot different than fent.

So sure, tramadol is pretty "weak", but if you have low to no tolerance, tramadol in the right dosage can bring effects that are much more rounded & enjoyable or even comparable to other opioids.

If you're use to more potent opioids like heroin or fent, then yeah tramadol will barely keep you out of withdrawal.
But for those with no to low tolerance, it can be life-changing, as long as you have access.

I agree too that the stimulating feeling has a lot more to do with it's opioid effect + all the other effects complimenting & boosting that effect. Because various other opioids can also stimulate me as well. Buprenorphine (with no tolerance) can feel stimulating. Heroin use to be stimulating for me (once walked 7 miles home after doing some cause I didn't wanna spend the night at some one's apartment lol). So opioids themselves can be stimulating. And for those who don't know what I mean by "stimulating", I don't necessarily mean the jittery, anxious type of stimulation you think of from classical stimulants. But more of this "natural energy" type of feeling that suddenly makes you want to get up & get stuff done that you would normally put off. I find this effect more prominent on tramadol versus something like hydrocodone or codeine.

I think histamine release also plays a role in stimulation. Because histamine release also causes dopamine reuptake inhibition (or at least this is how Modafinil works). So, despite google saying tramadol has zero histamine release, I know for a fact that it does, because I use to rub my nose red on it & scratch my body til I had claw marks all over it. I never get this effect from stuff like buprenorphine (which ends up becoming super sedating in the long-term). I would imagine it helps people stay awake & more focused (since these are the desired effects of the drug Modafinil, which works through histamine receptors to boost dopamine). But this is just conjecture on my part.

But you're right, taken responsibly & under the max daily dosage, tramadol can offer a lot of people pain & depression relief.

I honestly see nothing wrong with using tramadol ( or opioids in general) for depression. The only issue is making sure you'll have long-term access to it, otherwise you'll be in a world of hurt & your depression is gonna comeback 10 fold.

Stacking your doses helps convert it to the desired metabolite as well. So rather than taking your dose all at once, if you spread it out over an hour or two, you will metabolize more of the full agonist metabolite than if you had taken them all at once. This also helps prevent some of the more CNS overload & negative effects.