Hi, I've used tramadol on and off for the last five years for osteoarthritis in my lower vertebrae and left hip. I don't take any more than 200mg per day, slow release. I also try to intersperse my daily intake with 2 - 3 days per week with no tramadol at all, this helps with:
1. Constipation
2. Tolerance
3. Withdrawal
4. Sexual arousal
5. Sleep
Withdrawal from tramadol on even modest to low dosages (when taken everyday) is not pleasant. in my experience tolerance develops quickly. Constipation is a common and undesired side effect, to minimise constipation, drink plenty of water, apple and/or pineapple juice, 2 fish oil tablets per day, nuts, dried prunes, 2 cups of coffee per day and whole grain foods such as seeded bread, oats, bran, brown rice etc. There are over the counter drinks you can purchase at pharmacies and you can buy slippery elm powder from most health shops (mix with water). A good walk can also get things going.
I have found tramadol effects to be interesting, my pain is dulled, sexual arousal is numbed, however i find it acts as a stimulant for me (I get a lot of housework and gardening done after I take a 100 mg dose). It tends to suppress my appetite a little. I find it keeps me awake or in a light, surface sleep, and when its like this I feel relaxed, calm, peaceful (usually when not on tramadol and if I can't sleep I start feeling agitated and annoyed). I don't usually take tramadol at night e.g., I'll have one in the morning and if needed I'll have another100mg mid afternoon, but not later if I want to avoid losing sleep. It can diminish feelings of grievance and annoyance, in fact it can provide a sense of mental space and objective detachment from things, issues or people that might be driving you nuts.
I also use tramadol in conjunction with marijuana to help manage pain, there are no negative interactions whatsoever (in my experience), I smoke 2 joints per day in the evening to help with sleep and pain and have done so for 20+ years. I don't experience any nausea on tramadol, however would recommend marijuana for its excellent anti nausea effect, plus it is non toxic, however its not for everyone and there are over the counter anti nausea tablets, including health remedies such as ginger that may help. I don't drink much alcohol generally, I'll have 2-5 drinks over the course of a weekend e.g., Friday/Saturday, I don't drink through the week and think 2-3 standard drinks on lower doses (no more than 100mg per day) would be okay. I wouldn't advocate more than this however. I'm female, 45, average height & weight so please take this into account when thinking about your own intake. I don't use any other drugs at all. I find tramadol very useful, however you need to find the right balance to avoid the negative side effects. ��