US_DR_JD replied: "There is controversy over whether or not Tramadol is addictive or not. But my experience and now some studies are showing significant issues with withdrawal from the medication. The benefit is that Tramadol has a short half-life, so the withdrawal period, while uncomfortable, is much shorter than many opiates. Key medical problems are blood pressure and the possibility of seizures. While there is little that can be done about the seizure potential except to observe, it is good to understand that Tramadol is known to lower the seizure threshold in those prone to seizures. The other issue is blood pressure. Elevations in blood pressure could lead to cardiac issues and stroke. The blood pressure should be monitored during the withdrawal period and the patient taken to the A&E if it becomes significantly elevated. If your physician is available, he/she may be willing to monitor and prescribe a low dose antihypertensive during this period. Nausea and vomiting are not uncommon, and medications for this are helpful. Tapering usually is somewhat effective with Tramadol as it has a shorter half life, so decreasing to 50mg/day prior to stopping may help with withdrawal issues. However, the physician has probably stopped prescribing the medication due to overuse, and would be unlikely to try a taper. Tramadol is never meant to be taken every 3 hours, and when a patient is taking it on this schedule, it is usually by their own choice, and not following the precription. The following nutritional guidance may be helpful during the withdrawal period. Oral nutrition: Increase the right proteins!!!! Proteins are the building blocks for neurotransmitters and neurotransmitter receptorsas well as the building blocks for your natural opiate receptors For 3 weeks you must remove all red meats from your diet. Red meat has chemical components that increase inflammation and pain. Fish, chicken, eggs are good sources of protein. If you are having a hard time taking in solid foods go to a health food store and buy protein powders that can be made into smoothies or drinks. You absolutely must have increased protein intakeproteins are the building blocks for all enzymes, neurotransmitters, and enzyme receptors in the body. No chemical works in the body without receptors. Just like opioids have to have opioid receptors. L-Methioninea sulfur bearing amino acidnecessary for the production of S-Adenosyl-methionine (SAM-e)SAM-e is a necessary cofactor in the production of the master neurotransmittersserotonin, dopamine, adrenalin, and nor-adrenalinthis must be added to any amino acid therapy directed at rebuilding neurotransmitter production and function500 mgtwo twice per day Increase your intake of raw fruits and vegetablesyou get little or nothing from canned foodsfresh fruits and veggies are loaded with fiber which help bind and remove toxins from your bodythey also normalize gut function Stay off candy, and other sugar heavy foods Drink lots of good water, green teas are good for the antioxidants and anti-inflammatory propertiesno cokes or soda waters for three weeks When capable you must start exercisingswimming is best because it is low impact exerciseyogatai chiwalking dailydetoxing or otherwiseexercise is a normal component of good health. Supplements: Some need less and some moreremember the efficacy of all nutrition and supplement use is ultimately guided by your geneticsand we are all different to some degree Multivitamin with a strong mineral component: in gel caps onlyan excellent quality multivitamin is absolutely necessaryremember that vitamins and minerals are cofactors/coenzymes for repair, healing, and normal function of the bodymost times I have patients double up on multivitamins for the first 3-4 weeks Mineral complex: see above Fish oils, or flax seed oil.: necessary for repair and proper function of cellular membranesanti-inflammatorythese need to be mixed omega 3, omega 6, omega 9 oils4000 to 6000 mg per day in split dosesalthough some can be purchased as liquids and mixed with your smoothies. If you dont do the drinksget proteins as free amino acidsdouble up L-Glutamine 500mg capsat least 2000-3000 mg per daysplit the dose so that your doing it at least twice per dayhelps heal the gut and the building block for GABAthe primary inhibitory neurotransmitterhelps slow things downDo not take GABA as a supplementGABA is make in the brainwhen out side the brain the molecule is to large to cross the blood brain barrierthe building block for GABA is L-Glutamine or Glutamic acidthese building blocks readily cross the blood brain barrier. Valarian Root 450 mg: Botanical that reduces anxiety and helps one to sleepKava, Jamaican Dog Wood, Lemon Balm, Avena are all nervine botanicals which can be used together or by selfI find the doses for each individual varies but typically 1000 to 1500 mg every 4 hours. Melatonindosages varythis is a hormone released from the pinal gland in the human body at night time for sleepthis is essential for those coming off opioidsin my experience as little as 1 mg to 30 mg has been effectivedo what you have to doIve had addicts coming off $100.00 a day habits sleep 4 hours the first nightstart low and add 3-5 mg every half-hour till sleepresearch on healthy volunteers using up to 100 mg of melatonin in a single dose shows little side effectsMelatonin is also known as a very strong antioxidant with 1000 times the potency as Vit ETake only at night when you would be going to bed at the regular timethe room must be darkthats the way this hormone is released in the natural state Full Spectrum antioxidants: relieves inflammation and helps normalize inflammatory pathways and reduces damaging molecules (free radicals) present in the system while detoxing Vitamin C: 2000-3000 mg per day divided doses Reduced L-Glutathione 300mg per day: Helps liver detox metabolites of methadoneDetoxing agents can be found in many productsmost in combinations Adrenal Support: Research has shown that methadone, and drug use in general, has profound effects on the adrenal glands. In fact, research shows that there is a profound negative effect by opiates on the hypothalamic-pituitary-adrenal axis. This is why those that withdraw from opiates have protracted fatigue and problems with anxiety and insomnia. I often use freeze dried adrenal extracts in treatment with fairly good results. Youll find these products listed under names such as Adrenal Plus, or Adrenplusthe starting dose is around 1000 mg per day in split doses. Milk Thistle with alpha-Lipoic Acid is one combination that I use extensively---for liver repair and detoxification1200 to 1500 mg of milk thistle and 400 mg of lipoic acid per day in split doses This is the basics. There is absolutely no way to eliminate all the problems associated with withdrawal from opiates...one must have a supportive environment and sometimes with daily visits from a compassionate health care providerThis will not kill youit will be a miserable event In fact, cold turkey deaths coming off opioids are rare and usually associated with other health problems, or overdosing on pre ion medicationswithdrawal from opioids is much less of a risk than total withdrawal from alcohol. I wish you all luck on this endeavorMy compassion and empathy goes out to youUltimately, I know that he can do thisafter allit has to be done"