DOSE:

oral

Pharms - Tramadol

(pill / tablet)

BODY WEIGHT:

155 lb

Tramadol Part 2: Moderate Use Over 3 Months

Introduction

Given a large supply acquired in Southeast Asia during Chinese New Year, I returned to my teaching job in Taiwan. For about three months, I intermittently used 50-250 mg Tramadol. I used it 1-5 times a week. I occasionally mixed this with benzodiazepines (10mg Diazepam/0.5mg Lorazepam/0.5mg Clonazepam). Depending on the dose and current level of use, I experienced “mild” to “strong” subjective highs (where a “strong” high would be like that described in my ‘Tramadol Part 1’ account).

Dosages and Mindset

Over time, I could function quite well on 50-100mg, and I found little trouble in reading, studying Chinese, driving my scooter, and other regular tasks on these ‘lower’ doses. I was even able to effectively teach my class on these smaller doses, though I would definitely not suggest one do this. I am accustomed to opioid drugs, and I was comfortable and well-organized in my workplace, so being “high” and teaching really didn’t change my performance as a teacher – this applies to me of course, and I’m sure one should use their own judgment before doing this. On doses >100mg, I was much “higher”, and while I could still hold a coherent conversation, I would not have trusted myself to teach, drive, or retain my Chinese study notes as well.

This was all perhaps on a sliding scale – while I’ve heard Tramadol is less habit-forming and less tolerance-producing, I disagreed at this point already (and would really disagree later if you read ‘Tramadol Part 3’). I found tolerance developed rather quickly. If it was a ‘busy’ week in terms of my intake, I found 50-100mg did not have the same effect by day 4 as it had on day 1. Unlike Codeine, tolerance developed with the Tramadol quite quickly. At the same time, this tolerance disappeared just as quickly with a day or two of abstinence.

My mindset may also have had to do with the subjective high from one experience to another. On smaller doses, I was usually going to work, going to class, etc., things that required my to be more mentally alert. My intentions in these cases were to just bring a mellowness to an otherwise busy and potentially stressful day. When using larger doses on the other hand, my intentions were more specifically to “get high”. On these occasions I was more in the mindset to just ‘be high’ and enjoy myself. It was also on these latter occasions that I may have added benzodiazepines to the experience, which would have added to the sedation and ‘nod-outs’.

Some Specifics

Onset: I found the onset of action often varied from 15 minutes up to nearly two hours at times. I never figured out why this happened. It was not due to food – through repeated use, the natural experiment set itself up where I might take Tramadol on an empty stomach one day, and after a meal on another day. The variance in onset was erratic and didn’t conform to my diet (high carb/high protein/no food). It is possible, I figure, that the variance might have been due to different bioavailabilities of different brands of the Tramadol. I had acquired them from numerous pharmacies around Cambodia and Thailand and I noted more than ten different generic names to the capsules (however – all were small half-green half-yellow capsules, except for some white tablets that a friend acquired for me in Viet Nam). Given different manufacturing companies, it is possible that different capsule solubility and/or gastrointestinal absorption of the drug caused this difference. (This difference in bioavailability for generic Tramadol wouldn’t fly in North America, but I don’t know anything about pharmaceutical regulations in second and third world nations).

On occasion, I experienced a “rushing” sensation during Tramadol’s onset, an effect others have mentioned. Again, I couldn’t figure out why this occurred on some experiences but not others. If I recall correctly, however, this effect never occurred when I mixed Tramadol with a benzodiazepine.

Duration: I can’t give a specific number, but I would definitely say that Tramadol is one of the longer-lasting of the opioids (and I have taken many kinds). The plateau lasted several hours, which made the drug quite appealing. Even in times of addiction, that feeling of ‘needing the next dose’ was sometimes not felt for at least 10 hours. (In comparison, when dependent on Codeine, I might “feel the need” for a subsequent dose after only four hours). Given this effect and my experiences, I would imagine that the ‘offset’ of the drug is fairly slow and gradual.

Analgesia: Tramadol was quite efficient as a painkiller. I originally got into opioids due to pressure headaches from a faulty Eustachian tube. Tramadol did the trick in relieving the painful pressure headaches I frequently get due to this. While effective in relieving other aches and pains, one should probably not take Tramadol (nor other opioids) as it only relieves pain, but does not help to cure the problem, such as an anti-inflammatory agent might.

Constipation: I was happy that Tramadol did not produce as much constipation as other opioids. With moderate, intermittent use, constipation was not a problem at all. With higher doses on a regular basis, some constipation occurred, but this was still less severe than other opioids.

(Lack of) Hangover: Tramadol never produced any lingering problems the next day. No hangover was experienced with low-moderately high doses (which I would consider 50-250mg). An exception: At very high doses (>250mg) taken in periods of zero tolerance (i.e. I had not consumed any Tramadol for at least two weeks), nausea and an alcohol-like hangover headache occurred which diminished after violent vomiting.

Urination: I had not heard of this effect until it happened to me – when on high doses, urination can become very difficult. The urge to urinate is still felt, however when actually trying to pee, it seems nearly impossible. And even once I get the flow going, it may suddenly stop, and I have more difficulty trying to get it going again. It is as though the bladder muscles are paralyzed in a contracted state, and it can make a simple urination session last more than 5 minutes.

Respiratory Depression: Like most opioids, Tramadol depresses one’s respiration. This never seemed troublesome while on Tramadol. My mind was never preoccupied with this effect, the way it might be with larger doses of Oxycodone. The only time it became an issue was on large doses while trying to go to sleep. At these points, bouts of apnea occurred which occasionally would jolt me awake, and make getting to sleep difficult. This only happened at night on doses >250mg.

Last Words

Tramadol has always been a pleasurable experience in low to moderately high doses. The negative side effects are lesser in comparison to other opioids, but they do exist in higher doses. Tolerance developed and subsided quickly. Dependence did not occur to any strong degree, and it was fairly easy to take Tramadol for five days in a row, and then stop for several days (even when tolerance had occurred). This does not mean the drug would not produce strong dependence if consumed daily for a long period of time. The experiences above were intermittent over several months and dependence was never an issue for those experiences. Read on to ‘Tramadol Part 3’ to see what happened when larger quantities were consumed for a long time...

Exp Year: 2003	ExpID: 40105
Gender: Male
Age at time of experience: Not Given
Published: Mar 8, 2005	Views: 68,706
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Pharms - Tramadol (149) : Various (28), Retrospective / Summary (11)