DOSE:

repeated

Pharms - Tramadol

(daily)

BODY WEIGHT:

145 lb

I want to preface this by pointing out that my experience with this substance was very different from most. I ran into side effects that I had never even considered a possibility until they were too strong to deny. I'm sharing this because my experience was so unusual and despite hours of research into the subject, I didn't understand the risks I was taking until I was already facing the consequences. Hopefully my mistakes can be heard by somebody in a similar situation, because if had known what I do now I could have saved myself a world of hurt.

No other substances have ever, and hopefully will ever, have the hold that Tramadol had on me. It provided, at least in my case, worse consequences than any other substance I have ever used, worse than years of daily pot smoking, worse than a few years of on and off opiate addiction, worse than the benzo habit that peaked at 30mg Etizolam in one sitting, and far worse than anything the infrequent use of psychedelics, disassociates, and hard-stimulants caused me. This was a different beast entirely. It had a profound effect on my mental state and judgement, and I'm going to be dealing with the consequences of my actions, both socially and professionally, for quite some time. I am not blaming all of my hardships on this drug, I certainly was at fault and there were a lot of other contributing factors at that point in my life, but I have no doubt that Tramadol catalyzed a lot behavior that was seriously out of character for me.

I had one early brush with tramadol about a year before shit hit the fan. I ate maybe 25mg-50mg (the dust left after a friends failed insufflation attempt), on top of weed and kava kava at a 4/20 celebration. I barely noticed an effect. I still fantasize about how things would have turned out if I then developed the disdain for that molecule that I have now.

By the time I was exposed to tramadol again the focus of my drug use had transitioned almost entirely to self-medication. I was 18, and had been dealing with chronic headaches of gradually increasing frequency and intensity for 6 years. Everyday for 4 years and near constant for about 2 prior to this. They wax and wane in intensity, but I'm almost never free from pain without chemical assistance.

I was getting close to being a month clean from a sizable kratom habit when Tramadol re-entered my life. Like most of my worst habits, it started with a visit to the doctors. I got a concussion and the doc gave me a script. I filled it, got the refill cast it aside, and went back the next day saying I had a bad interaction (the foreshadowing here is painful to think about) and needed another med. I got a bottle of Vicodin and Tramadol didn't cross my mind again until I was all out. My use started a month after the concussion and was near constant for about 5 months following. In that time I developed a near endless supply between a friend who imported it, and the prescription I was given for my chronic pain.

I fell in love with it almost immediately. The cross of stimulation and painkilling effects was exactly what I liked about the kratom and with Tramadol's duration if fit so easily into my life. Besides that it had a fairly euphoric almost MDMA like serotogenic effect. Nobody I shared it with ever experienced anywhere near the euphoria I did, rather than taking this as the red flag it was I rationalized the extra pleasure as a result of the reduced pain rather than a pharmacological effect. This was the first of series of bad rationalizations that hid the true nature of the problem. I developed a dosing strategy that maximized my benefits and stuck with it throughout. I would take 25mg doses at half-hour intervals to promote metabolization into the more potent opioid and weaker SNRI o-desmethyltramadol, and take them until I hit my intended dose. I averaged 200-300mgs a day never crossing but occasionally reaching the recommended maximum of 400mg daily. In this period I was also taking prescribed benzodiazepines irregularly, and smoking just as much pot as always.

For awhile it was great. I was in the least pain I had felt in years, I was a fully functional individual for the first time since the headaches had taken over my life. Things were looking very positive, I caught up in school, got back into regular fitness, and ever got a girlfriend. When I took breaks I was hit with the worst withdrawal and physical dependency I had ever known, but at the moment I was fine because running out wasn't a possibility. All the unpleasant effects of the drug were disguised by the analgesia and euphoria, and I happily ignored them until tolerance to the positive effects no longer allowed me to. I was never in denial about the fact that it was an addiction, but I never dreamed that the drug was having such a drastic effect on my personality as it did.

I was a completely different individual from my old self. My quiet, introverted, and thoughtful demeanor faded away and was replaced with what feels to me like a completely separate personality. The person I had become was alien to me. I ran off impulse alone, never any thought before action. I bought and said quite a few things that I wish I could return. I was unnecessarily social. I wanted to interact with everyone, and this led me back to a lot of bad influences I had previously cut out of my life. For the first time in my life I truly felt a strong need for others attention, when prior I was a happy hermit who thrived off solitude, and only ever felt truly comfortable alone. All of a sudden I hated the solitude I worked so hard to preserve. This 180* turn led to some pretty sad attention seeking behavior, nothing that unusual for someone else but it's all cringey to me. My emotional tide was more turbulent than I'd ever experienced often without appropriate evocation. My emotions were so intense they bordered on hyperbole. Some days I felt so good it was like constant roll, others I felt soul crushingly depressed. My anger was irrational, I hated so completely and without reason. It only was thanks the intervention of some real friends that a lot of situations didn't devolve into violence.

Unfortunately I had nobody to hold me back in romantic endeavors. I pledged my complete and unconditional love to someone who did not deserve it. My delusional thought process made excuses for everything, lies, sexual deviancy, emotional manipulation, self-mutilation, amphetamine abuse, and ultimately infidelity. Up until the very end everything was so exciting I didn't care. Every single day off the tramadol I wanted nothing more than to leave and never look back, but I always rationalized that as a product of withdrawal rather than proper judgement, so I never acted on it. When things got really bad I just never stopped taking it. In the end all we had were complementing forms of instability and dissatisfaction with life. She decided it was over without telling me, strung me along for awhile as she slept around, and finally the delusions faded when she wound up institutionalized. She was 70lbs of bad intentions, the personification of most of the negative traits tramadol brought out in me, and the epitome of the mistakes I made under the influence. Now all we have of each-other are corresponding scars. This however managed to be the wake-up call I needed to quit the trams, and at the very least taught me a great deal about myself.

When I detoxed I knew I couldn't handle it cold turkey so I tapered my dose to 1/6 of what it was, switched to Vicodin to ride out the withdrawal of the non-opioid effects for a week, and then stopped altogether. Traditional opiate withdrawal, at equivalent analgesic dosages, has always been significantly more tolerable than tramadol withdrawal to me.

The culprit was hidden by Tramadol's wide array of pharmacological mechanisms. What ultimately brought me down was Tramadol's token 'anti-abuse' SNRI effects. The irony of the very function designed to keep me safer causing more hardship is not lost on me. In a small subset of people, myself included, SNRI's produce unwanted effects, hypomania, euphoria, anxiety, irrational thinking and behavior, and obsessive tendencies. Pronounced euphoria from SNRIs was the most prominent sign I got that I should not be taking them. The easiest way to describe it in retrospect is that it was like a brief brush with insanity. I lost my mind and became someone I'm not for a time. To verify that the SNRI action was responsible for my symptoms I decided to try a single dose of a pure SNRI. My doctors have been giving me them for awhile as a blanket headache prophylactic, but between initial concerns of side effects (guess my gut was right), and not wanting an interaction with tramadol I never bothered with them before.

I selected 30mg Duloxetine from the half dozen full unopened bottles, as my doctor seemed to prefer that over the alternatives. I made the mistake of giving it a try just over the hump of hydrocodone withdrawals, thinking it might ease the longer effects of tramadol withdrawal, and brought me to a state so unpleasant that I was wishing for the familiarity and predictability of opiate withdrawals. This triggered the most severe manic state I'd ever experienced, along with fairly unpleasant physical side effects. It was the same negative reaction I had to tramadol, just about twice as strong and lasted almost 2 days. I was painfully overstimulated, I didn't sleep until the 3rd night after this happened despite 10mg Etizolam on the 2nd. I had a breakdown on social media, lots of disorganized meaningless posts, harassed the ex, flushed the anti-depressants, gave away the tramadol, bought some Etizolam, 5-meo-mipt, and ethyphenidate to celebrate 'loose sobriety', and then it was over. The monkey was off my back, I was turning back to my normal self, and hopefully I learned what I need to never let that happen again.

I never tried just an SSRI to see whether the serotogenic effects were responsible, without the adrenic effects, but making assumptions based on stimulant use would suggest that would be the case. I guess the obvious conclusions are drugs effect different people in drastically different ways, just because a side effect is rare does not mean your immune, the most serious side effects are often hard to perceive at first, there's no substitute for real friends, and never trust any single individual blindly, be it a doctor, loved one, or yourself.

Hopefully this finds someone who finds it useful, or at least entertaining. This is just the tip of the iceberg of my tramadol stories, but I've rambled for too long enough about my boring life. I spent 6 more hours writing this than intended, and I'm about crash from ethylphenidate. Have fun, and stay safe out there!

Exp Year: 2014	ExpID: 103667
Gender: Male
Age at time of experience: 19
Published: Feb 3, 2017	Views: 8,280
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Pharms - Tramadol (149) : Combinations (3), Addiction & Habituation (10), Retrospective / Summary (11), Various (28)