Tramadol (Tramal) as a drug: signs of use, addiction, effect and consequences of use

History of appearance and use in medicine

Tramal and tramadol appeared in the early 60s. XX century. In 1962, the pharmaceutical company Grünenthal developed the drug Tramadol. Due to little research, it was difficult to find a safe dose of the drug. This led to frequent overdoses and the fact that the narcotic effect when taken became noticeable.

Sales of the drug increased many times, and during the “epidemic” about 350 million people died from overdose. In the early 60s, up to 25 thousand ambulance visits were recorded every day, but less than a third of the patients were able to be helped. Today, tramadol and tramal claim the lives of 10-15 people every minute. There are more than 120 million people addicted to it around the world.

Now the drug is produced and sold under strict government control. Each country independently decides whether tramadol is a drug or not:

Russia has not included the drug in the list of narcotic drugs, but limits its circulation: in the Russian Federation, tramadol is a medicine that is prescribed according to a special prescription;
Ukraine, Belarus, Uzbekistan have officially defined: tramadol is a drug, prohibiting its free circulation;
Sweden and some other countries sell tramadol or tramal under standard medical prescriptions.

Storage conditions, expiration date and release from pharmacies

The drug is released strictly according to prescription. Purchasing without a prescription or using counterfeit prescriptions is punishable by law.

Storage conditions: at temperatures up to 20 degrees, in a dry and dark place. It is advisable not to remove the ampoules from the packaging. Keep away from children.

Shelf life – 2 years.

Reviews about the medication

Olga, 56 years old: “I used an analgesic in the form of an injection solution during treatment for cancer. The effect was sufficient already at a dose of 300 mg, although doctors said that for cancer it is possible to exceed even 400 mg. The pain went away almost immediately, but, unfortunately, returned after about 6 hours. Then we had to inject again. In general, the injection process is simple; you can simply inject the substance under the skin. I had experience with injections, so the process of pain relief did not seem difficult to me.”
Oleg, 30 years old: “I was prescribed Tramadol after a severe injury – a displaced fracture, which was accompanied by constant pain. Other analgesics did not help, and although I did not want to use narcotic medications, I was prescribed Tramadol. In the hospital they gave injections into the area of the fracture, and after discharge I continued to use the capsules for some time. The dosage was only 50 mg, which was enough to completely overcome the pain. My course of therapy was short-lived, so there was no addiction. But while using the drug, I sometimes suffered from short-term migraines.”
Anastasia, 45 years old: “I was given Tramadol as injections only twice, during surgery. Other analgesics were not used due to allergies to them, in particular to novocaine. Tramadol numbed the area well and slightly reduced my overall sensitivity to pain, but after the operation I still suffered from nausea and vomiting for several hours. Although this is a normal reaction of my body to various new drugs, so I don’t know if this can be attributed to the shortcomings of the medication itself.”
Alexey, 26 years old: “An analgesic was used during the biopsy, other painkillers were not effective. I didn't notice any side effects. There was almost no pain, except that I continued to feel pressure.”

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Composition, mechanism of action and effect

So, tramadol - what is it? The drug is a synthesized opiate. Tramal is often used as a substitute for heroin. Addiction and overdose of the drug in terms of negative effects are comparable to opium, so the question “is tramadol a drug or not” has to be answered in the affirmative. An exception is when taking the drug exactly as prescribed (for example, in palliative care).

What is the difference between Tramal and Tramadol and what is the difference between their release forms? They have a common key active ingredient, but specific components are used for each of the commercial drugs. Sodium acetate is added to the injection solution, milk sugar and magnesium stearate are added to capsules, and so on. Without a thorough analysis of the patient’s condition and characteristics, the doctor will not be able to determine what to use, Tramal or Tramadol - which is better, specialists decide individually.

The mechanism of action of the drugs is similar. The active substance, when released into the systemic circulation, acts as an analgesic, blocking the transmission of pain impulses. The patient feels better within 20 minutes after taking the medicine in the form of tablets/capsules. Patients taking both Tramal and Tramadol feel relief - the difference between the mechanism of action is almost invisible. The drugs affect the central nervous system, causing: if the dosage is exceeded:

inhibition of reactions;
the appearance of hallucinations;
increased heart rate;
dizziness and so on.

Use while driving

It is not recommended to use the drug if the patient is about to drive or will soon perform life-threatening activities (interact with cutting machines in factories, etc.). During the period of use of the medication, it is recommended to take sick leave, abandon mental professional activities and hard work requiring fine motor skills and attention.

When using the medication, the following decreases:

speed reaction;
level of concentration;
coordination of movements;
fine hand motor skills.

Therefore, it is also not recommended to travel on any transport where independent control is necessary (this applies not only to cars, but also to bicycles, mopeds, etc. types of transport).

How tramadol is used by drug addicts - the narcotic effect and addiction to tramadol

As a drug, tramal is usually tablets and capsules. Injection solutions are used mainly for the production of a concentrated drug in liquid form in artisanal conditions. Drug addicts feel the effect within 1-5 minutes after taking it. The euphoric state, similar to the effect of ecstasy, lasts up to 36 hours. It is accompanied by unnatural emotional sensitivity, empathy and sympathy for all people, a surge of strength and relaxedness. Both tramadol and tramal have an effect - it doesn’t matter what the difference between the drugs is from the point of view of drug addicts. The punishment for them is much lighter than for “traditional” drugs.

Tramadol addiction - what is it? The mechanism “starts” one or two days after taking a “non-therapeutic” dose of the drug (7-8 capsules), when its effect wears off. A person suffers from nightmares and is afraid to be alone. He begins to hallucinate, which forces him to take another dose. As you get used to it, the duration of action of the drug decreases, and paranoid and manic states take the place of euphoria. That's what tramal is, and the psychological effect is not its only side effect.

Pharmacokinetics

The substance is absorbed by cellular tissues by 90%. Of the absorbed tramadol hydrochloride, only 68% is absorbed. With constant use of the drug, the body begins to better perceive the drug and absorb large doses of the substance.

The medication penetrates the placental barrier and affects the embryo, so use during pregnancy is carried out with extreme caution. The active substance also reaches 0.1% into the breast milk of nursing mothers.

At the end of the journey, the substance is excreted by the kidneys, about 35% of tramadol hydrochloride is removed unchanged from its original form.

In general, the analgesic effect lasts no more than 4-8 hours, after which a repeated injection of the drug is required.

Signs of use and consequences

At a therapeutic dosage, tramadol may not cause physical or psychological dependence, but it develops even when the indications are slightly exceeded. If the drug is used for more than three months in a row, it becomes the only drug taken. Canceling it is difficult - it takes up to 15 years to overcome psychological cravings; decay products are eliminated within 20-25 years.

Tramal or tramadol - which destroys the body more? The negative effects of the drugs are identical. Such powerful analgesics as Tramal and Tramadol also have significant side effects during withdrawal. These are dark and realistic hallucinations, mental disorders (hysterics, depression, aggressiveness). The body of a person taking tramadol also suffers: photos of patients in severe stages demonstrate the consequences of addiction. This is exhaustion due to lack of appetite, pale skin with a bullous rash, clouded eyes, dilated pupils, and so on.

Signs that “give out” a person who uses tramal - what are they? The dependence manifests itself as follows:

reluctance to communicate with loved ones, deceit and indifference;
disturbance of sleep and usual level of activity;
excessive gesticulation, unsteady gait;
sudden mood changes;
intense headaches, fainting, hair loss and so on.

Analogues of the drug

The drug can be changed to similar narcotic analgesics. The use of non-narcotic painkillers for severe pain is not justified.

Possible analogues:

Tramal;
Protradon;
Sintradon;
Tramolin;
Tramundin retard;
Tramolin retard.

Tramadol can be replaced with analogues only with the permission of a doctor.

You can also use different forms of the drug:

capsules;
pills;
solution for internal use.

If it is inconvenient to make constant injections, you can replace the release form with one of the above. But to do this, you need to visit the doctor again and ask for a prescription, otherwise the drug will not be sold even if you have a prescription for the purchase of ampoules.

When changing the release form of the drug, you need to take into account that the degree of absorption of different versions of the drug is different. Therefore, the dosage is slightly different. The doctor will make any necessary changes to the prescription.

How to get rid of addiction

Psychological problems caused by the fact that a person takes Tramal, side effects and the complete destruction of the body that threatens in the future force one to look for ways to get rid of addiction. But in practice, three quarters of patients continue to take tramadol after hospital treatment - they don’t know how to quit.

The Narconon program, unlike traditional drug courses, does not involve the use of replacement medications. This is a step-by-step procedure, the effect of which is achieved after 8-10 weeks. It includes unique step-by-step techniques for overcoming addiction:

non-drug weaning - specialists are constantly next to the patient, monitoring his condition and using physical assistive techniques to reduce pain;
“New Life” - reducing physical cravings for drugs through running, sauna, taking vitamin-mineral complexes with niacin and precise doses of nutrients;
“Objective Processes”, “Overcoming the Ups and Downs of Life” - restoration of social skills and the ability to clearly see the world around you;
“Personal values” and “Changing states in life” - taking responsibility for one’s actions, accepting the past in order to be able to move forward.

The final part of the program is “Life Skills”. These are classes to achieve long-term results, necessary in order not to return to drugs and start a full life again.

Are medications drugs?

Ritalin (methylphenidate)

Tramal retard, tablets

The doctor prescribes the dose depending on the patient’s individual sensitivity to the components of the drug and the severity of the pain symptom. Tablets of 100 mg are taken 2 times a day, one in the morning and in the evening. If the pain does not go away, then the dose can be exceeded by taking a 150-200 mg tablet; the interval between doses of medication should not be less than 6 hours. The maximum dose that can be consumed per day is 400 mg. The tablets do not need to be chewed; they are taken with a sufficient amount of water. The interval between taking tablets should be increased in elderly people and people with kidney and liver disease.

For pregnant and lactating women, the drug can be prescribed once only if it is vitally necessary.

Pharmacological interaction:

Potentiates the effect of central nervous system depressants (tranquilizers, sedatives and hypnotics, alcohol). Inducers of microsomal oxidation, including carbamazepine and barbiturates, reduce the duration of the analgesic effect and the duration of action. Long-term use of opioid analgesics or barbiturates stimulates the development of cross-tolerance. Anxiolytics increase the severity of the analgesic effect.

Naloxone activates respiration, eliminating analgesia after the use of opioid analgesics. MAO inhibitors, furazolidone, procarbazine, and antipsychotics increase the risk of developing seizures. Quinidine increases the plasma concentration of tramadol and reduces the concentration of M1 due to competitive inhibition of coenzyme CYP2D6.

Information sources:

“Register of Medicines of Russia: Encyclopedia of Medicines” 12th ed., M.: LLC RLS-2005, 2004 pp. 867-871

“Register of Medicines of Russia: Encyclopedia of Medicines” 8th ed., M., 2001

Toxicological Bulletin No. 3 2004 p. 40

Alf. index: 1-9 AZ

Contraindications

conditions accompanied by respiratory depression or severe depression of the central nervous system (poisoning with opioid analgesics, hypnotics and psychotropic drugs, alcohol);
severe renal and/or liver failure;
as a drug for the treatment of withdrawal symptoms resulting from the use of opioids;
tendency to abuse substances;
suicidal tendencies;
epilepsy that cannot be adequately controlled with medication;
simultaneous use of MAO inhibitors (monoamine oxidase) and 2 weeks after their discontinuation;
children under 1 year of age - for oral drops, up to 14 years - for other dosage forms;
pregnancy and lactation (except in vital cases);
hypersensitivity to any component of the drug or other opioids.

Tramadol is used with caution and under strict medical supervision in the following cases:

impaired renal and/or liver function;
disturbances of consciousness of various origins;
traumatic brain injuries;
increased intracranial pressure;
epilepsy;
convulsions;
drug addiction to opioids;
pain in the abdominal cavity of unknown origin (the so-called acute abdomen);
tendency to form dependence (alcoholism, drug or drug addiction);
simultaneous use of tricyclic antidepressants, selective serotonin reuptake inhibitors (some antidepressants and appetite suppressants), other tricyclic compounds, anti-migraine drugs (triptans), narcotic analgesics, antipsychotics and other drugs that reduce the threshold of convulsive activity.