Tramadol May Reduce Opioid Withdrawal Symptoms

A new clinical trial that explored the use of tramadol extended-release to treat withdrawal among patients with opioid misuse disorder showed promising results, according to a study published by JAMA Psychiatry.

Opioid misuse disorder has become a growing public health concern, as it has led to a substantial increase in overdose-related deaths. Medically supervised withdrawal is a common treatment for these patients; however, poor symptom management can lead to failed treatment.

Since opioids alter the way the brain responds to stimuli, the central nervous system, heart rate, respiration, blood pressure, and body temperature, withdrawal from the drugs can be significant.

According to the American Addiction Centers, early symptoms of withdrawal include muscle pain, sweating, anxiety, fever, and hypertension. Within 72 hours, patients may experience nausea, vomiting, diarrhea, stomach cramps, depression, goosebumps, and cravings.

While the withdrawal symptoms may last approximately 1 week, therapy is also recommended to treat psychological withdrawal symptoms.

Clonidine and buprenorphine are commonly used to manage opioid withdrawal. The study results indicate that tramadol hydrochloride may be an effective alternative therapy. The drug is an approved analgesic, but it has a low potential for misuse, according to the authors.

Included in the randomized clinical trial were 103 patients with opioid use disorder. During a 7-day taper period in a residential research setting, the authors explored treatment with clonidine, buprenorphine, and tramadol hydrochloride extended-release for withdrawal treatment.

The findings indicated that tramadol extended-release reduced withdrawal symptoms better than clonidine, according to the study. Tramadol extended-release was also found comparable in efficacy to buprenorphine.

The authors noted limitations, such as a primarily male population and no information about past 30-day use of drugs and alcohol.

"These data suggest that tramadol ER is a promising and valuable medication for the management of opioid withdrawal in patients undergoing treatment for OUD [opioid use disorder]. Future studies should evaluate whether relapse varies following supervised withdrawal with tramadol ER vs. other medications and whether tramadol ER can be used to transition patients to naltrexone treatment," the authors concluded.