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Ultram 2018-09-11T16:59:58+00:00

Is Ultram An NSAID? Important Things to Know About Ultram

Ultram is a commercial trade name for the opioid pain medication tramadol. Opioids, meaning “like opium,” are a class of pain-relieving medications and drugs that have effects similar to morphine. Ultram was first approved in Europe in the 1970s and has been approved in the U.S. for the treatment of moderate to severe pain since 1995. Though Ultram itself is not as potent as many other opioids, it is converted to the much more potent form desmethyltramadol in the human body. When Ultram is combined with acetaminophen, its effectiveness in treating pain increases; this formulation is available under the brand name Ultracet, among others.

Unlike virtually every other opioid approved in the modern era, Ultram (in its generic tramadol form) was not scheduled under the U.S. Controlled Substance Act until 2014, 19 years after its initial approval. It is now classified as a Schedule IV medication, a designation given for medications still legally designated as narcotics but with comparatively lower abuse potential. The perception that Ultram has this low abuse potential has led to its being a favored medication for physicians in treating patients for acute and chronic pain, a trend that only began reversing itself in 2015. Similarly, the perception that it is safe to use as a medication to aid in medical detoxification and management of opioid withdrawal has resulted in the widespread usage of Ultram for those purposes, despite a lack of scientific evidence that Ultram is particularly beneficial in these contexts.

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You may have been prescribed Ultram to treat an acute or chronic pain condition. You may have obtained it from a friend or colleague. Perhaps you’ve used Ultram to cope with difficult circumstances when other measures didn’t seem to be working. Perhaps your usage of it has become a problem for you, your family and friends, or your community.

If any of these situations describe yours, you aren’t alone. Forty-five million prescriptions for Ultram (or its generic, tramadol) were written in the U.S. in 2013. Many people, including even some physicians, were not aware until recently that Ultram is an opioid, with all of the risks of being such a drug, including the risk of withdrawal and the risk of addiction. If you feel your usage of Ultram has become a problem, Transformations Treatment Center can support you in your return to sustainable health and wellness.

How Ultram Works Within Your Body

Your body’s liver enzymes convert Ultram into the more potent desmethyltramadol, though some of the drug stays active as the less potent tramadol. Both forms of the drug, like most opioids, act on a group of access sites for the body’s primary pain control center: the mu opioid receptor. Here, Ultram and desmethyltramadol carry out functions similar to endorphins, the body’s naturally produced pain control compounds. Desmethyltramadol is strongly preferred by these receptors, compared to other opioids.

Ultram also acts as a serotonin and norepinephrine reuptake inhibitor, or SNRI, a quality it shares with several antidepressants, such as venlafaxine (Effexor) and duloxetine (Cymbalta). SNRI medications make the chemical nerve cell ‘messengers’ serotonin and norepinephrine more available in the communication space between nerve cells, which amplifies the messages the cells are communicating. Serotonin is responsible for, among other functions, regulating mood and anxiety. Norepinephrine is another multipurpose molecule whose roles include modulating pain, especially that which originates from faulty nerve cells (called neuropathic pain).

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Frequent or excessive usage of Ultram leads to physical tolerance and dependence over time. Administering the same dosage results in less effect, meaning more of the drug is required to achieve the same effect.

Abruptly stopping or reducing Ultram intake leads to withdrawal symptoms, but the dual actions of Ultram as both an opioid and an SNRI give it some unique features of withdrawal. Like withdrawal from other opioids, Ultram withdrawal results in flu-like symptoms such as muscle aches, nausea, vomiting, diarrhea, runny nose and teary eyes, among others. Users of Ultram can also experience SNRI withdrawal (referred to by healthcare professionals as a discontinuation syndrome), the symptoms of which can include anxiety, tremors, abnormal nerve sensations and increased urination.

Overdose of Ultram is not less common than it is with more potent opioids, though the level of respiratory depression (which makes some overdoses fatal) is less severe. However, combining Ultram with other medications that decrease respirations, such as benzodiazepines, can indeed be deadly. Ultram overdoses resulted in over 10,000 emergency room visits in 2014, with the overwhelming majority having Ultram as a component of a multi-drug overdose. The drug also increases your risk for seizure, especially when combined with other medications, like bupropion (Wellbutrin), which increase seizure risk on their own.

Particularly when combined with other medications that modulate serotonin— as many antidepressants do—Ultram can cause serotonin syndrome. In its severe form, this condition is a medical emergency, with symptoms that can include excessive sweating, elevated body temperature, elevated heart rate and blood pressure, agitation and confusion.

How to Spot Problematic Ultram Usage

Misuse of Ultram is common. Certain key signs can help you or your friends and family identify when the use of Ultram has become a problem. Some of those signs include:

  • Unsuccessful attempts to curb Ultram use or stop it
  • Engaging in risky behavior to obtain the drug
  • Taking Ultram in a non-prescribed manner
  • Lying about or hiding your use of it
  • Taking it in the absence of perceptible pain
  • Continuing to use it despite having negative consequences stemming directly from its use

The central feature of addiction to Ultram, or to any other substance, is a loss of control over your usage of it.

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Treating Ultram Addiction

Since Ultram is an opioid and an SNRI, and both classes of medication can result in withdrawal, treatment of addiction to Ultram begins with medical detoxification. Withdrawal from Ultram and other opioids is not fatal on its own, but it can be extremely unpleasant and physiologically stressful, especially when combined with the SNRI withdrawal effects. During detox, symptoms of withdrawal are managed under close supervision, sometimes with monitored doses of medications if the symptoms are severe enough. Vital signs are monitored closely until withdrawal symptoms have sufficiently subsided and the risk for seizures and serotonin syndrome has lowered.

Psychotherapy usually involves a form of cognitive behavioral therapy, or CBT. CBT is an approach which aims to change unhealthy behavior by carefully evaluating the thoughts, emotions and belief systems that helped lead to the behavior. It can be performed in either individual or group sessions and is a staple feature of most recovery efforts, along with 12-step- based program participation. Both 12-step participation and CBT have extensive scientific research that supports their usage in the treatment of addiction.

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It takes courage to confront the possibility that you have been dealing with an addiction to Ultram. At Transformations Treatment Center, we recognize and understand your situation, and we will actively engage with you so we can fully support your needs. Our staff of highly trained professionals will guide you through the treatment process and help you develop the tools to lead a fulfilling life, free of substances, free of shame and free of the destructive consequences of untreated addiction. Contact us today to start on your road to recovery.

Continue Reading: Effects, Signs & Symptoms
Ultram
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