Tramadol

Tramadol is a fully synthetic opioid meaning that it is not naturally occurring such as heroin or opium. It is generally considered a safer option than Morphine for treating moderate to severe pain. It is similar in its composition to codeine.

While Tramadol, itself, does little to activate receptors, one of its byproducts triggers events in cells that reduce pain signals. The result is a blunting of emotional responses to pain. It is this that provides pain relief. Some of the effects of Tramadol are non-opioid responses and can stop the reuptake of other naturally occurring body chemicals that are believed to enhance natural pain-relieving mechanisms.

As Tramadol is an opioid it can be treated using a reducing tapering regime of Tramadol or with Methadone or Buprenorphine. Due to recent advances in the pharmaceutical field, Buprenorphine can now be offered in a long-acting injectable form (Buvidal).

This depends, entirely, on the individual: Their age, physical health, other medications taken, amount of Tramadol used. Rapid detox is not advised as this leaves the client with significant craving and insufficient time in therapy to manage when they leave treatment. No reputable centre would admit a client for a rapid detox without therapeutic input. As a rule of thumb, a minimum of two weeks would be required. Most centres would not admit someone for less than four weeks.

Such an approach is never advised. The withdrawals can be extremely severe and family members/friends unable to provide the necessary medical care. Aside from the psychological manifestations, the physical consequences could lead to severe and prolonged dehydration (due to persistent diarrhoea) which can be a major medical emergency. Without a client entering into a therapeutic program, they will not have the necessary skills to prevent relapse.

A comprehensive discussion with a clinician is the first step towards addressing treatment needs and an appropriate treatment plan in a reputable residential treatment centre. Not all centres provide treatment for opioid dependency (this is mostly due to Home Office controlled drug licencing)

Same day admissions are rarely possible and can only be achieved if an enquiry is made very early in the day to allow the appropriate assessments to be completed and a safe decision made regarding appropriateness of placement.

Most people who are dependent on Tramadol will have gained a NHS prescription from their GP or from an NHS hospital which has been continued by their GP. There is increasing pressure on GPs to review opioid prescribing and, where clinically appropriate, reduce and stop Tramadol. Patients will, out of desperation, go to accident and emergency to try and source more as well as sometimes approaching private GP’s. Some people will, sadly, turn to street dealers and the item supplied may not be real. While it may say Tramadol on the box and the strip of medication, street sourced items are rarely what they are purported to be.

All community drug and alcohol provision are provided through your local authority. It is up to them how they provide help. They may commission private companies, charities or 3^rd sector providers or commission NHS services.  As such, help will be provided but it will be slow and there will be many hoops to jump through. Clients will have to undergo many meetings with non-clinical staff before they are able to access a clinician. Residential treatment may be funded but tends to be a very short residential detox only placement followed by residential rehab at a different location. Clients are usually expected to attend therapy groups, on a regular basis, for a period before the local authority will approve funding for residential treatment: if they have the funds. Many services do not have sufficient funds to provide residential treatment and may only be able to provide tapering in the community which rarely works.

As with any form of addiction, the NHS has a duty of care: but only to what is reasonable in the circumstances. If someone goes to A+E, in active addiction, unless there is an underlying medical need, once a patient has been stabilised, the patient will be discharged: You cannot circumvent local authority services to get a detox in A+E.