I have had two back surgeries in two years. The second was a followup on the first, so I was in chronic, debilitating pain for two solid years. I am writing this because my experience can be helpful in getting off of these drugs, and choosing whether they are even appropriate. If I had understood Tramadol, I would have never taken it. If I had understood rebound pain, I might have gotten off hydrocodone sooner.
I was placed on hydrocodone 10/325 for most of that period. 6 weeks after my second surgery I decided that my pain levels were manageable and stopped taking the hydrocodone. Big mistake. After a day of vomiting, I was advised by my doctor that I had to wean off of the pills. I weaned over a period of 2 months and when I took my last 5/500 pill of hydrocodone, I still had a minor adjustment period, but it was anything but traumatic. I had a couple days of digestive system problems and a couple weeks of rebound pain, but in the end, it was all very manageable with the weaning plan. Hydrocodone serves its purpose, but I realized why people can't stop taking it. If you don't know that you have to plan your exit and to expect the rebound pain, then you will think you are still injured and just go back for more. It takes a couple weeks for your body to remember how to treat pain naturally.
I was going pretty well after that, and then one more I woke up with my leg on fire again and a deep pain around the incision area. I contacted my surgeon's office and they recommended Tramadol because this was believed to be a chronic, not acute condition...and the next step for me surgically is a fusion, so we want to see if things will adjust on their own before taking such a drastic step. So I started taking tramadol. I would take 200 mg per day. This is a moderate dose. The maximum is 400 mg per day. Tramadol made me tired and depressed. It only slightly alleviated my pain. I was not able to interact well with people while on it. It also caused bad stomach cramps. I told my doctor and he said to stick with it and the side effects would subside. So I did. Most of the side effects at least improved, but I was still very vacant mentally. Then one day, I had a couple beers 8 hours after my last dose. Seemed like a safe distance. I blacked out completely. So, I decided to stop taking the tramadol because it was really affecting every part of my life negatively and only moderately reducing pain.
My doctor again recommended tapering, so I spent a couple weeks getting down to 50 mg (the lowest dose). And then, I stopped taking the pills. Even after tapering, I had horrible stomach problems, I was shivering, brain shocks, depressed, no sleep, no interest in anything. The only thing that made me feel better was a hot bath in a dark room. Whereas hydrocodone beat you up, but after 72 hours you are out of the woods, tramadol sticks with you for 7 days. 7 long days of very unpleasant physical and psychological problems. By day 8, I was starting to feel normal again physically, but the depression part of it stuck with me for another week. It was a really awful experience. Rebound pain wasn't so bad because it never really alleviated my pain. There was some, but it felt normal.
The doctors will tell you that tramadol is a non-narcotic pain reliever that is safe for long term use. I suppose it is, if you don't plan on ever stopping taking it. It is a synthetic opioid, so why would anyone think it is 'safe'. It was not very effective for me and screws with your serotonin and norepinephrine levels, so withdrawal gives the dual benefit of the opiate problems and deep depression. If you have chronic pain, you don't have a choice sometimes and you have to get through it, but don't assume this drug is any less dangerous than hydrocodone. Handle it carefully and be ready to lose a week of your life when you decide to stop.
The good news is today I take 300 mg gabapentin at bedtime to help with the pain from the nerve damage, but that is all I take for meds. Overall I feel very good considering what I have been through. I will not take anything stronger than ibuprofen now if I am not acute. I do not want to put anything in my body that I can't just stop taking. Your body does know how to deal with pain if given the opportunity to do so. We let our doctors tell us that the only solution is drugs, and we believe them, and then we stop making the natural chemicals to deal with pain so when you stop you think your pain was worse than when you started...it becomes an awful cycle and only the doctors and big pharma win.
Sometimes a little rest, an ice pack, and time are really all you need.
If anyone is trying to quit and needs someone to talk to for support, I am happy to help you. I am not a counselor, and quite frankly I suck at being empathetic most of the time, but I know how hard these situations are and wish the pain and the pain of withdrawal on no one.