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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18443
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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hi there, my husband (44 years old) has been in a severe

Resolved Question:

hi there,

my husband (44 years old) has been in a severe car acccident a couple of years back and has been introduced back then to Tramadol as a pain killer. Unfortunately he has developed a dependency on it since then and is finding it very hard to get off it. He usually takes a 100mg dose per day and is findind it very difficult to withdraw.

what do you advise to help him get off? is there a clinic / doctor you recommend we visit in London for treatment?

many thanks for your help
Hana
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
It will help if you could provide some further information:
What problems does he have when he tries to get off the Tramadol?
What withdrawal symptoms does he have?
Is there a reason that he does not want to work with the doctor that has been prescribing the Tramadol?

Customer: replied 3 years ago.

Hi Dr. Love, many thanks for your speedy reply


 


he becomes restless, cranky, angry, anxiety attacks, bad mood, you name it. He can't sleep at night without the help of a sleeping pill,


 


we live in Dubai, UAE. The doctor he was working with when he had the accident naturally stopped prescribing tramadol after sometime however my husband had by then started becoming dependent on it, had access to the medecine and continued taking it based on an advice from another doctor who told him it's ok to take it indefintely!! i realise he needs professional help but unfortunately cant find that over here. that's why I was thinking of seeking this kind of help when we are in London next month.


 


he is genuinely trying to and I want to help him get off it cuz it is really taking its toll on our relationship.


 


so what do you suggest?


 


many thanks Dr. for your time


Hana


 


 


 


 

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

Unfortunately, this is a problem that is not readily amenable to management with a single or a limited number of visits with a doctor.

There are excellent physicians in London that can deal with this issue, such as an addiction program at King's College London. The National Addiction Centre can be contacted by phone at 0207(NNN) NNN-NNNNor by email [email protected] (The software used by JustAnswer will frequently block e-mail addresses, so if the e-mail address did not come through, let me know.)

However, if the two of you will only be in London for a limited time, there also would be limited benefit that can be derived from seeing these specialists.

As for other suggestions for getting off the drug, the usual approach involves either a gradual taper off the current drug, the substitution of an alternate drug that can then be tapered, or medicines to help ease the more problematic withdrawal symptoms. With the symptoms that you describe, it may help to use medicines for anxiety, and it might be reasonable to consider an antidepressant before attempting the taper. Antidepressants will also treat anxiety and have also been shown to help ease chronic pain, so may help control the pain while the Tramadol is being tapered. In fact, the Tramadol has a mixed effect, working both on the opioid receptor (so that it works similar to morphine) as well as working on serotonin in the brain (so that it works like antidepressants). Once he is off the Tramadol and past the period of risk of withdrawal symptoms, then the chronic pain can be separately assessed to decide whether the antidepressant may be continued solely for management of the chronic pain.

All of these options involve prescription medicines, so maintaining a long-term relationship with a doctor that can work with him during the tapering of the Tramadol is the usual approach.

If you have any further questions or need clarification, please let me know.

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