Tramadol is an interesting medication. It is a controlled medication (i.e. cannot gain it without physician prescription) in most countries in the West (as far as I know), however it can be bought over the counter in pharmacies in Thailand, Cambodia, and in some places in China. It is a moderate analgesic (i.e. pain killer), it is also one of the accepted treatment methods for RLS, and as regular readers to this blog will know it is the method I use to control my RLS.
If you do a quick tramadol search on Google, you will come up with sites claiming that it is a member of the opiate family. Now if this is the case, then there is some cause to be concerned if one is taking tramadol as opiates are highly addictive. However even though many sites claim that tramadol is an opiate, actually if you dig a little deeper you will find some scientific questioning of this claim. A good article is here, with the author summarizing that it is and it isn’t. Indeed, tramadol will not return a positive for opiates in drug tests.
I have been more concerned lately as I my RLS has been plaguing me during the mornings – which is very unusual for me – and so I have had to take a tramadol in the morning. Suddenly I’m trying to wrack my brains to think of the withdrawal symptoms from opiates, and see if one of them could be mistaken for RLS (i.e. my morning RLS isn’t actually RLS, but rather my body reacting to lower level of tramadol in my blood stream). Well the jury is still out so far. It has only been this week, and it has only been in the morning, i.e. in the afternoon I have been fine. I am only taking it when my RLS is irritating me to the point where I can’t work properly (or sleep properly at night) – so does that justify it? So many questions.To add to the dilemma, Thailand has a strong “fake medication” business in a lot of pharmacies. Now the big name hospitals are trustworthy, however there are thousands of little pharmacies scattered throughout the city, and they are poorly controlled (hence the abiity to sell controlled meds OTC) and it is well known that many of the drugs are fake. That is they won’t work. I had a friend who worked in the pharmaceutical industry here for many years, and he said that at conferences they discussed this issue and generally it was accepted that fake medications in these pharmacies could be as high as 70%.
There isn’t any quick and easy solution to this. However I’m thinking that if my RLS continues in the daytime then I’ll try controlling it through lesser things such as acetaminophen and ibuprofen. I’m still trying to understand why I’m getting RLS in the mornings now. Has it been a change of diet? When I increased my calorie goal to 3400 per day I dramatically increased the number of carbs I am taking. Could that be it?
Then I read an article that states that perhaps addiction is not a disease of the brain. So perhaps there are some other chemical pathways at play here?
Like I said, there are no easy answers. Maybe I shouldn’t worry so much and just be thankful that I have a medication at hand to ease the RLS. It is a horrible affliction when it is active.
On a related issue, I have been sleeping very poorly lately. Last night I woke up at 1.30am with a full bladder (which is unusual), and then woke up again at 4.15am with an extremely sore back. It was really aching and I found it difficult to get in a position where it wouldn’t hurt. I ended up having a fitful sleep until 6.45am. Didn’t feel too hot at work!