Patients with established dependence tramodol often practiced occasional use of other opiates, primarily various extracts from poppy straw handmade. Only a small part can be diagnosed tramadol substance abuse in its pure form (only three patients had categorically denied the use of other opiates). It must be emphasized that patients who in the past has endured other opioid withdrawal syndrome, comparing it with the state of the abolition of tramodol, noted their similarity.

Along with common features during opioid withdrawal, with the use of tramodol observed a number of differences. Thus, the rate of development and intensity of somato-autonomic manifestations of withdrawal syndrome in individuals who consumed tramodol objectively lower than in patients who consumed hand-made preparations of opium. In addition, injecting tramadol is able to cancel it was no diarrhea, so typical of opioid withdrawal. Despite this, it is estimated the majority of the surveyed our group of patients, with equivalent doses of anesthesia and comparability of seniority, duration and subjective severity of the abolition of tramodol was more than able to cancel the other opioids.

The studies yielded the following conclusions :

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1. Tramodol has a noticeable addictive potential, that must be considered when using tramodol to relieve pain in the structure of opioid withdrawal.
2. Arising from non-medical use of tramodol mental and behavioral disorders in many respects similar to the disorders, including other opioids (F11 disorder according to ICD-10).
3. The only indication for use of tramodol in patients with opiate addiction can be a pain in muscles and / or joints that are not cropped by other means.
4. Time of Tramodol in the hospital, patients with opioid dependence, should be strictly limited to the duration of pain.
5. Adaptive method of therapy is desirable, providing a steady decrease in doses of tramodol as alleviation of pain, while limiting the dose used should not be above the maximum therapeutic.
6. At least two or three days before discharge patients from hospital tramodol should be abolished to ensure there are no manifestations of opioid withdrawal.