Originally Posted by Dr. Smith

Hi Marty,

I have a couple of clues where to look. What you're talking about in your OP is called a "medication vacation". The amount of time will vary for individuals, and it's possible that your tolerance may build quicker subsequently to the break than it did beforehand. The longer you are off of a substance, the better, but in the case of chronic pain, that's not usually a choice.

medication vacation

Tapering is probably the best way to come off of any opioid, especially tramadol.


An alternative is "medication rotation" where your doctor prescribes a different medication for a time. The theory is that you may be able to do with less than an equivalent dose—at least until your body becomes accustomed to the new medication, at which time you may be able to switch back to tramadol.

pain medication rotation

Some doctors are amenable to these strategies, and some are not. All opioids eventually give rise to tolerance and dependence, so some doctors believe you may as well stick with one that works well for you for as long as possible.

Addendum: I recently came across this excellent article on the whole topic of pain medications & chronic pain. Worth a bookmark, IMO.

A Patient's Guide to: Medication Approach to Chronic Pain

Doc