I'm at the stage were my pain is taking an increase & I like to try to stay ahead on what may happen, so perhaps make an educated guess on what to expect. Along with my daily 50mg of Nortriptylene, I'm presently taking 50mg of Tramadol in the AM, 4 days a week. On the weekend, I'll take 100mg (in one shot), in case we go anywhere, I'm good. I know some people can take Tramadol for years & still have the same dose work for them, and some not. What I'd like to know, has anyone experienced shifting from Tramadol to a stronger opiod when the Tramadol isn't working good anymore. If so, did anyone experience withdrawal symptoms from the change?

I worked my way up to Hydrocodone 10-325 and I believe that as long as the meds are on the rise there is no withdrawal worry. If the laws hadn't changed I would probably still be on the hydro. I quit it cold turkey as I had ran out. It was dicey for about 36hrs. If I had it to do over I would have titrated down before I ran out. If you go to hydro or the same family, watch out for constipation that coined the term "river gravel". I had to use miralax all the time on hydro. Constipation was one of the reasons that I had the will to stop, plus the laws changed and time had reduced my pain. Good Luck, Ken in Texas.