a little bit addictedI am going to promote a comment to this main section, as the material deserves a larger audience:

I’ve been taking Tramadol for 3 years now, 3 per day.  I’ve tried to taper down, I can’t even handle that.  I don’t know if I have a “problem” or if it’s all in my head?  My doctor doesn’t seem too concerned…. I feel powerless to them, yet I don’t even know where to begin.  I know that I’m very good about rationalizing my use of them.  Any advice for someone hooked on Tramadol, which is not technically an opioid, but equally as addictive.  It’s sometimes hard to see it as a problem, as my finances/marriage, etc. are not falling apart.

There are many interesting aspects to your question, and I thank you for sharing your concerns.

Most people addicted to substances spend great amounts of time and energy on tapering.  The natural thought, I suppose, is that ‘since I seem to need this substance, it will be easier to give up the substance gradually—maybe even so gradually that I won’t even miss it.’

But unfortunately, the mental forces that are causing you to take the substance are not rational, and not based on need.  The tiny decisions that lead to using are made in the dark, out of consciousness—or under the guise of what you insightfully recognize as ‘rationalization.’

When we are addicted, we use the addictive substance regardless of any plan or promise.  We try to tell ourselves that we are controlling things, but in reality the using is going on virtually independently, in spite of our attempts at control.  The only thing we control is the ‘spin’ that we place on using, in order to try to convince ourselves that we are in control!

My first bit of advice, then, is to recognize reality—that you have NO control over your use of this substance.  You wrote that you feel ‘powerless’—and yet you continue to act as if you have power, by tapering the pills.

The first step of AA, NA or CA is to recognize on a very deep level that you are completely powerless of the substance.  Not that you ‘feel powerless,’ but that you ARE completely powerless.  Once you truly understand, accept, and BELIEVE your powerlessness, the desire to use may just go away, as it does in many other people—at least until they start thinking that they have power again!

I use a quick demonstration of how powerless works when speaking with addicts.  I present a glass of liquid, and explain that the substance will produce a powerful high consistent with the high produced by their drug of choice.  Then I explain that the liquid also contains dissolved cyanide in sufficient quantity to guarantee their death within minutes of ingestion.  Would you have trouble avoiding a sip?  Of course not!  But then I say that in a second glass, I carefully layered the cyanide in the bottom, and poured the intoxicant on top very carefully, so that a person could sip off the top layer and avoid the cyanide.  Suddenly the mind starts to work….  Maybe you would try just a tiny bit, careful to stay far from the bottom?

Addicts who think that they can use in a way that will avoid consequences have no reason to stop using.  The only way to stop, in my opinion, is to realize the truth—that there is simply no way to protect yourself from the ‘poison’ that comes with using addictive substances.  In most cases, once a person truly understands that fact, the desire to use vanishes.

Your doctor’s lack of concern is unfortunate, but typical.  Doctors are in such a hurry these days that they generally react to crises, rather than take time to prevent them.  Tramadol has some opioid effects, by the way, and some non-opioid effects.  It is generally less addictive than potent opioid agonists if you measure addiction by the harm to society caused by the substance.   But some people fit better with one substance than another, and I’ve met a number of people who were quite addicted to tramadol.

You mention that your marriage and finances are not ‘falling apart’ from your addiction.  But people tend to grade their marriages on a curve, comparing their own to the worst marriages they know of, rather than trying to measure up against the best marriages.  And nobody on the outside can accurately know the state of health of someone else’s marriage.  It is hard enough to take stock of one’s OWN marriage!

If you are like most people, addiction has had effects on your marriage that you either dismiss as insignificant or miss because of denial.  Being ‘owned’ by a substance puts a person in a lousy mood that tends to create disharmony in the home.  Usually secrets and lies become more prevalent at some point.

And as addiction progresses, the addict develops an inner restlessness that destroys the pleasure of sharing quiet company with another person, for example our spouses or children.  I don’t know exactly why it happens, but I see it all the time—addicts who just don’t feel happy at home anymore.  They sit down on the couch, but then have to get up and go to another room, until loneliness there brings them back near family again.  Maybe the shame becomes too apparent when other people are nearby—I’m really not sure what causes it, or if different things make it happen for different people.

Consider picking up a copy of ’12 Steps and 12 Traditions,’ one of the best guides to 12 step programs that you will find.  Consider truly working the program, and even attending meetings if you are unable to stop taking the pills.  It is a safe bet to say that If you were to stop, life would improve in ways that you would now not even be able to imagine, or predict.

Photo by ToNG!?, available under a Creative Commons attribution license.