I picked up a billiards cue and smashed it over his head. I was screaming abuse at everyone. I even broke the windows. Abdul Hameed, now 24, remembers the moment he realised his drug habit had spiralled out of control. Two years earlier, aged just 13, he had tried the opioid-based painkiller Tramadol for the first time. Like many young Egyptians, he started by taking one quarter of a mg tablet to get high. By the time he went berserk in the games arcade Abdul Hameed was taking 57 painkillers a day - a mixture of Tramadol and other commonly available opioid-based tablets.
Tramadol is their drug of choice. It first appeared on the market in Egypt 20 years ago. Cheaper than heroin and easily available, it quickly became popular with addicts and then spread to the wider population as a way to deal not just with physical pain but also the stresses of everyday life.
Tramadol has taken such a hold in Egypt that addiction helplines say they are getting as many as calls a day from people desperate to break the habit. Addicts are likely to be young. The government-run drug rehab centre at Cairo's Abbasiya Psychiatric Hospital told the BBC more than half its patients are aged between 21 and Young mum Ahlam started taking Tramadol to cope with the drudgery of housework and childcare.
Like Abdul Hameed she began with a quarter of a mg tablet, but quickly progressed to four tablets a day and now, even if she ups the dose the drug no longer has the same effect. The toll addiction is taking on Ahlam is plain to see. She is pale and thin, chain-smokes cigarettes, and looks much older than her 28 years. But of course it wasn't true.
I used the money to buy Tramadol and I fed them cheap pasta instead. This is the sad truth. Ahlam has sold things from the family home to make money to feed her drug habit, and at one particularly bleak moment she even offered sex to a neighbour, also an addict, in return for some pills.
Our program of care is both comprehensive and individualized. The first step in every journey of recovery is the medical drug detox. Because Tramadol is so potent, the withdrawal symptoms can be severe if not adequately monitored. In most cases, the physical symptoms of withdrawal are not life-threatening, and they resemble the physical symptoms of very severe flu.
However, the psychological symptoms can lead an addict back to using before the detox process has come to an end and the patient has been physically stabilized. The most severe psychological symptom as reported by many newly sober opiate addicts is the intense mental cravings. At Garden State Treatment Center we focus on reducing cravings while making the overall treatment process as comfortable as possible.
Once a patient has completed medical detox he or she will be transferred to our state-of-the-art inpatient drug rehab. Here, the individual will undergo intensive inpatient treatment, including one-on-one and group therapy sessions, relapse prevention education, family therapy and the teaching of vital life skills.
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Tramadol is used to treat moderate to severe pain. People usually swallow it in pills or capsules. On its own, tramadol is a prescription-only painkiller. People who take tramadol illegally, or abuse their prescription, sometimes crush up the tablets and snort them. Although tramadol is not as strong as heroin , it shares many of the same effects and both are addictive.
Tramadol can make people feel drowsy or confused. How long a drug can be detected for depends on how much is taken and which testing kit is used. This is only a general guide. Tramadol can depress breathing and may be risky for people with asthma and chronic obstructive pulmonary disease.
Tramadol use has been linked with serotonin syndrome. This is a potentially life-threatening condition where the serotonin receptors are overstimulated. Serotonin syndrome can lead to high fever, rapid pulse, shivering, sweating, trembling, muscle twitches, agitation and confusion.
If you have epilepsy you should only take tramadol with clear medical advice because of the known risks. Although most tramadol is made by pharmaceutical companies to a high standard, tramadol bought from a dealer of from the internet can sometimes be cut with other substances or be counterfeit fake.
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