This is a study of tramadol as an agent for short-term opioid withdrawal treatment. A randomized, double blind clinical trial comparing the efficacy and safety of tramadol to clonidine and buprenorphine in the short-term treatment of opioid withdrawal will be conducted. Opioid dependent participants will be treated on a residential unit. The primary outcome measure is opioid withdrawal symptoms.

Inclusion/Exclusion Criteria:

• Participants in this study will be males and females between the ages of 18 and 60 years.
• Applicants must be opioid dependent based upon the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (SCID); in addition, they must have an opioid positive urine during the screening process (or have evidence of opioid withdrawal).
• They must be healthy, with no significant medical illnesses (e.g., insulin dependent diabetes), and without significant psychiatric illness (e.g., schizophrenia) besides their drug dependence.
• Females will have a pregnancy test prior to study enrollment, and if found to be pregnant will be excluded and referred to a substance abuse program for pregnant women (the Center for Addiction and Pregnancy) on the campus.
• Volunteers will also be excluded if they have pre-admission hypotension (due to the use of clonidine in the study).
• Applicants with a history of seizures (including substance-related seizures, such as alcohol withdrawal related) will be excluded.
• Alcohol and/or sedative dependence will be specific exclusionary criteria (given the small risk of seizures associated with tramadol use).
• Allergies to any of the study medications will be grounds for exclusion.

Adverse events are reported from the Taper and Post-Taper periods (approximately 18-19 days). No Adverse Events reported from Stabilization phase (7-10 day period) since this occurred prior to primary experimental manipulation and randomization to study drug (clonidine, tramadol, buprenorphine).

Standard terminology