Effect of medication (tramadol) on shooting accurately

[ChrisMcCracken]

Just to be clear, Ultram or tramadol is in a grey area. It hits the same receptors that other narcotics hit, however it is also a partial antagonists to those receptors as well. This mixed agonist/antagonist effect is why it isn't controlled to the same degree that full agonist only narcotics are regulated. You completely could react the same way with regard to intoxication on ultram as someone might on vicodin or oxycodone. It's just less likely to give you a buzz than they are. It is also not an opiate abuser's drug of choice because that antagonist effect can put someone who is chronically dependent on opiates into withdrawals, knocking the other opiates off the receptors and blocking them from doing their thing.

Kevin made an interesting point earlier quoting the PDR and some percentages with regard to symptom frequency. I would add to that by saying that those are only the REPORTED instances of symptoms like blurry vision or tremor. You have to also consider that the average patient in those trials isn't a competitive shooter and may not notice such subtle changes in vision, tremor, or coordination to bother reporting it during the drug studies. We're talking about a sport where the goal is to call your shots, requiring lots of motor and sensory systems to work almost perfectly.

My main message would be that this is presciption drug for a reason. If you have pain that your physican feels warrants use of this medicine, then that's between you and him/her. However the doctor will likely never warn you that the medicine may affect your accuracy with a handgun. You have to be self-aware and responsible for your body, how you react to medicines, and how you then choose to use the medicines. If just avoiding use of the medicine a few hours before shooting gets you back to your usual accuracy, then that is probably sufficient. Don't let your hobby cause you to live in pain all the time.

Alternative medicines should be discussed with your PCP. Some options include longer acting anti-inflammatories, like naproxen. There are also topical anti-inflammatories in gel and patch form that could give very focal pain relief. If you come off the ultram and find that you were more affected than you previously realized, as some of the others have posted, by all means avoid it and seek alternatives.

It's also very much worth noting that one person's response and sensitivity to this medicine may be vastly different than anothers. Again, self-awareness is key.

Anyway, that's just the .02 of a family doctor who is somewhat familiar with this medicine and the other options.

Edited March 5, 2012 by Erucolindon

[Nuke8401]

Kent,

I wasn't picking on you just trying to relay my experience in that I was functioning at what I perceived to be "Normal" and it was only after I was off the meds for I think 3-4 days before I realized that they were indeed affecting me.

I definitely understand pain and the hard choices one has to make and I hope that your current meds/plan keep it at bay.

It sounds like Erucolindon has much knowledge in this area as I am only a single data point in the big picture.

David

[KentG]

Kent,

I wasn't picking on you just trying to relay my experience in that I was functioning at what I perceived to be "Normal" and it was only after I was off the meds for I think 3-4 days before I realized that they were indeed affecting me.

I definitely understand pain and the hard choices one has to make and I hope that your current meds/plan keep it at bay.

It sounds like Erucolindon has much knowledge in this area as I am only a single data point in the big picture.

David

I understand what your saying and I need to lay off a few days to see if I can tell. I may this week since first match of the year is Sunday and see if I notice and diff. I can just load up on Advil.

[Joe L]

Erucolindon--

Thank you for the very clear and informative addition to this thread. I am one of those people who have very little tolerance for this medication, and it took shooting for me to even become aware of some of the side effects of even one 50mg tablet/day.

My goal here was to improve my own shooting abilities by identifying and eliminating any substances which may be affecting me. Perhaps others will benefit from at least considering what may be limiting their abilities as well.

Joe

[KentG]

Just to be clear, Ultram or tramadol is in a grey area. It hits the same receptors that other narcotics hit, however it is also a partial antagonists to those receptors as well. This mixed agonist/antagonist effect is why it isn't controlled to the same degree that full agonist only narcotics are regulated. You completely could react the same way with regard to intoxication on ultram as someone might on vicodin or oxycodone. It's just less likely to give you a buzz than they are. It is also not an opiate abuser's drug of choice because that antagonist effect can put someone who is chronically dependent on opiates into withdrawals, knocking the other opiates off the receptors and blocking them from doing their thing.

Kevin made an interesting point earlier quoting the PDR and some percentages with regard to symptom frequency. I would add to that by saying that those are only the REPORTED instances of symptoms like blurry vision or tremor. You have to also consider that the average patient in those trials isn't a competitive shooter and may not notice such subtle changes in vision, tremor, or coordination to bother reporting it during the drug studies. We're talking about a sport where the goal is to call your shots, requiring lots of motor and sensory systems to work almost perfectly.

My main message would be that this is presciption drug for a reason. If you have pain that your physican feels warrants use of this medicine, then that's between you and him/her. However the doctor will likely never warn you that the medicine may affect your accuracy with a handgun. You have to be self-aware and responsible for your body, how you react to medicines, and how you then choose to use the medicines. If just avoiding use of the medicine a few hours before shooting gets you back to your usual accuracy, then that is probably sufficient. Don't let your hobby cause you to live in pain all the time.

Alternative medicines should be discussed with your PCP. Some options include longer acting anti-inflammatories, like naproxen. There are also topical anti-inflammatories in gel and patch form that could give very focal pain relief. If you come off the ultram and find that you were more affected than you previously realized, as some of the others have posted, by all means avoid it and seek alternatives.

It's also very much worth noting that one person's response and sensitivity to this medicine may be vastly different than anothers. Again, self-awareness is key.

Anyway, that's just the .02 of a family doctor who is somewhat familiar with this medicine and the other options.

OK good info. For my issues of back and as of late some shoulder pain due to a touch of arthritis, what you you reccomend I ask my primary MD about? Naproxen? Other suggestions to ask my MD about? Thanks.

[ChrisMcCracken]

I would just asking them for alternatives and see what they suggest. Naproxen is one of the most common longer acting NSAIDS take twice a day. Others include diclofenac, celebrex, indomethacin, meloxicam, and nabumetone. Diclofenac comes in a gel and patch as well, Voltaren gel and Flector patches, for very focal pain. The oral NSAIDS can all be hard on your stomach, including the possibility of severe GI bleeding.

For non NSAIDS, don't forget tylenol. It can be used up to 1000mg every 8 hours if your have a happy and healthy liver. Other options include lidoderm patches, with the numbing medication lidocaine in a patch form, good for localized pain.

For nonmedicines, heat can work wonders for some types of pain. The stick on chemical heating pads can work for 6-8 hours at a time for days that you need to be out and functional, like shooting matches.

Other options include neurontin or lyrica for nerve pain, typically described as burning, tingling, or shooting pain. For very chronic muscle pain, amitriptyline can be a good option. It's an old anti-depressant that when used in low doses (10-100mg) can provide surprisingly effective lowering of pain for certain patients.

Keep in mind, many people will have pain every day of their life. Part of the goal for them is learning to live with it and still be functional. On pain scales, that may mean bringing it from a 7 out of 10 down to a 4 out of 10 with medicine. There are always other things you can do, including physical therapy, regular exercise, sleeping well, eating right, and interventional approaches like injections or surgery.

I hope that helps.

Edited March 6, 2012 by Erucolindon

[Joe L]

I've spent the month of March being very careful with the medications and observing how I shot. I have concluded that I shoot best if I haven't had any Tramadol (ultram) for 24 hours before shooting. I can do almost as well if I have only had 25 mg at least 4 hours before shooting. Almost is the key word here. Fifty mg 4 hours before shooting and I can't group anything less than 7" at 25 yards. I can usually tell how the session will go after shooting 20 rounds through a 22 at 25 yards as a warm up. If I can't shoot a 4" group first thing, I keep shooting the 22 until I tighten up the groups. If I am not on track after 100 rounds, I SHOULD just go home. If I don't, I am usually disappointed and that is a bad thing. I'm learning. Today, the 22 groups were tight right out of the bag, so I quickly moved to the 9 and shot 200 rounds with good results.

This discussion has been very helpful to me and I really appreciate the feedback and input from everyone that took the time to respond.

Joe

[GlockDoc]

Some days I can shoot very well out to 25 yards, like sub 2" groups standing strong hand. On other days, like today, 5" groups at 20 yards. I am having some difficulty seeing the sights as clearly as I do on the good days. Also some trigger control issues, obviously, on the "bad" days. I've been thinking about what may be different on the good days versus the bad days and have come up with one likely possibility so far.

I have been taking 25mg of tramadol (Ultram) per day for nearly 10 years, with some increase over the last 6 months while recovering from 2 shoulder surgeries. Usually I take the medication in the morning and shoot in the afternoon. Sometimes another 25mg at lunch time, but never less than 4 hours before shooting well. Never more than 75mg/day, which is a very low dosage, I'm told. Today, I took the full 50 mg after breakfast and was shooting at the range about an hour later so I was out of my normal routine. I had a much worse day than normal.

I'm thinking the tramadol has been affecting my eyesight and muscle control just enough to cause the groups to spread. Has anyone else observed this when taking medications or better yet, specifically tramadol?

I am allergic to NSAIDS and can't take any of the usual pain killer narcotics, and I don't drink any alcohol, so tramadol has been very helpful for controlling back pain and, most recently, shoulder pain.

I'll lay off the tramadol entirely for 24 hours and try again tomorrow morning while waiting for any responses or input.

I am looking for other people's experience regarding how muscle/trigger/vision control can be affected by even these supposedly non-narcotic medications.

Joe

Joe--your use of "supposedly non-narcotic" is a good one--Tramadol is a synthetic opioid that's most closely related to Fentanyl. It's a little mind-blowing that people still call it a non-narcotic, because it behaves in your body exactly the same way.

That said, 25mg daily is a small, small dose of tramadol, and I'd be surprised if you noticed any change at all in your shooting, especially if you're taking it long-term. You probably have a decent tolerance built up, and the psychomotor effects would be pretty minimal at this point.

Of course, pain/stiffness/decreased mobility in your body can make it harder to relax into an index position and probably make groups spread a bit too. I'd be more inclined to think that's the problem. Good luck, and I hope you're feeling better soon, whatever the problem is.

Edited April 5, 2012 by GlockDoc

[KentG]

I have to admit I may be wrong about this issue. I have done some personal evaluation of this. After paying attention to effects before during and after what I laughingly call practice it seems that Tramadol DOES affect my motor skills for pistol. It became clear last week shooting plates at about 20-25 yards with pistol that my hands had a bit of issue holding a clear and steady sight picture for my dot. It wasnt enough that I would call it shakes or tremors but it was there. Rifle or Shotgun are not noticeable at all. Not near enough to notice if I held my hands out and watched them but holding a pistol and trying to hold the dot on a plate for a few seconds it seemed to be harder than with no Tramadol at that point in the day. Its not anywhere near enough to be noticable in normal day to day issues and there is definatly no clarity issues mentally but I will now give my mea culpa that it may cause some VERY MINOR stability issues. Enough that I wont be taking any before a match or pistol practice.

I still like it for minor pain and will continue it otherwise and I am a daily user of 3-4 50mg tabs as needed. Live and learn.

[Joe L]

Kent, I've experimented a little over the last couple of months and confirmed that, for me, 25 mg before shooting does not seem to have an adverse effect in the morning if I haven't had any Tramadol during the evening before. Fifty mg in the morning definitely affects my abilities. My current personal guideline is still no more than 25 mg 4 hours before shooting if possible, and this is easy when I shoot in the afternoons, just 25 mg at lunch after 25 mg in the morning and I'm OK at 6pm.

As you mentioned, the effect is there, but difficult to notice unless shooting a pistol at 25 yards.

Joe

[Atlgentlegiant]

This is a great thread. I too use tramadol for shoulder, back and ankle issues (2 bad shoulders and 2 bad ankles from football and wrestling) and this thread has been great to follow. I too cannot take NSAIDs due to gastric bypass surgery and given the recent discoveries with tylenol I try to limit my tylenol intake. I had shoulder surgery last year but I am still dealing with associated issues from 20+ years of the damage I did to myself pushing very hard to be competitive. I will do my own experiments and report back as I can. I have talked with some medical professionals and based on their feedback they do believe that tramadol is better for me than most OTC meds so I just need to work all of this out and find that balance. Right now I am taking <25mg per day if at all possible so we shall see.

[RammerJammer]

This is an awesome thread. I have had two back surgeries and have taken almost every pain med available and a couple that are no longer available. I had an awful experience with ultram. I switched to ultram after taking percocet 10 for a couple of months. I was still very aware of the pain but didn't care. It's not that I felt good I just didn't care. I also couldn't drive or get a key into a door or anyting else that required any kind of precision movement. I switched off of it after a week of worthlesness. My vision was very blurry and I would almost pass out everytime I stood up. I know that every individual is effected differently but I couldn't imagine trying to shoot on ultram. Well not trying to hit anything anyway.

[diehli]

I quit taking tramadol because it quit being effective.

Dilaudid is still effective. But I seem to have less strong side effects from it, which scares me enough to ensure I don't take it all the time.

[chancesR]

Tramadol is a prescription drug that is highly sought after by drug abusers. Like all drugs, there are legitimate users, and abusers. It is a scheduled drug in some states. For accurate infor look it up on the DEA site. Anyone shooting and/or driving while taking this medication is doing so 'under the influence' whether prescribed or not. IMO, if an accident happens, you can and should be held accountable. Friends don't let friends shoot when taking such meds. And by the way, I am a health care provider who prescribes these medications routinely as needed.

Edited June 20, 2012 by chancesR

[KentG]

Tramadol is a prescription drug that is highly sought after by drug abusers. Like all drugs, there are legitimate users, and abusers. It is a scheduled drug in some states. For accurate infor look it up on the DEA site. Anyone shooting and/or driving while taking this medication is doing so 'under the influence' whether prescribed or not. IMO, if an accident happens, you can and should be held accountable. Friends don't let friends shoot when taking such meds. And by the way, I am a health care provider who prescribes these medications routinely as needed.

And a part time drama queen. The plus of this medication and the reason so many people use it is because it does NOT affect clarity. I dont care if your a health care provider I know plenty of MD's who say otherwise. My wife used to bring home blister sample packs of Ultram and only stopped because the hospital/clinc made it a policy that they did not accept samples from drug reps. ANY drug taken in excessive doses can cause problems. I KNOW that I function normaly on this because my job requires me to be clear headed and able to diagnose complex machines controled by computers, CNC's and PLC's. Solve problems on said equipment in sometimes just a few minutes. Plus be able to physicly climb on, in and do delicate tasks as needed.

Edit for spelling. Or is the the colors Im seeing

Edited June 20, 2012 by Kent Grewe

[chancesR]

Kent, I really don't care about your spelling errors. What I do care about is your misinformation. People leave bars everyday saying that the alcohol doesn't affect them...and it is the same thing with many prescription drugs, tramadol/ultram being one of them. You live far enough way that you are not a threat to me, just others that share the road with you. I don't care what other MDs tell you, ask an attorney what will happen if they do your blood test. Or for that matter, having Ultram in your possession without a valid prescription can cause you a lot of trouble.

[diehli]

Somewhere there's a soapbox without its pedant.

[KentG]

Somewhere there's a soapbox without its pedant.

[ChrisG164]

I can't imagine tramadol (non-narcotic) has much drowsy effects or any others that would noticeably deteriorate your shooting skills in real time. I have no choice but to be on Opana (narcotic) slow release tablets all day every day due to a serious spinal injury and it slows my reaction time significantly. I've never measured it objectively, but I just know it's slowed me. It just makes sense. Luckily I make sure I don't take my breakthrough pain med which is instant release because that would severely effect my reaction times if not more factors than time.

[Joe L]

Well, its been a while since I have added anything to this thread. I'm a much more experienced shooter now and have a much better understanding of what my own personal reactions are to tramadol. I still see the same results now that I did nearly a year ago--less than 25 mg 4 hours before shooting and I shoot well. If I take 50 mg (one tablet) less than 8 hours before shooting, shooting is affected. For a Saturday match, nothing after noon on Friday seems to work just fine. Our matches are in the morning on Saturday, so nothing on the morning of the match. 50 mg within 4 hours of shooting means the 25 yard groups will open up from the usual 2" five shot group to around 4". Not good.

Note that I am very sensitive to most medications, so I am sure there are people out there who may not be affected by one 50 mg tablet like I am. I have a 50 mg/day limit when I'm NOT shooting, and usually split that up 25 mg in the morning and 25 mg at noon, with nothing in the evening. This has worked well combined with Voltaren gel and Naproxin Sodium tablets in the morning.

Joe

[818-DVC]

I was gonna say to take ibuprofin the morning of matches, and from experience, tramadol has similar effects as opiates. I don't take any of either any more, and I just deal with it. when I have really bad muscle pain I get a hardcore anti-inflam injection like Toradol.

I found over time, both ultram and opiates do absolutely nothing but lightly dull the pain, and make me wacky. Then there's the dependency issues with both.