Narcan works for methamphetamine overdoses


(1R, 2R) -tramadol (1S, 2S) -tramadol

Tramadol is a prescription synthetic opioid analgesic, which is characterized by an additional anxiolytic and antidepressant effect.

Along with tilidine and codeine, it is one of the weakly effective opioids, but also acts as a reuptake inhibitor of norepinephrine and serotonin secretion at the same time.

Consumption [edit | Edit source]

Dosage form[Edit | Edit source]

Tramadol is a widely used pain medication. It can be present in tablets or in a liquid solution. Tramadol in solution has a bitter taste[1].

Tramadol occurs in two different stereoisomers, which have a different effectiveness. A 1: 1 mixture (racemate) of these stereoisomers is used as a drug.

In some combination preparations, tramadol is combined with the non-opioid analgesic paracetamol. Since paracetamol in high doses can be severely damaging to the liver, such a combination preparation is not suitable for intoxicating consumption.

Some tramadol preparations are also retarded, i.e. the active ingredient is released continuously at a slower rate.

In the case of Tramadol, which was obtained from dealers, it should be remembered that this may also have been adulterated (street drugs).

dosage[Edit | Edit source]

As an analgesic, tramadol has about 1/10 the potency of morphine. Medically used single doses are 50 to 100 mg, with a daily dose of 50 to 400 mg and an approximate duration of action of 6 hours.

The Tripsit Wiki makes the following dosage recommendation:

Light 50-100 mg
medium 75-200 mg
Strong 250+ mg

When consuming it for the first time, you should start with a low dose of 50 mg in order to exclude possible sensitivities.

If taken continuously, tolerance and opioid dependence may develop. Tramadol is cross tolerant to other opioids.

Because of its effect as a serotonin secretion, there may be a cross-tolerance to the entactogenic effects of MDMA and ecstasy with regard to the non-analgesic effect.

effect[Edit | Edit source]

see also: Opioid # effect

mentally [edit | Edit source]

As an opioid, tramadol has a depressant effect and can cause euphoria.

There is a deep relaxation, you feel like 'wrapped in cotton wool'. One gets tired, can fall asleep or fall asleep. The depressant effect usually seems to be significantly less than that of the equianalgesic dose of other opioids such as morphine or oxycodone.

The body feeling is warm, light and the head feels free.[2] Things like music or art often appear more beautiful and harmonious.

In very high doses, effects typical of anticholinergic drugs can occur. These can be real hallucinations[3] be.

physically [edit | Edit source]

Tramadol's main effect is to reduce pain.

Urinary retention can occur, i.e. the inability to urinate (sometimes up to 8 hours![4]). This can be very uncomfortable when the bladder is full, which is why you should empty it before getting intoxicated and not drink too much during this time.

Nausea can also occur. Opioids inhibit bowel movements and can lead to constipation. Sweating also occurs in high doses.

In the event of an overdose, there is a risk of respiratory depression or dangerous unconsciousness with vomiting.

Set & Setting [edit | Edit source]

Set [edit | Edit source]

Since the effect increases relatively slowly, you can be tempted to add more. One is also inclined to forget the last intake or the previous total dose, so that unwanted overdosing can occur.

Opioids give you the feeling of a clear head, but at the same time the feeling is very positive and negative emotions are suppressed. In this state, risks are often rated as lower and possible consequences are often not sufficiently taken into account when making decisions.

One should be aware that tramadol can easily lead to dependence and is therefore not suitable for daily consumption. At the latest when you notice a development of tolerance you should take a longer break.

Setting [edit | Edit source]

As downers, opioids are suitable for quiet environments to deepen relaxation. You intensify the enjoyment of music, art, films, body contact and / or close your eyes to feel your own body feeling.

Everyday tasks can seem difficult or strenuous when under the influence of tramadol. Participation in road traffic, the use of heavy machinery and dangerous tasks cannot be performed safely in this state.

A consumer can react to external disturbances with aggression.

Duration of action [edit | Edit source]

The effect sets in after one to two hours and reaches its peak after three to four hours. In total, the effects can last for 5 to 7 hours.

The slow onset is due to the fact that tramadol metabolites are also psychoactive and, in particular, the metabolite O-desmethyltramadol is the more potent opioid.

Some tramadol drugs are retarded, i.e. the active ingredient is continuously released at a slower rate. In the case of sustained-release drugs, the intensity of action increases more slowly, reaches a lower level and lasts much longer.

risk[Edit | Edit source]

Addiction risk[Edit | Edit source]

Tramadol has a risk of addiction typical of opioids.

Continuous use should be limited to a few weeks, as physical opioid dependence can develop, which is associated with severe withdrawal symptoms.

Mixed consumption[Edit | Edit source]

Tramadol can have negative effects in combination with many drugs.[5]

Serotoninergic Drugs
Since tramadol acts as a serotonin secretion, it can lead to serotonin syndrome in combination with other serotoninergic drugs.[6] This applies in particular to MAO inhibitors, serotonin reuptake inhibitors (SSRIs), other serotonin secretions such as ecstasy, and amphetamines.

The herbal antidepressant St. John's wort can also lead to serotonin syndrome.

GABAergic drugs
As an opioid, tramadol has a depressant effect, which is intensified when combined with depressant GABAergic drugs such as ethanol, benzodiazepines and GHB.

Vomiting and loss of consciousness Edit source]

A user may fall asleep while intoxicated, be on the verge of unconsciousness, or become delirious in general. In such a state he is unable to react to vomiting and in the worst case scenario can choke on vomit.

A trip sitter should take care of the consumer. The stable side position is recommended if you are unconscious.

Neurotoxicity[Edit | Edit source]

Due to its action as a serotonin secretion, tramadol has a neurotoxicity similar to MDMA. This is particularly relevant since it has so far been assumed that this harmful effect will add up over a lifetime. For longer-term use, other opioids should be given preference.

Mechanism of action[Edit | Edit source]

Tramadol acts as an agonist on the μ, δ and κ opioid receptors.

Tramadol also acts as a norepinephrine and serotonin reuptake inhibitor and as a serotonin secretion[7]which results in a slight anti-anxiety and antidepressant effect.

Tramadol can act as a muscarinic anticholinergic[8]which may be due to anticholinergic effects such as hallucinations in high doses.

Mainly responsible for the effect is the liver-formed tramadol metabolite O-desmethyltramadol.

Legal status [edit | Edit source]


Tramadol does not fall under the German Narcotics Act, but is a prescription drug and should be treated in accordance with the Medicines Act.


Tramadol is only available from a pharmacy.[9]

Chemistry Edit source]

Tramadol is an atypical opioid, i.e. it does not have the morphinan structure of the classic opioids. However, there are structural similarities, for example morphinane and tramadol have a phenylcyclohexane structure.

History [edit | Edit source]

The substance was developed synthetically by Grünenthal GmbH and launched on the market in 1977 as a medicinal product under the name Tramal.

Trade names [edit | Edit source]

Monopreparations[Edit | Edit source]

Adamon (A), Amadol (D), Contramal (A), Cromatodol (A), Ecodolor (CH), Jutadol (D), Lanalget (A), Noax (A), Nobligan (A), T-long (D ), Tradolan (A), Tradonal (CH), Tramagit (D), Tramal (D, A), Tramundin (D, CH), Travex (D), Ultram, numerous generics (D, A, CH)

Combination preparations[Edit | Edit source]

With paracetamol: Dolevar (D), Zaldiar (D, A, CH, B)

Trivia [edit | Edit source]

  • Tramadol was isolated from the roots of Nauclea latifolia and five other plants in Cameroon. However, it is not a natural alkaloid, due to the massive use of the agent in the local livestock industry, it got into the soil and thus also into the plants.[10]
  • The legal high sold as kratomkrypton was shown to contain the opioid O-desmethyltramadol, which is related to tramadol, in addition to kratom. [11]

References [edit | Edit source]