Mixing Tramadol & Cocaine | Effects & Dangers

When drugs of very different classes are abused simultaneously, the resulting combinations of effects can be dangerously unpredictable.

This appears to be the case with tramadol, an atypical opioid painkiller, and cocaine, a naturally occurring stimulant—two contrasting drugs both known to increase serotonin activity.

Effects Of Mixing Tramadol & Cocaine

Tramadol, sold under the brand names Ultram and Conzip, is an opioid painkiller, though it has a number of properties that differentiate it from other opioids/opiates used to treat severe pain, like oxycodone, fentanyl, and hydrocodone.

But, like any other opioid, tramadol can be abused in high doses to stimulate the body’s opioid receptors for a euphoric and addictive high.

Cocaine, on the other hand, works by blocking transporter proteins in the synapses of the central nervous system to boost neurotransmitter levels, especially dopamine, for a short period.

A cocaine high, whether the drug is delivered as powdered cocaine or freebase crack cocaine, is highly energetic, can make a person feel vibrant, invincible, and free from inhibition.

Counterbalanced Effects

Opioids tend to make a person feel slow and sleepy, sometimes going “on the nod” due to sedating drowsiness. Stimulants, meanwhile, can make a person paranoid and jittery, or anxious and distressed once the drug’s effects wear off.

In theory, the combined effects of a stimulant plus an opioid should balance out, each relieving the negative symptoms of the other for an elevated euphoric experience.

Dangers Of Mixing Tramadol & Cocaine

Mixing stimulants and opioids is a dangerous and often lethal practice. The toxic stress of the push/pull reactions of tramadol and cocaine can do severe damage to a person’s body and brain.

Tramadol, while still a prescription drug, is a weak painkiller compared to other opioids analgesics and has properties in common with antidepressants. This is because tramadol is a serotonin-increasing substance, and blocks reuptake of both serotonin and norepinephrine.

Cocaine generates its effects by increasing dopamine activity. However, cocaine is also known to block serotonin and norepinephrine transporters, similar to tramadol.

This increases norepinephrine and serotonin activity, which (depending on one’s dosage) can result in a potentially dangerous drug interaction between cocaine and tramadol known as serotonin syndrome.

Serotonin Syndrome

Serotonin syndrome, or serotonin toxicity, occurs when two or more serotonin-increasing drugs are taken at once.

Symptoms can range from mild to life-threatening and may include:

• agitation
• insomnia
• confusion
• rapid heart rate
• elevated blood pressure
• elevated body temperature
• dilated pupils
• twitching
• tremors
• muscle rigidity
• heavy sweating
• diarrhea
• headache
• shivering
• goosebumps
• muscle breakdown
• seizures
• loss of consciousness
• death

Increased Toxic Effects

There is one published case study where an athlete with a history of doping and substance abuse took an excessive dose of cocaine along with a large dose of tramadol and therapeutic doses of the pain reliever acetaminophen, all while in the midst of benzodiazepine withdrawal.

This resulted in a fatal overdose that included:

• symptoms of serotonin syndrome and high adrenaline levels
• uncontrolled shaking movements
• very high body temperature
• rapid blood pressure changes
• high blood acidity
• low blood potassium levels
• muscle tissue breakdown, a condition that swiftly destroy the heart and kidneys

The study’s authors surmised that the tramadol the individual used before their death most likely primed the toxic effects of the cocaine.

The typical effects of opioid overdose, including respiratory depression, did not play any significant role. However, polysubstance use can increase the risk of cocaine or tramadol overdose.

FAQ

What Happens When You Mix Tramadol & Cocaine?

If you mix tramadol and cocaine, you may have an increased risk of serotonin syndrome, cocaine or tramadol overdose, and long-term addiction.

Cocaine & Tramadol Addiction Treatment

Both tramadol and cocaine can be highly addictive when abused, either alone or together. But treatment is available that can help you or your loved ones establish a healthier lifestyle free from the dangers of tramadol overdose or serotonin syndrome.

Personalized addiction treatment options that may be recommended include:

• medical detox to manage uncomfortable withdrawal symptoms
• outpatient or inpatient treatment
• medication-assisted treatment for opioid addiction using buprenorphine, methadone, or naltrexone
• behavioral therapy
• aftercare support

To learn more about our cocaine and prescription drug abuse treatment options, please contact Ark Behavioral Health today.