Citation: Dumb. "Party Problems: An Experience with Tramadol, Alcohol (Beer), Ibuprofen (Advil) (exp73962)". Erowid.org. Sep 13, 2009. erowid.org/exp/73962
I had gone out of town to attend a party at my friend's university. Recently I've been using generic tramadol for pain relief, anti-anxiety, and opiate-like euphoria on a semi-regular basis. I have consumed no more than 200mg in a day prior to this experience, and I have never combined it with alcohol. I'm aware that combining true opiates with alcohol can be a deadly combination, but I was under the impression that the reason for that was severe respiratory depression, causing the user to stop breathing and simply die.
As far as I know, tramadol does not carry that particular side effect in the same degree that normal opiates do, so I was curious if I could get away with using tramadol early in the day to relieve my social anxiety and allow me to break out of my shell a bit in terms or talking to people, and then still drink at night, as long as I stayed within reason.
To test the effects, I began by taking 150mg of tramadol at about 7:45 AM. After some time, I decided that the high was not good enough, and took another 50mg pill. This was a nice buzz. I was up before everyone else and I spent my time thinking about some ideas for work, I even wrote a poem with little magnetic words that my friend had stuck to his fridge. It was not a masterpiece, but decent, considering the limited vocabulary. It was about sinning, or opiates, and satan... or something. Using the only non-dirty words I could find on the fridge, I titled it 'Come Clean'
'Perhaps God is never brilliant
Embrace in me and my dark universe
We can drink to your Eternity'
It made a lot of sense to me at the time, it doesn't seem so special now, but regardless, I was feeling good.
I spent the morning high, not even close to nodding, but just... a little euphoric and talkative. I was enjoying myself and meeting some new people. At around noon, I drank a bottle of beer, just to see if I would notice any extreme reaction between the two drugs. Nothing. Little buzz, felt normal.
I stayed in the house and drank a few more beers as the hours went by. I was really enjoying the ability to talk to people without the extreme social anxiety that I normally feel. I felt like I was on my game. Like people were enjoying my company. It was fantastic.
As hours passed, still no bad reactions. Little buzz whenever I drank, and standard effects from the tramadol, but as day turned to night I felt the effects begin to dissipate. Now, from personal experience I know that tramadol causes effects within the brain that can last over 24 hours. I will still feel pretty damn good 12 hours after ingestion, and 26-28 hours later, I typically still feel good enough not to want another pill without sufficient reason. This implies to me that its serotogenic effects are long lasting and serious.
Even knowing this, I decided to re-dose. My prescription says not to exceed 8 pills in a day, and being slightly high, I decided to go against my better wisdom and dose another 100mg to try and get that feeling back -- even knowing that I planned to drink more later. I really wanted to talk to this one girl, and I could feel the moment falling through my fingers -- I had to take a little more to make the night memorable.
I dosed up, and before I knew it, I was feeling pretty high again. Except, my head sort of felt weird, and I was worried that I might induce a seizure. I waited for the feeling to pass, then took another 50mg, waited for that same feeling again, and let it pass, then took another 50mg.
All the while I had begun drinking much more rapidly. I don't know exactly how many beers I had, but I felt buzzed, hardly drunk.
Finally, several drinks later, I started feeling drunk. I had practically forgotten about the tramadol and was *loving* the night. I couldn't believe that I was talking with this girl. I'm way too socially awkward for her to want to spend this much time talking with me... but there we were. I was so happy.
Then things get hazy. I stayed out on the balcony, and she went inside. Things start to get dark, and suddenly, I'm throwing up. I vomit a bit on the balcony between my shoes and then realize how retarded that is, and toss my stomach contents over the edge for a good 20 minutes at least. I eventually got moved inside by my friends to finish my tossing in the bathroom. I felt like a tool. I couldn't have had more than 6-8 drinks, spread out over 2 hours, and here I was, violently vomiting. I figured it was a little bit of the tramadol and alcohol and just... a bad combination.
Things got much worse.
I finally managed to lay down. At this point I realize that I'm going to have a headache that will be fully debilitating in the morning. What I don't realize is that I will wake up early at an unknown time, but several hours ahead of everyone else again, and stumble my way to the bathroom to vomit grass-colored yellow-green bile into the bowl. Something was wrong here.
I continued to vomit, and between vomiting, had extremely vivid closed eye hallucinations. Typically the hallucinations would put me in another place, doing something or talking to someone, only to be snapped back into the shitty reality of this bathroom and my condition. They reminded me of the delirium caused by insomnia and large doses of diphenhydramine.
I couldn't hold my body up properly, and my legs went fully numb, followed shortly after by my arms. Each time I would vomit it would be difficult. Like I was extracting every last bit of liquid out of my body. Yellow bile was all that was left in me, and I would be fine until my stomach filled with enough of it, I would inevitably vomit it out. Typically about 2-3 tablespoons worth of liquid, and nothing else.
I could not move. At times I would attempt to urinate or defecate, and though sometimes successful, I often could not pull my pants back up afterward. The energy required to do so was simply too great. Before people in the house started waking up, I managed to pull my pants onto my hips, but could not button them or put my belt on.
I had a high fever, though the exact number is unknown because I had no access to a thermometer. I was sweating, and my body just felt like shit. I sat there for hours, drifting in and out of hallucinations and occasionally vomiting bile. Eventually my friends came to ask if I was alright, and I told them no, but that there wasn't much they could do for me. I asked for water, but I knew that I couldn't drink it. I put a few drops in my mouth just to try and wash some of the acidity out, but just doing that made me feel like I needed to vomit again.
Eventually, as things began to calm down, I waved a friend into the bathroom. I was now propped up against the wall, facing toward the bedroom they were in, and looking fairly... dead.
I asked him if our friends could vacate the bedroom so that I could try to rest. The hallucinations were still strong and I was drifting in and out of sleep and dreams. I wanted a bed. I hoped this could be slept off.
My friends complied and I enjoyed the bed. I got vicious cold sweats. My whole body was soaked. But the exhaustion was extreme, so I eventually drifted off after vomiting just one more time into a bucket.
The interesting thing here is that the tramadol euphoria was still somewhat strong, and I found myself singing 'Don't Stop Me Now' by Queen into the bucket as I was dry heaving. In this deathly feeling state, I was there singing 'I'm having such a good time, I'm having a ball! If you wanna have a good time, just give me a call!'
After a little rest, I woke back up, feeling much much better, but entirely too fucking hot. I couldn't believe how hot it was. I was shivering just a little while ago, and now I felt like I needed to strip naked. The good news was that the stomach churning nausea had faded, and I was able to start slowly sipping water to rehydrate myself. To relieve the headache I had acquired, I downed three Advil Cold and Sinus. I normally take these for sinus headaches, and I know the pseudoephedrine can get my heart going fast sometimes, but I was about to realize I just made another mistake.
As the headache faded, I went out to the living room. Suddenly my fingers grew numb. Then my hands. Then my arms. Within 30 minutes both of my arms were completely numb and tingly, and I could hardly use them to lift things. My heart was racing, but I was fully coherent by this point and began to ask my friends 'You guys know what to do if I have a heart attack right? You know CPR?' they didn't really know it, but they had a general idea. Due to the tramadol euphoria, I was alright with a general idea. I'm sure they wouldn't let me croak. Right? It was strange to be thinking about my potential death while completely coherent and euphoric. I didn't really care too much. Or as I later said to a friend 'I had a rather cheery disposition regarding my expiration.'
The numbness eventually faded after giving everyone a good scare, and I decided that it had something to do with the extreme lack of food in my system and just everything else that I had been ingesting that the pseudoephedrine gave me a pretty scary side effect.
Now, about 12 hours after the whole ordeal has passed, I'm able to have some retrospective on it.
At first, I believed that I had triggered an extreme serotonin toxicity in my brain, but now that I've done some googling, I've found that I just got a wicked combination of things. There was probably some serotonin toxicity, though I suffered no renal or liver failure, and that was my greatest fear. I constantly checked my eyes for signs of yellowness. I believe that I was severely dehydrated and exhausted, which may have caused the hallucinations. The sweating and fever may have been induced by a serotonin toxicity, and the numbness in my arms the next morning was most certainly caused by the pseudoephedrine being taken under such extraordinary circumstances.
If I could re-do that night, I would have hydrated better throughout the day and night. I probably still would have redosed, because my reasoning behind that was not entirely logical, so it would be hard not to do it again in the same circumstance. I also would have drank less. Perhaps 1 drink per hour, ideally matched with a drink of water between each alcoholic beverage. And I should have taken regular Advil, without the pseudoephedrine.
In the end, I feel like I should have been smarter than this -- and my youthful sense of immortality has caused me to do something that I feel very stupid about in retrospect. I'm embarrassed to even talk about it. I'm supposed to be more responsible than this, and to know what I am doing.
I do not know if I was genuinely at risk of death or long term injury, though I did notice some extremely shallow breathing before I went to sleep, and that obviously could have been very dangerous. I was certainly miserable and showing signs of some kind of overdose. I'm sure it scared my friends, especially because they did not know what I had taken. My advice would be to not follow my example. Tramadol should not be used in combination with other drugs, and it can potentially be dangerous to do so.
As for me? I have to rectify how absolutely stupid the whole thing was, and pray that the girl did not think lesser of me from growing violently ill off of 6 beers :-P
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