Yellow and green capsules that were acquired as ‘MDMA’ were tested and found to contain only
tramadol.

What is tramadol?

Tramadol is a synthetic opioid which is a central nervous system depressant/painkiller.
It’s a very different substance from MDMA, which is a stimulant/empathogen.

Combining tramadol with drugs that affect serotonin can cause serotonin toxicity, a serious
medical emergency.

This includes:

• MDMA
• Methamphetamine
• Cathinones like mephedrone
• Antidepressants (SSRIs, SNRIs, MAOIs, TCAs)

Combining tramadol with other depressants (e.g. alcohol, benzodiazepines) can cause respiratory depression and overdose.

Signs of serotonin toxicity include:

• Agitation or confusion
• Heavy sweating, feeling very hot
• Shaking, muscle twitching or stiff muscles
• Rapid heart rate or chest pain
• Loss of consciousness or seizures

What to do:

• Call triple zero ‘000’
• Keep the person cool
• Place in the recovery position
• Stay with the person until help arrives

Signs of opioid overdose:

• Slow, shallow or stopped breathing
• Snoring, choking or gurgling sounds
• Unresponsive or hard to wake
• Blue (or grey) lips and fingernails
• Pale, cold or clammy skin
• Slow or irregular pulse

What to do:

• Call triple zero ‘000’
• Give naloxone
• Rescue breaths if not breathing
• Place in the recovery position
• Give more naloxone if no response
• Stay until help arrives

Harm reduction tips

• Test your drugs – Even if you think you know what you have, it’s best to test and be sure
• Carry naloxone – Opioids can be in any substance. Naloxone reverses opioid overdose, is legal and widely available
• Avoid mixing drugs – Tramadol can interact with prescription medicines and other drugs
• Avoid using alone – Use with people you trust who can help if something goes wrong
• Start low, go slow – Start with a small amount, don’t redose until you know what to expect

Call triple zero ‘000’ immediately If you or someone else experience adverse effects.

Get your drugs tested!
Only a very small amount is needed – approximately 10mg (0.01g)
Victorian Pill Testing Service
95 Brunswick Street
Fitzroy VIC
Call: 1800 762 844
www.vicpilltesting.org.au