Quick info
Valoron®, Valoron® N, Valtran® etc.
Tilidine is an analgesic with a morphine-like effect for the treatment of moderate pain and belongs to the group of weakly acting opioids. The drug is used when mild, non-opioid painkillers such as paracetamol and ibuprofen no longer have sufficient effect. However, tilidine is significantly less potent than strong opioids such as morphine or fentanyl.
Tilidine inhibits pain-mediating neuronal systems in the body and thus has a pain-relieving effect. When consumed in higher doses, it has a euphoric and anxiety-relieving effect. Due to its opioid properties, regular use can quickly lead to dependence. Abrupt discontinuation of tilidine leads to withdrawal symptoms.
Onset of action
Drops: after 5 - 10 minutes
Tablets: after 10 - 20 minutes
Duration of action
3 - 5 hours, depending on the form of consumption. In the case of sustained-release tablets, up to 12 hours (active substance is released delayed over a longer period). Side effects can last between 1 and 12 hours.
Appearance
Available in drop or tablet form (retarded and de-retarded). Pure tilidine requires a prescription and is classified as a narcotic.
In Germany, tilidine is only available as a combination preparation with naloxone (8 mg naloxone to 100 mg tilidine). This is intended to prevent misuse of tilidine: At a very high oral dosage or when the drug is injected, naloxone as an opioid antagonist cancels the effect of tilidine. Naloxone is used in emergency medicine for opioid overdoses from heroin, methadone or fentanyl.
Swallowed:
Light: at approx. 25 - 50 mg psychoactive effects may already occur
Medium: 50 - 75 mg
Strong: Doses of 100 mg or more are considered too strong by many users and increase the risk of respiratory arrest.
With sustained-release tablets there is a risk of overdose due to delayed release of the active ingredient! The perceived effect is extremely different depending on the person and tolerance. In combination preparations with naloxone, the desired psychoactive effect of tilidine is cancelled out from approx. 300 - 400 mg by the naloxone contained.
When consuming for the first time, low doses should be used, as the risk of respiratory arrest is increased.
Risks
Known adverse reactions are nausea, vomiting, dizziness, drop in blood pressure, drowsiness, tiredness, headache, excessive sweating and nervousness.
In opioid addicts who abuse Valoron® N in high doses as a substitute for morphine or heroin, the drug triggers acute withdrawal symptoms (anxiety, trembling, sweating) due to the naloxone or intensifies already existing withdrawal symptoms.
Overdose
In higher doses, hallucinations and euphoria may occur, which is why the drug is consumed as a psychoactive intoxicant. The anxiety-relieving, disinhibiting and euphoric properties can lead to aggression, loss of control and increased risk-taking in higher doses. Some German media reported robberies in connection with extremely aggressive, pain-resistant young people under the influence of tilidine.
Long-term risks/consequences
Regular, abusive use of tilidine can lead to dependence with severe withdrawal symptoms such as seizures, sleep disorders and depression. Withdrawal, as with all opioids, should not be abrupt and should only take place under medical supervision.
Opioids are highly effective medications that should only be used for a limited time and, at best, with a doctor's supervision.
Start with a low dose and wait for the effect and tolerance before adding more.
After a period of abstinence, use a much lower dose! The usual dose before the abstinence phase can otherwise quickly have life-threatening consequences.
If you inject opioids, dose even more carefully, as the range between desired effect (rush) and dangerous overdose is even more difficult to assess. Avoid injecting opioids; the risk of overdose is particularly high. Always use new (clean and sterile) injection material! Never exchange syringes, filters, water, disinfection swabs to avoid transmission of hepatitis and HIV.
Do not rely on dosage information from colleagues who regularly use opioids. Due to habituation or dependence, their doses are significantly higher and can be fatal for new users.
Take longer breaks (at least several days) between consumption.
Refrain from citrus fruits (especially grapefruit) before or during consumption. The combination can lead to an increase in the effect of the opioid and/or respiratory depression.
The simultaneous consumption of depressant substances such as alcohol, ketamine, GHB/GBL, nitrous oxide, benzodiazepines and/or other opioids is dangerous as there is an increased risk of vomiting and unconsciousness. The risk of suffocation is high!
The combination with methoxetamine (MXE, Metha-Keta) increases the opioid effect.
Mixing opioids with DXM is generally not recommended - there is an increased risk of central nervous system disorders as well as heart and respiratory problems. In addition, DXM lowers the individual opioid tolerance, which is why the risk of overdose increases considerably.
Mixed use of opioids with stimulants (such as cocaine, amphetamine, methamphetamine) puts extreme strain on the body and the cardiovascular system. The effects can mask each other, so that they are subjectively felt to be weaker. If the effect of the stimulants wears off before the opioids, there is a risk of delayed overdose and even respiratory depression.
LSD analogues are substances that are chemically very similar to LSD and can have comparable effects. Some of them have been known for a long time (e.g. ALD52, ETH-LAD, AL-LAD, PRO-LAD etc.) and have been studied pharmacologically as well as psychopharmacologically, at least in part. Others are newer "creations" (e.g. the derivatives 1P-LSD,1B-LSD, 1cP-LSD, 1V-LSDetc.), for which only few or no data are available. Certain LSD analogues can (still) be legally produced, traded and consumed in some countries, which is the main reason for their distribution.
Most LSD analogues are naturally different from LSD in their effect and/or potency (e.g. ETH-LAD, AL-LAD, LSZ etc.). In contrast, the so-called 1-acylated LSD compounds (e.g. 1P-LSD, 1V-LSD, 1B-LSD, ALD-52, etc.) are presumed, on the basis of pharmacological studies, to convert into LSD in the body (they function as so-called prodrugs) and thus have a comparable psychoactive effect to LSD.
In the case of prodrugs of LSD and LSD analogues, it has not been conclusively clarified whether, in addition to their psychoactive effect, they can produce other pharmacological effects. How potent these prodrugs are compared to the resulting substance (e.g., 1P-LSD to LSD), and to what extent a delay in onset of action occurs in each case, may be substance-dependent and cannot be generalized. Therefore, it is important to approach the dose/effect carefully to avoid overdoses.
If you or someone else needs urgent help after taking drugs or alcohol, call an ambulance on 144. Tell the emergency responders everything you know.
It could save lives.