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Tramadol and ketamine sold as codeine and promethazine ("Lean")
Risk assessment
A sample declared as codeine and promethazine ("Lean") contained the painkiller tramadol instead of the expected active ingredients.
Tramadol is a synthetic opioid that is used to treat moderate to severe pain. In contrast to codeine, tramadol not only acts as an opioid receptor agonist, but also inhibits the reuptake of serotonin and noradrenaline. There is a risk of unexpected differences in effect, as tramadol has a different potency and duration of action than codeine. Tramadol is typically dosed higher than codeine, which can result in a weaker pain-relieving effect with the usual codeine dosage. It also lacks the sedative effect of promethazine, which weakens the expected calming effect.
Tramadol can trigger serotonin syndrome at higher doses or in combination with other serotonergic substances and has a known risk of seizures, especially at high doses.
Drugs purchased on the illegal market are often misrepresented; it is therefore essential to have them tested before use or to test them at a lower dose than usual.
The small amount of ketamine indicates contamination rather than deliberate admixture.
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Safer Use
Analysis
Have your substance tested in a drug check if you bought it on the black market or on the internet. Counterfeit blisters may look identical to the original packaging.
Mixed use
Do not mix any depressant substances such as benzodiazepines, alcohol, GHB/GBL or opioids. Risk of unconsciousness or respiratory paralysis!
Dosage
Feel your way to the dosage and do not rely on dosage information from friends. Various factors such as habituation or dependence can contribute to a greatly increased dosage!
Testing
If you do not have the possibility to have substances analyzed, first test a maximum of one third of the pill. Some counterfeit drugs contain a more potent substance than the original.
Wait and see
Wait at least 2 hours after taking the drug. With some drugs, the onset of the intoxicating effect is very slow or it is difficult to perceive.
Disclaimer
If you are in possession of a substance that does not appear on this page, this in no way means that it contains the expected ingredient or that it should be safe. The warnings we publish only refer to the substances listed in our Drug Checking offers, these substances pose a high risk of consumption and should not be consumed. A substance may have the same visual appearance (shape, size, colour, etc.) and yet have different ingredients or a different composition. There is no drug use without risk! Only a complete renunciation of drugs is risk-free! If you still decide to use drugs, you should at least follow the safer use rules.
