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Published online: 2025-02-05

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Combined tramadol and morphine overdose — a rare case report

Jefrilla Nancy Joseph1, Meenakshi V Venketeswaran1

Abstract

The use of opioids in cancer patients for pain management can improve the quality of life, but it comes with the risk of overdose and the potential risk of suicide. This case report highlights a 42-year-old male cancer patient who attempted suicide by overdosing on morphine and tramadol, both prescribed for pain management. Opioid-induced respiratory depression is the primary cause of death in such cases, which can be reversed with naloxone. The patient was successfully treated with naloxone infusion and supportive measures. Individual risk factors like neuropsychiatric illness, family history of suicidal behavior, and drug and alcohol misuse have a strong predilection for suicide. Identifying and managing opioid overdose is crucial for saving lives, as opioids potentially cause disinhibition and impulsive behavior which can be one of the contributing factors leading to suicide. It is important to screen patients for substance abuse and psychiatric conditions, educate families on managing medications cautiously, and monitor patients closely for signs of suicidal ideation. This case report provides insights into managing a double opioid overdose in cancer patients. Overall, understanding the risks associated with opioid use and implementing appropriate measures for monitoring and intervention can help reduce the incidence of suicide due to opioid overdose in cancer patients.

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