There is some evidence which suggests that the use of Irish stick weapons may have evolved in a progression from a reliance on long spears and wattles, to shorter spears and wattles, to the shillelagh, alpeen, blackthorn (walking-stick) and short cudgel.
Moreover, most of the associated drugs fatalities including tramadol have been reported with other central nervous system (CNS) depressants, particularly benzodiazepine [9], [10], [11], [13] and [14]. In certain cases, benzodiazepine levels were in the therapeutic range or slightly higher.
Codeine, hydrocodone, tapentadol, and tramadol are considered weak full agonist opioids. Both tramadol and tapentadol have additional mechanisms of actionânorepinephrine and serotonin reuptake inhibition for tramadol and norepinephrine reuptake inhibition for tapentadol.