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fixing language #168

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50cd6a7
Update combos.json
zelixir25 Mar 1, 2025
c1d4f35
Update combos.json
zelixir25 Mar 1, 2025
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50 changes: 26 additions & 24 deletions combos.json
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@utaninja utaninja Oct 3, 2025

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While unconscious, may cause vomit aspiration as well.

I like the overall wording changes but this sentence seems a bit odd to me. Could we reword it?

"Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, there is a risk of dangerous vomit aspiration as well."

Original file line number Diff line number Diff line change
Expand Up @@ -348,7 +348,7 @@
"status": "Caution"
},
"benzodiazepines": {
"note": "Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"caffeine": {
Expand Down Expand Up @@ -385,7 +385,7 @@
"status": "Unsafe"
},
"dextromethorphan": {
"note": "Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Additionally, CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.",
"note": "Both drugs increase the CNS depressant effects of each other. At moderate-to-high doses, there is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well. Avoid on anything higher than 1st plateau.",
"status": "Dangerous"
},
"dmt": {
Expand Down Expand Up @@ -454,7 +454,7 @@
"status": "Caution"
},
"opioids": {
"note": "Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"pcp": {
Expand Down Expand Up @@ -712,7 +712,7 @@
"status": "Low Risk & Decrease"
},
"alcohol": {
"note": "Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"amphetamines": {
Expand All @@ -732,7 +732,7 @@
"status": "Low Risk & Decrease"
},
"dextromethorphan": {
"note": "Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.",
"note": "Both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.",
"status": "Caution"
},
"dmt": {
Expand Down Expand Up @@ -775,7 +775,7 @@
"status": "Low Risk & Decrease"
},
"opioids": {
"note": "Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"pcp": {
Expand All @@ -786,7 +786,7 @@
"status": "Low Risk & No Synergy"
},
"tramadol": {
"note": "Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration is a risk when passed out, lay down in recovery position if ingested.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
}
},
Expand Down Expand Up @@ -1148,7 +1148,7 @@
"status": "Unsafe"
},
"alcohol": {
"note": "Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Additionally, CNS depression can lead to difficulty breathing. Avoid on anything higher than 1st plateau.",
"note": "Both drugs increase the CNS depressant effects of each other. At moderate-to-high doses, there is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well. Avoid on anything higher than 1st plateau.",
"status": "Dangerous"
},
"amphetamines": {
Expand All @@ -1159,7 +1159,7 @@
"status": "Dangerous"
},
"benzodiazepines": {
"note": "Small doses of benzos can end a bad trip, but both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.",
"note": "Both substances potentiate the ataxia and sedation caused by the other and this can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.",
"status": "Caution"
},
"caffeine": {
Expand Down Expand Up @@ -1198,7 +1198,7 @@
"status": "Unsafe"
},
"ghb/gbl": {
"note": "Both substances cause ataxia and bring a risk of vomiting and unconsciousness. If the individual falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position. This combination is hard to predict",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"ketamine": {
Expand Down Expand Up @@ -1332,7 +1332,7 @@
"status": "Low Risk & Synergy"
},
"opioids": {
"note": "CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.",
"status": "Dangerous"
},
"pcp": {
Expand All @@ -1343,6 +1343,7 @@
"status": "Dangerous"
},
"tramadol": {
"note": "This combination can dangerously increase serotonin levels in the brain leading to serotonin syndrome in addition to increased CNS depression.",
"status": "Dangerous"
}
},
Expand Down Expand Up @@ -1625,7 +1626,7 @@
"status": "Low Risk & Decrease"
},
"alcohol": {
"note": "Even in very low doses this combination rapidly leads to memory loss, severe ataxia and unconsciousness. There is a high risk of vomit aspiration while unconscious.",
"note": "Even at relatively low doses, both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"amphetamines": {
Expand All @@ -1636,7 +1637,7 @@
"status": "Low Risk & Decrease"
},
"benzodiazepines": {
"note": "The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"caffeine": {
Expand All @@ -1654,7 +1655,7 @@
"status": "Dangerous"
},
"diphenhydramine": {
"note": "Both substances are CNS depressants, potentiating each other strongly and unpredictably, raising the chances of memory loss, severe ataxia, and unconsciousness. The interaction will cause greater inhibition and risk of injury. If the user falls unconscious it is strongly recommended to put them into the recovery position and monitor breathing.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"sources": [
{
"author": "William J Tharion, Donna J. McMenemy, Terry M. Rauch",
Expand Down Expand Up @@ -1717,7 +1718,7 @@
"status": "Caution"
},
"opioids": {
"note": "The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"pcp": {
Expand All @@ -1728,7 +1729,7 @@
"status": "Low Risk & No Synergy"
},
"tramadol": {
"note": "The sedative effects of this combination can lead to dangerous respiratory depression.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
}
},
Expand Down Expand Up @@ -3358,7 +3359,7 @@
"status": "Low Risk & No Synergy"
},
"alcohol": {
"note": "Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"amphetamines": {
Expand All @@ -3370,7 +3371,7 @@
"status": "Low Risk & No Synergy"
},
"benzodiazepines": {
"note": "Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position Blackouts/memory loss likely",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"caffeine": {
Expand All @@ -3384,7 +3385,7 @@
"status": "Dangerous"
},
"dextromethorphan": {
"note": "CNS depression, difficult breathing, heart issues, hepatoxic, just very unsafe combination all around. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well. Additionally if one takes DXM, their tolerance of opiates goes down slightly, thus causing additional synergistic effects.",
"status": "Dangerous"
},
"dmt": {
Expand All @@ -3395,7 +3396,7 @@
"status": "Low Risk & No Synergy"
},
"ghb/gbl": {
"note": "The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"ketamine": {
Expand Down Expand Up @@ -3660,6 +3661,7 @@
"status": "Unsafe"
},
"tramadol": {
"note": "Increased risk of serotonin syndrome.",

@utaninja utaninja Oct 3, 2025

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Spies, P. E., Pot, J. L. W. H., Willems, R. P. J., Bos, J. M., & Kramers, C. (2017). Interaction between tramadol and selective serotonin reuptake inhibitors: are doctors aware of potential risks in their prescription practice?. European journal of hospital pharmacy : science and practice, 24(2), 124–127. https://doi.org/10.1136/ejhpharm-2015-000838
Park SH, Wackernah RC, Stimmel GL. Serotonin Syndrome: Is It a Reason to Avoid the Use of Tramadol With Antidepressants? Journal of Pharmacy Practice. 2013;27(1):71-78. doi:10.1177/0897190013504957

The second study noted dosage is relevant, perhaps we can reword to note this. (ie medical dosages may not be of concern with monitoring, but higher/recreational doses are of higher risk)

"status": "Dangerous"
}
},
Expand All @@ -3675,7 +3677,7 @@
"status": "Unsafe"
},
"alcohol": {
"note": "Heavy CNS depressants, risk of seizures. Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. Place the affected individual in the recovery position to prevent vomit aspiration from excess. Memory blackouts are likely.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of seizures, blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"amphetamines": {
Expand All @@ -3686,7 +3688,7 @@
"status": "Dangerous"
},
"benzodiazepines": {
"note": "Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration is a risk when passed out, lay down in recovery position if ingested.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"caffeine": {
Expand All @@ -3711,7 +3713,7 @@
"status": "Unsafe"
},
"ghb/gbl": {
"note": "The sedative effects of this combination can lead to dangerous respiratory depression.",
"note": "Both drugs increase the CNS depressant effects of each other. There is a high risk of blackouts/memory loss, unconsciousness, and respiratory depression leading to death. While unconscious, may cause vomit aspiration as well.",
"status": "Dangerous"
},
"ketamine": {
Expand Down Expand Up @@ -3799,4 +3801,4 @@
"status": "Dangerous"
}
}
}
}