There was a country man of mine who died of the overdose by apparently choking on his own vomit
I use tramadol every now and then, pretty much the only thing that makes me somewhat happy / worry free. But for me, even 300mg gets me vomiting sooner or later. I also get very itchy even from 100-200mg. Then again, I do have eczema so I got a itchy skin very often anyways, but with tramadol it can get really annoying, to the point of near madness even
Bit offtopic, but related to the itch, when I had a girlfriend 5 years ago, at evenings we usually did some massaging to each other, at least 20 minutes and then change. At some point I actually wanted her just to scratch me, as hard as she could, if I was bleeding, that was good. And it had absolutely nothing to do with self-harm, it just felt really, really good to get that itch away like that for some time. I did this sometimes with a knife that had a "saw like" blade on the back, I use to go back and forth on my legs with it, sometimes to the point of bleeding just to get that itch away