الفهرس 
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Abstract
The present study included 72 male volunteers who were recruited from the out–patient clinic of Institute of Psychiatry, Ain-Shams University. They were subjected to medical examination and a questionnaire, then they were divided into three groups as follow:
The first group: consisting of 23 healthy males.
The second group: consisting of 21 males addicted to tramadol only.
The third group: consisting of 28 males addicted to cannabis and tramadol.
Blood samples were withdrawn from each participant and serum/plasma were separated and kept frozen in vials. Urine samples were collected and centrifuged and kept frozen in vials. The following parameters were measured:
1. Concentration of serum sodium
2. Concentration of serum potassium
3. Concentration of plasma aldosterone
4. Concentration of serum renin
5. Concentration of plasma Angiotensin II
6. Concentration of tramadol in urine
7. Concentration of THC in urine
In addition, age, addiction duration (except in non-addicted individuals), as well as both systolic and diastolic blood pressure for each individual were recorded. Results of the present study are presented in tables (table 5ـــtable 14) as means ± SD for all parameters.
Briefly, results of the present study revealed that tramadol addiction alone affect significantly both diastolic blood pressure and serum potassium levels.
Regarding cannabis co-abused with tramadol addiction, cannabis showed a synergetic effect to tramadol addiction with respect to both systolic and diastolic blood pressures as well as potassium and plasma aldosterone levels. On the other hand, cannabis co-abused with tramadol addiction revealed that cannabis has an anti-synergetic effect to tramadol addiction with respect to levels of serum renin and plasma angiotensin II as well as serum sodium.