Could these be symptoms of substance abuse? ?

Someone I know (not me, I'm daft but not THIS stupid) was on tramadol for headaches. Took the last one midnight Thursday then got utterly drunk friday night. She's now got pain and pins and needles in her left arm. Could it be because of her less than sensible antics recently? Or could it just be that the bad headaches are migraines? What does painkillers like tramadol added to vast amounts of alcohol do to you, anyway? Also she is seriously fat.