Pentazocine abuse in sickle cell anaemia patients: a report of two case vignetes

Abstract

The article aims to draw attention of clinicians to the addictive potentials of Pentazocine use in sickle cell anaemia patients and to highlight some of the associated problems of pentazocine abuse. It also hopes to stimulate the need to review guidelines for the use of analgesics in the management of bone pain crisis or other chronic pains. Two case reports of pentazocine abuse seen in a psychiatry clinic at the University of Ilorin Teaching Hospital (UITH) Ilorin, Nigeria were made. It was found that both patients who were sickle cell anaemia (HbS) patients were first given intramuscular pentazocine in private hospitals during an episode of bone pain crises. They claimed that though the bone pain crises subsided after a few days on admission, they continued to feign pains in order to be given pentazocine because they enjoyed its dysphoric effect. There were features of pentazocine dependence as shown by intense craving for the drug, excessive sweating, body (not bone) pains, signs of needle pricks on the body, sudden extravagance, begging for money, stealing and poor academic performance among other things. There was no clinical evidence of bone crisis or complications of sickle cell anaemia. It was concluded that more than before, clinicians should be cautious in the use of analgesics which has potential for addiction in sickle cell anaemia and chronic pain patients.

Alcohol-pentazocine combination: implication on the cytoarchitectural profile of the medial prefrontal cortex and cerebellum of juvenile male rats

“…Lang and Pilon (1980) reported that PTZ produces minimal euphoria but has some dysphoric effect in the insignificant number of individuals. It was initially thought to be non-addictive ethical medication, but its potential for abuse and dependence was soon observed (Weber and Fromme, 1970;Huskisson, 1974;Makanjuola and Olatunji, 2009). Since then, various 'pharmaco-medicolegal' efforts have been made to significantly minimize its abuse and dependence (Makanjuola and Olatunji, 2009).…”

“…It was initially thought to be non-addictive ethical medication, but its potential for abuse and dependence was soon observed (Weber and Fromme, 1970;Huskisson, 1974;Makanjuola and Olatunji, 2009). Since then, various 'pharmaco-medicolegal' efforts have been made to significantly minimize its abuse and dependence (Makanjuola and Olatunji, 2009). Incidences of drug abuse in Nigeria has persisted from the 1960s till date (Asuni, 1964;Lambo, 1965;Adelekan et al, 2000;Adamson et al, 2010;Onyecho et al, 2016).…”

Survey of Pentazocine Addiction and Opioid Use in Adult Sickle Cell Anaemia Patients: The Perspective of Healthcare Providers

“…The use of opioids as a sole agent in the treatment of chronic pain has been identified as a cause of addiction [18]. Pentazocine addiction may present as intense craving for the drug, excessive sweating, body (not bone) pains, signs of needle pricks on the body and poor academic performance [19,20]. Some personality disorders resulting from opioid dependence reflective of dysfunction in the limbic system and higher centres are loss of productivity at work, truancy and criminal tendency ostensibly to raise funds for crave satisfaction.…”

“…Some personality disorders resulting from opioid dependence reflective of dysfunction in the limbic system and higher centres are loss of productivity at work, truancy and criminal tendency ostensibly to raise funds for crave satisfaction. Ultimately, job loss, premature school attrition and other socio-economic are untoward effects of pentazocine abuse [20,21]. It has also been associated with stealing [20,21] and other corrupt practices (to raise money for its purchase) as well as loss of job following associated physical deformity [21].…”

“…In Nigeria, despite regulation, pentazocine is still being purchased "over the counter" in many places [21]. Clinical experience has indicated a rising prevalence of addiction to pentazocine in the Nigerian population in people living with sickle cell disease [20,21]. This study is designed to determine the extent of the problem, assess the prescription pattern of the attending physicians as well as evaluate the necessity for guidelines in the prescription of opioids.…”