Pentazocine Addiction

INTRODUCTION

The treatment of severe painful crises, in patients with the sickle cell disorder (SCD), often requires the use of an opioid drug. The preferred opioid analgesic (pain killer) drug is morphine, which unlike pentazocine, is not available over the counter in our pharmacies and is only supplied directly to genuinely registered hospitals.

Pethidine, another opioid analgesic, is no longer recommended because it can be toxic to nerves and can lead to seizures, especially in persons with poor kidney function. On the other hand, pentazocine is available and widely used in Nigeria and has led to severe addiction in several cases.

CASE REPORTS

Case 1:

Many years ago, a friend introduced to me his son who had the sickle cell disorder (SCD). Despite his Hb SS status, the son's health soon stabilized with his use of modern treatment and he was able to run a profitable business.

When a while later, I was invited to the wedding of his son which I was pleased to attend, I was happy to meet his charming wife. Less than a year later, I met his wife again and asked how their business was progressing, only to be informed that her husband was spending all available money on himself and not on her or on his business. On making further enquiry, I discovered that he had become addicted to pentazocine, which he regularly injected into his thigh several times a day. Several attempts to help him to overcome the addiction failed. His marriage and business were destabilized until he finally succumbed to the addiction and died.

Case 2:

A few years ago, a young man with SCD was referred to me. He had no job and was dependent on friends, relatives, and whoever, for financial assistance.

On examination, I found signs of several injections on his thigh, which he admitted were from repeated self-injections of pentazocine. What he expected was my funding and not my criticism and I soon lost contact with him.

Case 3:

She was a good looking married lady who had SCD and a fairly long history of addiction to pentazocine. The latter had apparently ruined her marriage. She was referred to me on account of her SCD. I went to see her in a hospital in Lekki under the care of a consultant psychiatrist. Unfortunately, I have not received a pertinent medical report, which I had expected, and have lost touch with her.

DISCUSSION

Unfortunately, once a patient becomes addicted, he/she does not need to have any pain before seeking the drug for use. Thus, addicted persons spend all or most of their money and time on acquiring and using the drug.

Please enlighten your sickle cell affected siblings or spouses or children on the addictive properties of pentazocine and encourage their health carers to acquire copies of the Handbook On Management Of Sickle Cell Disorder For Doctors & Nurses from the Sickle Cell Foundation Nigeria.

By Professor Olu Akinyanju, OON
Chairman, Sickle Cell Foundation Nigeria