Pentazocine Addiction

Pentazocine Addiction

Pentazocine Addiction

Pentazocine AddictionFifty years ago when pentazocine came on the market, the medical community was excited about it. Some 12,000 patients tested pentazocine, and it proved proven to be effective and not habit-forming. Reporters wrote glowing stories about how a non-addictive substitute for morphine had finally been discovered — the very drug scientists had been seeking for centuries. People in chronic pain would no longer become narcotic addicts. Pentazocine could be safely placed in medical kits kept in boats and fallout shelters, and no one would steal them. Doctors would not have to keep elaborate records every time they prescribed drug. Street addicts would not steal it from homes and pharmacies.

Sadly, none of this came to pass. Within four years of its introduction, scientists were performing studies on pentazocine addiction and abuse. Tens of thousands of Americans and Europeans were addicted to it, especially a version called “Poor Man’s Heroin,” a combination of pentazocine and Ritalin that produced a high similar to a speedball, the notorious blend of heroin and cocaine. Others liked combining pentazocine with certain antihistamines, a combination that produced an even longer-lasting euphoria.

In order to counteract pentazocine abuse, its manufacturer added a narcotic antagonist. Immediately, the number of people abusing it decreased. Today as people increasingly are abusing narcotic painkillers, pentazocine — even in the new formula– is making a comeback and listed as a “drug of concern” by the United States Drug Enforcement Agency.

What is Pentazocine?

Pentazocine is a narcotic painkiller once thought to be non-addictive. Unlike opium, it is made not from plants, but rather from synthetic materials such as coal tar. About 50mg of pentazocine has the pain-relieving strength of 60mg of codeine, and 38mg of pentazocine is equivalent to 10mg morphine. Pentazocine begins to work within 15 to 20 minutes and reaches its peak at 1.7 hours.

A trademarked version of pentazocine called Talwin was introduced in the late 1960s, but many people became addicted to it that the manufacturer added naloxone, an ingredient that blocks the euphoric effects of narcotic drugs, and renamed it Talwin NX. Today Talwin NX is the most common version of pentazocine, and it comes as scored yellow tablets marked A 211 and manufactured by Acetavis Totowa. Fortral and Sosegon also contain pentazocine and naloxone. Talacen contains 25mg pentazocine and 650mg acetaminophen. These names are all registered trademarks.

In 1979 the United States government classified pentazocine as a Schedule IV Controlled Substance, which means it has potential for addiction, some medical uses, and is available by doctor’s prescription only. The United States Drug Enforcement Agency has labeled pentazocine “a drug of concern,” meaning it is frequently abused. Pentazocine is classified as a Schedule III Controlled Substance on the international level.

The chemical formula for pentazocine is 17-Allyl-4,5α-epoxy-3,14-dihydroxymorphinan-6-one hydrochloride, and its molecule looks like this:

What are the Medical Uses of Pentazocine?

Pentazocine is prescribed for moderate to severe pain. The usual dosage is one pentazocine/naloxone tablet every three to four hours for those over 12 years old, and not more than 12 tablets a day. Pure Pentazocine is usually injected into a patient at a hospital or a doctor’s office.

There is some evidence that women get more pain relief from pentazocine products than men do.

What are the Side Effects of Pentazocine?

The most common side effects are drowsiness, fatigue, confusion, lightheadedness, moodiness, headache, vomiting, and constipation. Some people need to stop taking pentazocine because of more serious side effects such as trouble breathing, shortness of breath, problems in urination, skin lesions, disorientation, and unusual behaviors or thoughts. The following side effects can indicate that something is wrong and you may have to stop taking pentazocine: tremors, anxiety, restlessness, swelling, shakiness in legs, ulcers in the mouth, swollen glands, bleeding, hallucinations, blisters, fainting, puffy eyes, cough, chills, fever, or fainting.

What Drugs Interact with Pentazocine?

Any drug that slows down the central nervous system has the potential of producing a dangerous reaction with pentazocine. Central nervous system depressants may include alcohol, narcotics, narcotic painkillers, general anesthesia, tranquilizers, sedatives, sleeping pills, antihistamines, barbiturates, cold and flu medications, certain antidepressants, and almost any drug that makes you sleepy. Do not combine pentazocine with MAO Inhibitors, fluoxetine, yohimbine, Sufentanil, clonidine, methadone, GHB, cimetidine, naltrexone, or sibutramine. Do not use pentazocine with anticholinergics or phenothiazines. Tobacco will clear pentazocine quickly and therefore make it less effective as a pain killer.

What are the Risks of Taking Pentazocine?

Pentazocine can cause addiction in that you can become physically dependent on this drug, develop a tolerance for its effect, and go into withdrawal when you try to stop taking it. You can also develop drug cravings and drug-seeking behaviors, and put yourself in danger of a pentazocine overdose. People who become addicted to combinations of pentazocine and anti-histamines or Ritalin are at a high risk for a difficult withdrawal and recovery. Addicts who inject this drug are at risk for acquiring HIV/AIDS virus and other infections. Some studies show that pentazocine injections are linked to blood clots in the lungs, vascular occlusions, and serious and sometimes fatal skin ulcers and abscesses.

Some people develop severe side effects such as difficulty breathing, fast heartbeat, hallucinations, and fainting, and require medical treatment.

Some people have severe allergic reactions the first time they take pentazocine. They develop chest tightness, rashes, hives, difficulty breathing, fainting, seizures, swelling in the mouth and tongue, and blurred vision. These reactions can be life-threatening so you need to seek immediate medical attention.

What People Should Not Take Pentazocine?

People with Addison’s disease, high blood pressure, enlarged prostrates, porphyria, asthma, hypothyroidism, or problems with their gallbladders, stomachs, livers or kidneys should not take pentazocine. It is not usually prescribed to those with hypoxia, airway obstructions, mental illnesses, too much carbon dioxide in the blood or chronic obstructive pulmonary disorders. It is not prescribed to people with histories of alcoholism or drug addiction because of the danger of dependency.

Pentazocine raises the pressure of cerebrospinal fluid so it is not prescribed to people with head injuries, brain diseases, or brain tumors.

Pentazocine is not usually prescribed to pregnant or nursing women. Newborns have been born dependent on the drug if their mothers used it during pregnancy. If the mother frequently abuses it with anti-histamines, the baby is at risk for certain birth defects. A study of pregnant laboratory animals that took one dosage of pentazocine found their babies were at increased risk for being born with their brains outside their skulls and for other defects of the head and skull.

Because pentazocine can increase the likelihood of falls and confusion, it is prescribed to the elderly only with caution and sometimes only at low doses.

Finally, if you are taking certain medications, you will be unable to take pentazocine because of dangerous interactions.

Does Pentazocine Show Up in Urine Tests?

Pentazocine does show up on urine tests because nearly all of them test for opiate-related (narcotic) drugs. Pentazocine is metabolized in the liver and excreted in urine, and its half-life is approximately two to four hours. Most sources say this drug can be detected for one to five days.

What is a Pentazocine Overdose?

Pentazocine overdoses occur when a person takes too much pentazocine. However, the usual scenario is that the person has combined pentazocine with Ritalin, certain antihistamines, other narcotics, alcohol, or other central nervous system depressants. Certain drug combination can slow the central nervous system to the point that the person enters a coma and dies.

Symptoms of a pentazocine overdose are hallucinations, seizures, low blood pressure, dizziness, vomiting, lethargy, anxiety, drowsiness, and sleepiness. Other symptoms can be pinpoint pupils, abdominal cramps, dry mouth, rapid heartbeat, weak pulse, difficulty breathing, convulsions, headache, and bluish skin. When the person arrives at an emergency medical facility, healthcare professionals usually do not induce vomiting, but administer charcoal, laxatives, intravenous fluids, and naloxone. Pentazocine overdoses are usually not as serious as heroin or morphine overdoses. Although some people have died from them, most recover.

When abuse of pentazocine was popular in the late 1970s and early 1980s, emergency medical facilities reported about 4000 pentazocine overdoses a year. When naloxone was added to the formula, the number of ER visits related to pentazocine dropped to only 300 a year.

What is Pentazocine Withdrawal?

Pentazocine withdrawal syndrome can occur after a person stops taking the drug. Symptoms will depend upon how long a person has been taking it, and in what amounts. In general, people who take pentazocine under medically supervised conditions for pain relief can become physically dependent on the drug, but are not likely to become addicted. If their doctors gradually wean them from pentazocine by decreasing their dosage in tiny amounts, they may be able to avoid a withdrawal syndrome. People who are addicted to narcotic painkillers like pentazocine will also experience a psychological withdrawal in the sense they will crave the drug and are more likely to relapse into its use.

Symptoms of pentazocine withdrawal can be chills, abdominal cramps, nausea, vomiting, fever, runny nose, restlessness, anxiety, itching, sweating, insomnia, tremors, and nightmares. The person may have a general feeling of illness that lasts two to six weeks, depending on the level of physical dependency.

You should go through withdrawal from pentazocine under medically supervised condition because health professionals can ease your symptoms. The usual methods are to gradually reduce the amounts taken, substitute other drugs like methadone, or to just help the person stop “cold turkey.”

What is Pentazocine Addiction?

Pentazocine addictions were very common in the late 1970s and early 1980s, before naloxone was added to the pills. Nevertheless, many drug addicts tell researchers that the ingredient that was supposed to deter addiction does not work, and they became addicted to the drug anyway. Today pentazocine addictions are more common in third world countries, especially on the continent of Africa, but they seem to be making a comeback in the United States, because so many people are addicted to prescription narcotic painkillers. They turn to pentazocine when they cannot get their drugs of choice. People tell researchers that they feel serene, more sociable, and euphoric after they take pentazocine. However, one to ten percent of people who try this drug have unusual reactions such as seizures, delusions, hallucinations, or problems in thinking clearly. About 14% of people who use pentazocine become addicted to it.

One problem with pentazocine addiction is that addicts who use the drug intravenously are in danger of developing particularly dangerous skin conditions, including ulcers and severe abscesses that have led to amputations of hands, arms and legs. This is particularly true of people who inject Fortran, which is pentazocine in a lactate injectable form.

Using pentazocine is with antihistamines on a long-term basis can cause permanent lung damage, memory loss, and anxiety disorders. Using pentazocine with Ritalin can cause psychosis and severe emotional depression.

Slang terms for pentazocine are 44s, Teacher, Ts, yellow footballs, and crackers. Combinations of pentazocine and Ritalin are called Poor Man’s Heroin, Ritz and Ts, Ts and Rits, or Ts and Rs. Combinations of pentazocine and certain antihistamines are called Ts and blues or Ts and Bs.

What Treatments are Available for Pentazocine Addiction?

Although some people have become addicted to pentazocine after being prescribed for medical reasons, the majority of pentazocine addicts are abusing it along with other drugs and alcohol. Like all narcotic addicts, the majority also have underlying psychological problems called comorbidities that contribute to but did not necessarily cause their drug addictions. The most common comorbidities are depression, bipolar disorder, unresolved childhood trauma, posttraumatic stress syndrome, and so forth.

Addicts have impaired control over their drug use in that they use drugs compulsively. They continue to use drugs despite being aware of the harm they are doing to themselves and others. They develop drug cravings, tolerance to large amounts of drugs, and withdrawal syndromes, and usually need professional help to overcome their addiction. Even with professional help, they are at high risk for relaxing back into drug use.

The best way to recover from pentazocine or any other drug addiction is to enter a residential treatment center and remain there for at least several months. A good center will have psychiatrists and psychologists on staff, who can treat not only as drug addiction but also comorbidities. A good program will involve getting into top physical shape after detoxification, and enjoying a full schedule of classes, counseling sessions, and therapies involving art, music and drama. Other vital components of a good program are exploring new hobbies and interests, and participating in active sports. One-on-one therapy with a psychologist trained in cognitive behavioral techniques can help a client make major life changes, such as finding a new career or abandoning unhealthy relationships. Once a client returns, he or she usually continues in psychotherapy with a local therapist and attends self-help meetings in the local community with other people struggling with the same problem.

How Can I Tell if I am Addicted to Pentazocine?

If you can answer yes to any of the following questions, it may be time for you to have a discussion with your health professional or an addiction specialist about your problem with pentazocine.

• Are you using pentazocine without a prescription?
• Are you combining pentazocine with antihistamines or Ritalin?
• Do you use pentazocine intravenously?
• Have you tried to quit pentazocine unsuccessfully on your own?
• Do you need to keep increasing the amounts of pentazocine you use in order to get the same results?
• Do you abuse alcohol or illegal drugs or other prescription painkillers along with pentazocine?
• Do your family members or friends criticize you for using drugs?
• Do you spend too much time and money on your drug habits?
• Are you unable to go more than a day or two without taking drugs?
• Do you believe that your drug habits are out of control?
• Do you suffer from unwelcome side effects, such as insomnia or constipation, but yet you cannot quit using pentazocine?
• Have you ever driven a car under the influence of drugs or otherwise endangered your life because of your drug habits?
• Do you worry that you will get into financial and legal trouble because of your drug problems?
• Do you ever think that you could have a more fulfilling life if you stopped using drugs?
• Do you ever feel guilty or ashamed about your drug habits?

Refrences:

Brody, Jane. “Pain Killing Drug Approved by the FDA,” The New York Times, June 27, 1967.
Plumb, Robert. “Pain Drug Found Non-Addictive But As Powerful as Morphine,” The New York Times, September 11, 1963; and Brody, Jane. “Pain Killing Drug Approved by the FDA,” The New York Times, June 27, 1967.
Chambers, Carl et al. “A Critical Review of Pentazocine Abuse,” HSMHA Health Reports,
Vol. 86, No. 7, Jul., 1971.
Lahmeyer HW, Craig RJ. “Pentazocine–naloxone: another “addiction-proof” drug of abuse.” International Journal of Addiction, 1987 Nov; 22(11):1163-6.
“Pentazocine,” Drugs of Concern, The United States Drug Enforcement Agency, see http://www.justice.gov/dea_old/concern/pentazocine.html
Plumb, Robert. “Pain Drug Found Non-Addictive But As Powerful as Morphine,” The New York Times, September 11, 1963.
“Talwin,” The RX List, see http://www.rxlist.com/talwin-nx-drug.htm
Brody, Jane. “Pain Killing Drug Approved by the FDA,” The New York Times, June 27, 1967.
“Talwin,” The RX List, see http://www.rxlist.com/talwin-nx-drug.htm
“Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241
“Pentazocine Tablets,” The National Institutes of Health, DailyMed, see http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ad152f7f-8256-4a98-a7e5-330fc1a21669
Ibid.
“Pentazocine,” Drugs of Concern, The United States Drug Enforcement Agency, see http://www.justice.gov/dea_old/concern/pentazocine.html
“Pentazocine Tablets,” The National Institutes of Health, DailyMed, see http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ad152f7f-8256-4a98-a7e5-330fc1a21669
“Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241
“Pentazocine,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/cdi/pentazocine.html
“Pentazocine,” The United States Library of Medicine, Medline, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601092.html
“Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241
Ibid, and see also “Talwin Interactions and Side Effects,” The RX List, see http://www.rxlist.com/talwin-nx-drug/side-effects-interactions.htm
“Pentazocine,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/cdi/pentazocine.html
Ibid, and “Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241
“Talwin Interactions and Side Effects,” The RX List, see http://www.rxlist.com/talwin-nx-drug/side-effects-interactions.htm
“Pentazocine Tablets,” The National Institutes of Health, DailyMed, see http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ad152f7f-8256-4a98-a7e5-330fc1a21669
“Pentazocine,” The United States Library of Medicine, Medline, see http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601092.html
“Pentazocine,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/cdi/pentazocine.html
“Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241; and see “Talwin Overdose,” The RX List, see http://www.rxlist.com/talwin-nx-drug/overdosage-contraindications.htm
“Talwin Warnings,” The RX List, see http://www.rxlist.com/talwin-nx-drug/warnings-precautions.htm
“Pentazocine Tablets,” The National Institutes of Health, DailyMed, see http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ad152f7f-8256-4a98-a7e5-330fc1a21669
Debooy, V.D., et al. “Intravenous Pentazocine and Methylphenidate Abuse during
Pregnancy. Maternal Lifestyle and Infant Outcome.” American Journal of Diseases
of Children 147 (1993): 1062–65.
“Talwin Warnings,” The RX List, see http://www.rxlist.com/talwin-nx-drug/warnings-precautions.htm
“Pentazocine,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/cdi/pentazocine.html
Reid RW, Gerbeck CM Detection of pentazocine and tripelennamine in urine. Clin Chem. 1981 Jan; 27(1):10-3.
“Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241
“Pentazocine Overdose,” The New York Times, Health Topics, see http://health.nytimes.com/health/guides/poison/pentazocine-overdose/overview.html
Schmidt, William. “Development of Abuse-Resistant Opiates,” Opioid Risk Management, March 2005.
“Pentazocine,” Official Information from the United States Food and Drug Administration, Drugs.com, see http://www.drugs.com/cdi/pentazocine.html; see also “Pentazocine and Naloxone (Oral Route), The Staff of the Mayo Clinic, see http://www.mayoclinic.com/health/drug-information/DR603241
Chambers, Carl et al. “A Critical Review of Pentazocine Abuse,” HSMHA Health Reports,
Vol. 86, No. 7, Jul., 1971.
Chambers, Carl et al. “A Critical Review of Pentazocine Abuse,” HSMHA Health Reports,
Vol. 86, No. 7, Jul., 1971.
See also Mudrick, Colin, Jonathan Isaacs, and Jessica Frankenhoff. Case Report: Injectable pentazocine abuse leading to necrotizing soft tissue infection and florid osteomyelitis. Hand (N Y). 2011 December; 6(4): 457–459.
Showalter, C.V. “T’s and Blues: Abuse of Pentazocine and Tripelennamine.” Journal of
the American Medical Association 244 (1980): 1224–25.

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