Pentazocine abuse in Sickle Cell Disease Patients Seen at a Tertiary Hospital in Nigeria: A Chronic Menace

Background: Pentazocine abuse in patients with Sickle cell disease (SCD) has not received adequate attention in Nigeria. Many of these SCD patients have had their conditions unduly worsened and quality of life severely breached by complications of pentazocine abuse. Despite the growing incidence observed in clinical practice and palpable tendency to degenerate further, given the current ease of access to the drug in our environment, it has remained underreported. This study evaluated the myriad physical complications and socioeconomic burden of pentazocine abuse on patients with SCD.
Method: This study was carried out on SCD patients (attending the adult hematology clinic) who abused parenteral pentazocine. Data were obtained mainly from detailed history and physical examination. The findings were analysed accordingly.
Results: Eleven SCD patients who abused pentazocine were recruited and comprised of 8 males (72.7%) and 3 females (27.3%). Their mean age was 34±6 years, 81.8% were not married, 81.8% had some kind of job and 22.2% of these suffered loss of job. The mean duration of pentazocine abuse was 7.4±3.7 years while mean dose of pentazocine injected by the study participants on daily basis was 279±228 mg; 63.6% needed no prescription papers to purchase the drug and 36.4% used forged prescription papers. The mean monthly expenditure on pentazocine was NGN 27,000±22,000 (Nigerian Naira). It was also noted that 18.2% (2) of the study participants abused other drugs alongside pentazocine. As high as 90.9% (10) had scars and/or ulcers; 63.6% (7) developed lymphedema while 90.9% (10) had some degree of fibrous myopathy. Majority (63.6%) of the participants had fixed contractures and/or deformities of their limbs (and digits) with varying degrees of loss of joint movement and/or gait abnormalities observed in 72.7% (8) of participants.
Conclusion: We advocate vigorous sensitization of both healthcare givers and SCD patients on the risk and complications (consequences) of pentazocine abuse. This is to underscore the need for more caution with pentazocine prescription and use. As much as possible oral formulations, when necessary, should be recommended since most of the observed physical complications were apparently due to the parenteral route of administration of the drug. Finally, any SCD patient presenting with the highlighted physical complications must be considered as a case of pentazocine abuse until proven otherwise.