Abstract

Background: Pentazocine is a synthetic opioid analgesic with mixed receptor activities. It acts as a partial agonist at the µ-receptor as well as being a kappa agonist. Its analgesic effect is estimated to be about 25-50% greater than that of morphine. Pentazocine acts has a short onset of action which occur about 10-20 minutes after administration and could last 2-4hours.
 Aim: The study was aimed at further awakening the consciousness of this growing menace among people living with sickle cell disease as well as proffering solutions to curtail this increasing peril. 
 Presentation of Case: A 36 years old Nigerian female with three years history of excessive use of parenteral pentazocine on account of sickle cell bone pain crisis. She commenced self-administration after exposure by a private hospital on account of bone pain crisis where other analgesic fails to give her the necessary relieve. Hence, the beginning of her dependency. She started with two ampules daily and later increased to 20 ampules on the account of this, patient was said to have developed cutaneous and musculoskeletal complication. A diagnosis of pentazocine addiction in a SCD patient was made, she was admitted and jointly managed by a Psychiatrist, Phychologist, Haematologist and Plastic Surgeon. We hereby advocate for effective legislation, orientation and reorientation of health workers and the society at large about the risks and complication of parenteral pentazocine abuse. This menace can possibly be curtailed if oral formulation is made available and less addictive medications are used. 
 Conclusion: Analgesics that are less addictive should be administered after examining the nature of pain before furtherance to stronger analgesic which could predispose to addiction.

Highlights

  • Sickle Cell Disease (SCD) is a chronic heterogeneous group of autosomal recessive, structural haemoglobin disorder [1]

  • This menace is of particular increase among people living with sickle cell disease which Nigeria bears the highest burden of disease condition in SubSahara Africa

  • O. is a 36 years old Nigerian female retired banker with sickle cell anaemia that was diagnosed while she was 2 years old using haemoglobin electrophoresis. She presented on the 6th of January, 2019 at the Haematology Day Care Unit of the University of Calabar Teaching Hospital with a three years history of selfadministration of pentazocine. She said she got addicted to the drug about three years ago when she was admitted at a private hospital in Lagos, South-West Nigeria on the account of bone pain crisis affecting both her upper and lower limbs with a pain score of 10/10 which lasted for about 48hours and was non responsive to several analgesics such as diclofenac, tramadol and dihydrocodiene but got some relieve after intramuscular administration of pentazocine which patients claim pain began to subside and she was able to sleep

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Summary

INTRODUCTION

Sickle Cell Disease (SCD) is a chronic heterogeneous group of autosomal recessive, structural haemoglobin disorder [1]. Opioid analgesic still remains the major therapy for the management of bone pain crisis in SCD patients [1]. Pentazocine is a synthetic opioid analgesic with mixed receptor activities [7]. Despite the analgesic effect of pentazocine, chronic parenteral use or abuse predisposes to the following complication; skin fibrosis, ulceration, abnormal pigmentation, fibrosmyopathy, contractures and pyomyositis [6,7,8]. Cases of opioid abuse have been on the increase worldwide [1] This menace is of particular increase among people living with sickle cell disease which Nigeria bears the highest burden of disease condition in SubSahara Africa. In Nigeria, Ahmed et al reported a prevalence of 17.8% of opiate dependence among SCD patients in Maiduguri, North-East Nigeria with male preponderance [15]. This report is aimed at further enlightening and awakening the consciousness of this growing menace among people living with sickle cell disease as well as proffering solutions to curtail this increasing peril

CASE REPORT
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