Background: Pentazocine is a readily available opioid like analgesic. There has been an increase in
the number of patients seen with pentazocine abuse with complications. A high index of suspicion is
required. The skin is the tissue most evidently affected in drug addiction. When peripheral veins are
sclerosed or inaccessible, the subcutaneous tissue and muscle are injected. Patient injects into thighs,
forearms and buttocks under non sterile conditions.'Woody' cutaneous fibrosis with a background
history of chronic pain is pathognomonic for pentazocine abuse.
Objectives: To show our experience in the management of ulcers that develop following abuse and
addiction of pentazocine, diagnostic clinical features, challenges in managing addicts and the way
forward.
Method: 4 patients who had easy access to pentazocine are presented. They persistently abused
parenteral pentazocine by indiscriminately injecting both thighs in unsterile circumstances until they
developed extensive necrotizing fasciitis and muscle necrosis. They were co-managed with the
psychiatrist. They were admitted for inpatient wound care and investigations. Some challenges were
encountered in their management.
Results: They were females between 31-42 years, 3 patients had HbSS while 2 were health workers.
Dose administered range between 360mg and 700mg/day. Duration of ulceration ranged from 10
months to 2 years. NPWT significantly improved their wounds.
Conclusion: Pentazocine is a drug which is abused by patient with chronic pain. Obvious and extensive
tissue loss is not a deterrent factor to further abuse. There is need for modification of the use of
pentazocine and possibly should be a controlled prescription medication.
ULCERES DES EXTREMITES LIES A L’ABUS DE LA PENTAZOCINE
Abikoye FO, Ayoade OA, Hassan AS, Lawal MA, Egbeogu DC
Department of Burns & Plastic Surgery, National Orthopaedic Hospital Igbobi, Lagos, Nigeria
Contexte: La pentazocine est un opioïde facilement accessible comme analgésique. On a observé une
augmentation du nombre de patients ayant des antécédents d’abus de pentazocine et des
complications. Un indice élevé de suspicion s’impose. La peau est évidemment le tissu le plus affecté
dans les cas de dépendance à la drogue. Lorsque les veines périphériques sont sclérosées ou
inaccessibles, la drogue est administrée par le tissu sous-cutané et les muscles. Le patient s’injecte
dans les cuisses, l’avant-bras et les fesses dans des conditions non stériles. La fibrose cutanée aux
aspects ligneux avec des antécédents de douleur chronique est pathognomonique de l’abus de la
pentazocine.
Objectifs: Montrer notre expérience dans la prise en charge des ulcères liés à l’abus et à la
dépendance à la pentazocine, les caractéristiques cliniques diagnostiques, les défis de la prise en
charge des toxicomanes et les perspectives d’avenir.
Méthodologie: 4 patients qui avaient un accès facile à la pentazocine se sont présentés. Ils ont
administré sans interruption et par voie parentérale la pentazocine en s’injectant sans distinction les