talwin-nx and Substance-Related-Disorders

Pentazocine, in combination with the antihistamine tripelennamine, was a popular drug of intravenous abuse in many large cities in the late 1970s and early 1980s. To stem the abuse of pentazocine, naloxone was added to the tablet. This would presumably allow oral activity, but naloxone would block the euphoria if the pills were injected. Abuse of pentazocine appears to have diminished, but we have recently treated three addicts who continued to inject pentazocine, despite its naloxone content. Two patients experienced no overall decrease in the drug-induced euphoria. The third patient became acutely psychotic with each injection. Hypotheses are advanced to explain these findings.

Topics: Adult; Drug Combinations; Drug Interactions; Humans; Injections, Intravenous; Male; Naloxone; Pentazocine; Psychoses, Substance-Induced; Substance-Related Disorders; Tripelennamine; United States

The combination of pentazocine hydrochloride and tripelennamine hydrochloride (T's and blues) has been abused as a heroin substitute. In response to this abuse, the formulation of pentazocine has been changed to include naloxone hydrochloride, a short-acting narcotic antagonist, in the tablet (Talwin Nx). Two cases of abuse of the new pentazocine and naloxone formulation along with tripelennamine are reported. Potential reasons for the failure of naloxone to block the effects of pentazocine are discussed.

Topics: Adult; Drug Combinations; Drug Interactions; Humans; Illicit Drugs; Injections, Intravenous; Male; Naloxone; Pentazocine; Substance-Related Disorders; Tripelennamine