A Report of the Ruinous Effects of Pentazocine Abuse in a Female Adult with Sickle Cell Anaemia Seen in Uyo, Niger-Delta Region of Nigeria: An Urgent Call to Action

Painful crisis is the commonest and most distressing clinical manifestation of sickle cell anaemia (SCA), thus prompt and adequate analgesia should be provided to ameliorate the suffering of the patient. Pentazocine is a potent opioid analgesic with mixed receptor activities commonly used in the management of pain in SCA patients. Its abuse among SCA patients has remained a daunting challenge in medical practice worldwide, especially in developing economies like ours. However, reports on opioid abuse or dependence among SCA patients in our environment are inexistent. This report sets out to highlight the addictive potential of pentazocine and the complications associated with its abuse in SCA patients. We report a case of a 40-year-old known SCA female with a five-year history of excessive use of parenteral pentazocine. She commenced self-injection of pentazocine following a previous admission in a private hospital on account of bone pain crisis. Other analgesics such as diclofenac, ibuprofen, piroxicam and tramadol were not efficacious in alleviating her excruciating pain but the administration of parenteral pentazocine provided her with quick and complete relief, hence the beginning of her dependency. She had a hankering desire to use the drug which she used on daily basis. Initially, she injected 30-60 mg (1 – 2 ampules) of pentazocine per day but in the last one month before presentation in our facility, she increased the dose of the drug to 270 mg (9 ampoules) daily. She developed multiple cutaneous and musculoskeletal complications. A diagnosis of pentazocine dependence in a sickle cell anaemia patient was made. She was admitted and jointly managed by the Haematology, Orthopaedic and Mental Health Teams. We hereby advocate effective sensitization of healthcare providers, SCA patients, their caregivers and the society at large about the risks and complications of pentazocine abuse. This is to espouse the fervid need to exercise caution with pentazocine prescription and use. As much as possible, oral formulations, when deemed necessary, should be recommended since most of the observed physical complications occurred apparently as a result of parenteral administration of the drug. Lastly, pentazocine should be categorized as a controlled drug with stringent measures in place to regulate its sales in our environment.