Pentazocine Opiod Abuse in Plastic Surgery Patients

SavageGlow · #1 ● 11-13-2022, 07:21 PM

Parenteral opioid abuse is not uncommon amongst patients presenting for plastic surgery care, especially health workers. Pain is the commonest reason for initiating and sustaining the injections. Complications such as lymphedema, cellulitis, ulcers etc. are common sequelae of this psychosocial disorder.

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Figure 1:
A thirty eight year old female nurse of AA genotype, who commenced pentazocine injections 6 years prior to presentation. This was prescribed for preterm labour at the OB/GYN clinic. However, her addiction started 3 years prior to presentation when she started purchasing the drugs from the open drug market, and injected herself daily into the veins on her forearm, and even into the tissues, when venous access became difficult. She developed lymphedema and ulcers few months later for which she presented. The ulcers were multiple and deep, the largest measured 8 × 6 × 2cm. She was placed on conservative management with elevation, compression bandaging, saline and honey wound dressings, with resultant improvement. Mental health unit reviewed; insomnia, anorexia and restlessness were the withdrawal symptoms she had. She wants to quit but cannot resist the urge .

Figure 2 and 3:

A twenty eight year old male generator technician, a known sickler. who started abusing pentazocine 6 years prior to presentation after it was prescribed at a general hospital on
account of vaso-occlusive crisis. He got the drugs via retained prescription, or OTC and injected himself 2-3 times a day into the veins of the forearm. He presented with bilateral upper limb swelling and forearm ulcers of 2 years duration. There was improvement in the condition of the wound following in-patient conservative management. Pain was his only withdrawal symptom and is being co-managed with mental health. He wished to stop the injections if only he was pain-free see.

Figure 4 and 5:

A twenty eight year old female of SS genotype, an auxiliary nurse, whose first pentazocine injection was given for vaso-occlusive crisis at the hospital where she worked while in training. She subsequently purchased the drug from patent medicine dealers and the open drug market and injected herself in the thighs and later into both legs, when ulcers developed on the thighs. This abuse started 2 years prior to presentation. She presented with bilateral lower limb swelling (lymphedema) and ulcers, then was discharged during an industrial action and lost to follow-up.