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Abuse of Pentazocine and Tripelennamine

Craig V. Showalter, MD
JAMA. 1978;239(16):1610-1612. doi:10.1001/jama.1978.03280430026009.
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To the Editor.—  Pentazocine abuse is commonly believed to be largely confined to the medical community and to patients iatrogenically addicted. We would like to call attention to the widespread and increasing abuse of pentazocine among "street" addicts. In this situation the user most often crushes pentazocine tablets and combines this with crushed tripelennamine (Pyribenzamine). The mixture is then dissolved in water and injected intravenously. The origin of this combination is unknown but produces a desired effect for the user not obtained from either drug alone. Referred to as "T's and Blues," these two drugs have achieved considerable popularity among illicit drug users.A frequently reported effect of this abuse is tonic-clonic seizures, which are possibly due to central excitation from tripelennamine. The user is careful to establish the correct ratio of the two drugs (usually two pentazocine to one tripelennamine tablet) to get the sought after high while avoiding


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