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Talwin

Pentazocine is a synthetically-prepared narcotic drug used to treat mild to moderate pain. Pentazocine is sold under several brand names, such as Talwin. more...

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In the 1980s, recreational drug users discovered that combining pentazocine with the antihistamine tripellenamine (most commonly dispensed under the brand name Pyribenzamine) produced a euphoric sensation much like that brought on by heroin, and users who were already addicted to the latter often used this combination when heroin was unavailable to them. Since tripellenamine tablets are typically blue in color, the pentazocine/tripellenamine combination acquired the slang name Ts and blues.

After health-care professionals and drug-enforcement officials became aware of this scenario, the narcotic-antagonist naloxone was added to preparations containing pentazocine, and the reported incidence of its abuse has declined precipitously since. Pentazocine is still classified in Schedule IV under the Controlled Substances Act in the United States, even with the addition of the naloxone. Internationally, pentazocine is a Schedule III drug under the Convention on Psychotropic Substances.

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1 in 12 drugs inappropriately prescribed to elderly
From Healthfacts, 3/1/04

Nearly 8% of the ambulatory medical care visits made by elderly people resulted in at least one inappropriate drug prescription, according to a survey reported in Archives of Internal Medicine (2/9/04). Urban women and white people made the majority of visits to physician offices and hospital outpatient departments.

Margie Rauch Goulding, PhD, of the U.S. Centers for Disease Control and Prevention, conducted the survey, which identified pain relievers and central nervous system drugs as making up the largest share of the inappropriately prescribed medicines. The two pain relievers are pentazocine (brand name: Talwin) and propoxyphene. The latter is sold under the brand names of Darvon, Darvon-N and prescribed in combination with acetaminophen (Tylenol) as Darvocet-N and Wygesic. Or sold as Darvon Compound, which combines propoxyphene, aspirin and caffeine. Propoxyphene is a narcotic that should be avoided by everyone, not just elderly people. Studies conducted over 20 years ago showed that it is no more effective as a pain reliever than aspirin or a placebo, even in people with cancer or postoperative pain. Furthermore, propoxyphene has the potential for addiction and overdose.

The inappropriately prescribed central nervous system drugs include barbiturates, tranquilizers, and antidepressants. Often, drugs in this category are prescribed to elderly people for insomnia, or in the case of antidepressants, for pain. The problem tranquilizers are flurazepam (Dalmane) chlordiazepoxide (Librium), meprobamate (Equanil, Miltown) and diazepam (Valium and others). The antidepressants that caused problems were from an older drug class amitriptyline (Elavil, Amitid) and doxepin (Sustiva).

Dr. Goulding found that the odds of having an inappropriate drug prescribed were double for women and high for any visit in which multiple drugs were prescribed. To determine what is an inappropriate drug for elderly people, Dr. Goulding drew on criteria developed by panels of experts in geriatric medicine. Inappropriate was defined as a drug that panel members agreed would have a risk of adverse effects that was larger than the potential benefits.

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