Pentazocine Addiction: Symptoms, Treatment and Recovery

Pentazocine is commonly thought of as an opioid that carries less addiction risk than other opioid alternatives. However, pentazocine is a controlled substance and addiction is possible. For this reason, it is important to be aware of the symptoms of pentazocine addiction.

What Is Pentazocine?

Pentazocine is a generic drug, previously sold under the brand name Talwin, prescribed to treat moderate to severe pain. Pentazocine is only available in combination with the opioid blocker naloxone in the United States, and is not sold on its own. Pentazocine is a unique drug in that it activates certain opioid receptors while blocking others. Because pentazocine activates some opioid receptors as a way to relieve pain, it is classified as an opioid.

Pentazocine Side Effects

The side effects of pentazocine are similar to other opioids and caninclude: 

• Drowsiness
• Itching
• Constipation
• Nausea
• Vomiting 

However, unlike many other opioids, Pentazocine can also cause hallucinations, bad dreams and delusions. It also has a unique feature called a “ceiling effect,” which means that there’s a limit to how much it can help with pain relief, as well as how much it can harm you. This is because the medication contains naloxone, which prevents people from misusing it when crushing it or breaking it apart. If taken as directed, pentazocine can be very helpful in easing pain without any negative effects. This is why pentazocine is always sold in combination with naloxone.

When someone is prescribed pentazocine, they’re usually instructed to take it by mouth every 3–4 hours as needed. If it causes nausea, patients should take it with food. If someone has already regularly been using an opioid medication, pentazocine may cause withdrawal. This is because when someone is opioid-tolerant and they use naloxone, it can trigger sudden withdrawal. Of course, this should only occur if the pentazocine is misused by physically disrupting the tablet. The medicine itself may also cause dependence and withdrawal symptoms in some patients.

What Does Pentazocine Look Like?

Pentazocine usually comes as a tablet. The tablets are oblong-shaped and scored. The dosages of pentazocine hydrochloride and naloxone hydrochloride are usually 50 mg of pentazocine and 0.5 mg of naloxone. Some dosages of pentazocine are light green, and others are yellow. The imprints on the tablets vary, depending on who the manufacturer is. Pentazocine is also available in injectable formulations.

Pentazocine Addiction

If you or a loved one are prescribed pentazocine, it is important to be aware of the medication’s addictive potential. Remaining vigilant to the signs and symptoms of a pentazocine addiction can help you or a loved one know when it’s time to seek help about your pentazocine use.

Is Pentazocine Addictive?

Pentazocine is a Schedule IV controlled substance, meaning that it carries a risk of abuse, addiction and dependence. Due to its misuse, naloxone was added to pentazocine formulations to reduce misuse potential. People would often crush and snort or dissolve the tablets, which is a common practice for many opioids intended for oral use. The addition of naloxone has significantly reduced recreational use of pentazocine. However, pentazocine can still be addictive, and those prescribed it should only use it as directed and inform their doctor if they have a history of substance use disorder with alcohol, prescription drugs or street drugs.

Signs of Pentazocine Addiction

The symptoms of pentazocine misuse can be similar to the misuse of other prescription opioids. The signs that someone is abusing or misusing pentazocine often manifest in any number of physical and behavioral symptoms, including but not limited to the following.

Physical Signs

• Crushing or breaking the pills to snort or inject them
• Taking more pentazocine than prescribed
• Taking pentazocine without a prescription
• Taking pentazocine more often than prescribed
• Sweating
• Dizziness
• Drowsiness
• Constipation
• Nausea
• Vomiting

Behavioral Signs

• Changes in mood or personality
• Increased risk-taking behavior
• Lying or stealing to get pentazocine
• Experiencing financial problems
• Changes in social activities or relationships
• Neglecting responsibilities at work or school
• Spending a lot of time obtaining or using pentazocine
• Isolating oneself from friends and family
• Withdrawal symptoms when not taking pentazocine

Effects of Pentazocine Addiction

When someone misuses pentazocine for a long period of time, it can have serious effects on their body, brain and life. Some of the serious and long-term effects of pentazocine addiction can include:

• Impotence, infertility and sexual problems: Pentazocine can affect the hormones that regulate sexual function, which can lead to impotence, infertility and other sexual problems.
• Missed menstrual periods: Pentazocine can also affect the menstrual cycle, which can lead to missed menstrual periods.
• Complications from chronic constipation: Pentazocine can slow down the digestive system, which can lead to constipation. Constipation can be a serious problem, and it can make other health problems worse.
• Other gastrointestinal complications: Pentazocine can also cause other gastrointestinal problems, such as nausea, vomiting and diarrhea.
• Breathing problems: Pentazocine can depress the central nervous system, which can slow down breathing. This can be a serious problem, especially for people with sleep apnea or other breathing problems.
• Increased risk of cardiovascular problems: Pentazocine can increase the risk of cardiovascular problems, such as heart failure and myocardial infarction.
• Various hormonal problems: Pentazocine can affect the body’s hormones, which can lead to a variety of problems, such as weight gain, mood swings and fatigue.
• New or worsening psychological disorders: Pentazocine can worsen existing mental health conditions, such as depression and anxiety. It can also lead to the development of new mental health problems.
• Increased pain sensitivity: Pentazocine can actually increase pain sensitivity over time. This can make it difficult to manage pain, and it can lead to addiction.

If you or someone you know is struggling with pentazocine addiction, there is help available. Please reach out to the professionals at The Recovery Village who are ready and able to help you with treatment options. 

Pentazocine Overdose

It is possible to overdose on pentazocine, but the risk is lower than with other opioids. There are a few factors that can increase the risk of pentazocine overdose:

• Crushing or breaking the tablets to snort or inject them.
• Taking pentazocine with other medications that depress the central nervous system, such as alcohol, sleeping pills or anti-anxiety medications.
• Taking more pentazocine than prescribed.

Symptoms of pentazocine overdose can include:

• Slow or shallow breathing
• Pinpoint pupils
• Blue or purple skin, especially around the mouth and fingernails
• Confusion
• Drowsiness
• Seizures
• Coma

If you think someone is overdosing on pentazocine, call 911 immediately and administer naloxone (Narcan).

Mixing Pentazocine and Alcohol

Some people may intentionally mix alcohol and pentazocine to enhance the effects of each substance. However, mixing alcohol and pentazocine is a dangerous combination that can lead to serious health problems, including overdose and death. The drug carries a Boxed Warning against use with alcohol because of this risk.

Both alcohol and pentazocine are central nervous system depressants; they both slow down the activity of the central nervous system, which can lead to a number of side effects, including:

• Drowsiness
• Dizziness
• Confusion
• Lightheadedness
• Impaired thinking
• Impaired judgment
• Problems with memories or blackouts

In addition to these common side effects, mixing alcohol and pentazocine can also lead to more serious health problems:

• Low blood pressure
• Fainting
• Respiratory distress
• Coma
• Death

The risk of these serious side effects is increased if you take more pentazocine than prescribed, or if you mix them with other central nervous system depressants, such as sleeping pills or anti-anxiety medications.

Pentazocine Withdrawal and Detox

Pentazocine withdrawal symptoms can be unpleasant and even dangerous. They can start within a few hours of stopping pentazocine and can last for several days. Some of the common pentazocine withdrawal symptoms include:

• Agitation
• Anxiety
• Muscle aches
• Tearing of the eye
• Insomnia and sleep disturbances
• Runny nose
• Flu-like symptoms
• Yawning
• Cramping
• Dilated pupils
• Goosebumps
• Nausea and vomiting

If you or someone you know is experiencing pentazocine withdrawal symptoms, it is important to seek help.

Pentazocine Withdrawal Timeline

After the last dose of pentazocine, withdrawal symptoms typically start within 12 hours. The severity of pentazocine withdrawal may vary depending on the duration of opioid dependence. Early signs of withdrawal include:

• Tearing up
• Muscle aches and pains
• Agitation
• Insomnia
• Anxiety
• Elevated blood pressure
• Rapid heartbeat

Withdrawal symptoms from pentazocine usually start within 24 to 48 hours and begin to weaken within a week. Some people may experience ongoing symptoms like insomnia, anxiety or depression for weeks or months. Symptoms can persist for several hours if the naloxone present in pentazocine formulations is activated. This is called precipitated withdrawal.

Pentazocine Detox

Someone who is addicted to an opioid medication such as pentazocine could find relief through a medical detox program. Medical detox involves seeking treatment at a facility that provides 24-hour medical attention and care. This facility specializes in detoxification and provides continuous medical care and attention to its patients.

Medical detox can help people safely stop using pentazocine and other substances they may be dependent on. During opioid withdrawal, certain medications like methadone and buprenorphine can be used. These medications are approved for this use and act similarly to other opioids but in a milder way.

Other medicines can be given during opioid withdrawal to treat symptoms like insomnia, cramping, or diarrhea, in addition to medications specifically approved for such use. These medicines can be prescription or over-the-counter.

How Long Does Pentazocine Stay in Your System?

Although the half-life of a drug can give an approximate idea of how long it will remain in someone’s system, there are other factors to consider. Each individual’s characteristics and circumstances will determine their unique drug elimination time. 

Some of the factors that may influence the duration of pentazocine in your system include:

• Consuming other substances at the same time: It may take a longer duration for the body of a patient to metabolize a dose of pentazocine if they have also taken other substances, compared to someone who solely consumed pentazocine.
• Taking pentazocine long term: Pentazocine, when used for an extended period, can build up in the system of the patient, resulting in a longer elimination time.
• Having a fast metabolism:  Assuming all other factors are equal, an individual with a faster metabolism will probably eliminate pentazocine from their body more quickly than someone with a slower metabolism.
• Being older: Older people generally have longer drug elimination times than younger people.
• People with liver or kidney functionality problems.
• Hydration levels: The level of hydration and urinary pH can affect the duration of pentazocine elimination.
• Physical activity: Someone who engages in physical activity may eliminate substances from their body more quickly than someone who does not.

Half-Life of Pentazocine

Understanding the half-life of pentazocine is important for several reasons, including preventing an overdose and avoiding harmful interactions with certain substances. The half-life of a drug measures how long it takes for half a dose to be eliminated from the body and no longer have an effect. Pentazocine has an estimated half-life of 3.6 hours, and it typically takes about five half-lives for a drug to be fully eliminated from the body. Therefore, most of a pentazocine dose will have left a person’s system within 18 hours.

How Long Is Pentazocine Detectable in Urine, Hair and Blood?

Pentazocine may be detectable in certain drug tests. The most common type of drug test is a urine test, which can detect pentazocine up to three days after its use. Hair tests have the longest detection window, and can detect pentazocine in a 1.5″ hair sample up to 90 days after its use. Blood tests have the shortest detection window and are not commonly used. Pentazocine use may be detectable in a blood test for at least six hours.

Pentazocine Addiction Treatment

If someone shows pentazocine addiction symptoms, they may require professional treatment, which usually begins with a medical detox. From there, people can participate in an inpatient or outpatient rehab.

Inpatient Pentazocine Rehab

An inpatient pentazocine rehab can be short- or long-term, lasting anywhere from 28 days up to six months or more. An inpatient pentazocine rehab has some features and pros and cons. Key features and benefits of inpatient rehab include:

• Living in a facility
• A highly structured environment
• Supervision and around-the-clock care
• Supplemental therapies such as nutritional or vocational counseling
• Putting distance between the patient and the stresses and triggers of work or home life

As with anything, there are downsides to consider with an inpatient pentazocine rehab. First, inpatient rehab tends to be more expensive than other options, but insurance may cover the costs. Inpatient rehab may not be an option for someone who can’t leave their work, or doesn’t want to leave their family. Inpatient rehab can also require traveling to another state, which some people might not be comfortable with.

Outpatient Pentazocine Rehab

An outpatient pentazocine rehab can be something that someone participates in after a residential stay, or it can be the only type of treatment they participate in. Outpatient rehab is generally less structured and has fewer support systems in place than inpatient rehab.

Outpatient rehab can vary quite a bit regarding structure and requirements. There are intensive outpatient rehabs that are essentially the same as inpatient rehab, except participants sleep at their homes. There are also programs that may require a commitment of several hours a week while a person continues going to school or work. Then, there are less formalized outpatient rehabs, where participants might meet once a week for group therapy or a 12-step program. 

Outpatient rehab allows for more freedom and flexibility and is also usually less expensive than inpatient rehab, but it might not be enough for someone with a severe addiction. Outpatient rehab may also be inappropriate for someone who lacks home support or who has a destructive or chaotic home environment.

Get Help for Pentazocine Addiction Today

Pentazocine addiction is not a life sentence. You can overcome addiction with the right tools and resources. The Recovery Village is here 24/7 if you’d like to talk or ask questions. If you want to take a step toward recovery from pentazocine addiction, we’re here for you.

Editor – Heather Lomax

At Advanced Recovery Systems, Heather uses her experience by working closely with medical experts to produce helpful, accurate articles on the challenges of navigating substance use, recovery and mental health conditions. Read more

Medically Reviewed By – Dr. Jessica Pyhtila, PharmD

Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more