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April 9, 1973

Pentazocine in Methadone Hydrochloride Maintenance

Author Affiliations

Hollywood, FL

JAMA. 1973;224(2):247. doi:10.1001/jama.1973.03220150055022

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To the Editor.—  In a letter in the Jan 29, issue of The Journal (223:557, 1973), Degnan and Haupt stated that pain medications for methadone hydrochloride maintenance patients can be prescribed as for the general population with the normal precautions taken when doing minor (or major) surgery. I would like to give a few warnings to this advice.First of all, pentazocine (and I think it is a good analgesic) is a narcotic antagonist and will cause a methadone maintenance patient to suffer acute withdrawal symptoms shortly after administration. Also, we must always remember that the addict, prior to his stabilization with methadone, was always trying to hustle the doctor into prescribing such drugs as morphine, meperidine hydrochloride, hydromorphone hydrochloride. These traits remain and the physician might be asked to prescribe these drugs in excessive amounts by his patient.My advice in this regard is to be cautious and to