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To the Editor.—
Concerning the letter on "Abuse of Pentazocine and Tripelennamine" by Showalter and Moore (239:1610, 1978), the illicit use of this drug combination is not confined to Chicago. Since the summer of 1977, drug addicts in St Louis have been using pentazocine and tripelennamine, both orally and intravenously, as a heroin substitute. The sale of these compounds does not carry the strict legal penalty associated with the sale of heroin because of a loophole in the Missouri Controlled Substance Act. The compounds are illegal to sell without prescription under federal law; however, the offense is only a misdemeanor. Since the drugs apparently act as a substitute for heroin, and since illicit sales are almost never prosecuted, the trade in "T's and Blues" has become a profitable business.This past February a drug war over the street distribution rights of "T's and Blues" erupted in St Louis. At least
Poklis A. 'T's and Blues'. JAMA. 1978;240(2):108. doi:10.1001/jama.1978.03290020030005
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