OBJECTIVE: To describe the magnitude of the problem of abuse by self-injection of dipianone HCl/cyclizine HCl (Wellconal) and to document the associated morbidity, mortality and prevalence of HIV infection. DESIGN: We conducted a retrospective analysis of 121 admissions of 86 patients who were current intravenous Wellconal abusers and presented to Johannesburg and J G Strijdom Hospitals over an 18-month period. Case records were analysed in respect of age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. MAIN OUTCOME MEASURES: Age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. RESULTS: Complications of Wellconal abuse occurred in young adults (median age 24 years) with an approximately equal gender distribution. Opiate overdose was the most frequent presenting diagnosis (32%), followed by right-sided endocarditis (20%) and deep-vein thrombosis (12%). A wide variety of complications accounted for the remaining 36%. A 2% HIV antibody positivity rate was found, which is substantially lower than that encountered in intravenous drug abusers in other parts of the world. Seventy-eight per cent of patients completed therapy successfully, but 19% left hospital prematurely against medical advice. There was a mortality rate of 3%. CONCLUSIONS: While the prevalence of Wellconal abuse in the broader South African community is unknown, our study draws attention to the extent of the problem in Johannesburg.
OBJECTIVE: To describe the magnitude of the problem of abuse by self-injection of dipianone HCl/cyclizine HCl (Wellconal) and to document the associated morbidity, mortality and prevalence of HIV infection. DESIGN: We conducted a retrospective analysis of 121 admissions of 86 patients who were current intravenous Wellconal abusers and presented to Johannesburg and J G Strijdom Hospitals over an 18-month period. Case records were analysed in respect of age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. MAIN OUTCOME MEASURES: Age, sex, median hospital stay, complications, HIV antibody status and eventual outcome. RESULTS: Complications of Wellconal abuse occurred in young adults (median age 24 years) with an approximately equal gender distribution. Opiateoverdose was the most frequent presenting diagnosis (32%), followed by right-sided endocarditis (20%) and deep-vein thrombosis (12%). A wide variety of complications accounted for the remaining 36%. A 2% HIV antibody positivity rate was found, which is substantially lower than that encountered in intravenous drug abusers in other parts of the world. Seventy-eight per cent of patients completed therapy successfully, but 19% left hospital prematurely against medical advice. There was a mortality rate of 3%. CONCLUSIONS: While the prevalence of Wellconal abuse in the broader South African community is unknown, our study draws attention to the extent of the problem in Johannesburg.