The ABCs - Talwin and Ritalin (T's and R's)

"Ts and Rs," "Ts and Rits," "One and Ones," "Crackers," and "Set" are street names for a mixture of the prescription drugs Talwin® (pentazocine) and Ritalin® (methylphenidate). When injected together, Talwin, a painkiller, and Ritalin, a stimulant, produce a "high" similar to the effect of heroin mixed with cocaine. Because of this similarity and their low cost when obtained legally, Talwin and Ritalin have been called "poor man's heroin."

Talwin and Ritalin are still prescribed individually for medical purposes. To prevent abuse of these drugs, Alberta has a triplicate prescription program, making it hard to acquire these drugs fraudulently. As a result, Talwin and Ritalin are often stolen from pharmacies or imported from outside the province and sold on the street. Since the short lived "high" from Talwin and Ritalin can cause a person to take them more often, using these drugs can become very expensive.

Little information is known about non-prescription use of Talwin and Ritalin, possibly because their use is limited to Western Canada.

Effects on Health

Talwin and Ritalin use can cause a number of unpleasant effects, including dizziness, nausea, vomiting, shakiness, confusion, constipation, anorexia, insomnia, and paranoia. The "high" created by Talwin and Ritalin is also followed by a "low" feelings of emotional and physical depression. High doses of Talwin and Ritalin can cause your blood pressure to go up. You may also have hallucinations. Taking very high doses of Talwin and Ritalin can cause you to go into a coma and die.

Users who inject Talwin and Ritalin with a used or dirty needle can get infected veins, abscesses or superficial skin ulcers. They also risk becoming infected with HIV, the virus that causes AIDS. Users may also get infections of the lung, heart, and bones, and liver.

Long-Term Effects

Over the long-term, Talwin and Ritalin users may experience hallucinations, delusions, and confusion. Using syringes damage your veins and other tissue at injection sites. As well, filler material in Talwin and Ritalin doesn't dissolve, and can get into your lungs and cause breathing problems and lung disease.

Tolerance, Dependence and Withdrawal

As your body gets used to Talwin and Ritalin, it needs more and more of it to get the same effect. If you use Talwin and Ritalin regularly, you may become dependent on them. When dependent users stop taking Talwin and Ritalin, they may get withdrawal symptons. Agitation, insomnia, abdominal cramps, nausea, and anxiety are symptoms of Talwin withdrawal. Ritalin withdrawal symptoms include severe emotional depression and exhaustion.

Withdrawal symptons from chronic, heavy Talwin and Ritalin use can be severe because two addictive drugs are involved. In AADAC's experience, users of Talwin and Ritalin often also abuse other substances. This pattern of abuse can make withdrawal even more complicated.

Talwin and Ritalin are not as commonly abused as other drugs. However, it is important to remember that using Talwin and Ritalin together is unhealthy under any circumstances. Injecting drugs and using contaminated needles create additional risk, making this form of drug abuse particularly dangerous.

For more information contact your local AADAC office or call the AADAC Help Line at 1-866-33AADAC (Alberta only).