Illicit intravenous drug use in Johannesburg--medical complications and prevalence of HIV infection.
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.


METHODS
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.


METHODS
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.
Williams
P G
PG
Department of Medicine, University of the Witwatersrand, Johannesburg.
Ansell
S M
SM
Milne
F J
FJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects; D002545:Brain Ischemia / Q000209:etiology; D005260:Female; D005734:Gangrene / Q000209:etiology; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D006679:HIV Seropositivity; D006417:Hematuria / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000209:etiology; D015995:Prevalence; D044469:Racial Groups; D012189:Retrospective Studies; D012206:Rhabdomyolysis / Q000209:etiology; D012640:Seizures / Q000209:etiology; D012737:Sex Factors; D013019:South Africa; D015819:Substance Abuse, Intravenous / Q000150:complications*; D016896:Treatment Outcome
D000701:Analgesics, Opioid