The clinical findings associated with IV methylphenidate/pentazocine abuse in emergency department visits are reported from the University of Missouri-Kansas City, MO. Twenty nine patients seen between 1987 and 1992 were treated 34 times. The mean age was 32 +/- 9 years. Central nervous system complications in 7 were anxiety/agitation (5%), seizures (9%), or loss of consciousness (6%). The typical symptom complex of chest pain, anxiety, muscle spasm, dizziness, and nausea was present in 58%. Treatment was mainly supportive and included oxygen and fluids. 
COMMENT. IV abuse of methylphenidate is unlikely in children with ADDH but the increased use of stimulant medication in teenagers (see Ped Neur Briefs October 1994) provides a possible source of concern. The combination of crushed Talwin® (pentazocine) tablets and Ritalin® (methylphenidate) is called “Ts and Blues” in Kansas City, MO, and has resulted in acute myelopathy in one reported case. The CNS complications are reviewed by Caplan LR et al.