"Ts and Rs," "Ts and Rits," "One and Ones," and "Set" are street names for a mixture of the prescription drugs Talwin (pentazocine) and Ritalin (methylphenidate). When combined and injected, Talwin, a painkiller and Ritalin, a stimulant, produce a brief but intense sense of euphoria 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 mans Heroin."
Talwin and Ritalin are still prescribed individually for medical purposes. However, Alberta's triplicate prescription program has made it difficult to acquire these drugs fraudulently. Consequently, Talwin and Ritalin are often stolen from pharmacies or imported from outside the province and are now expensive on the street. Since the short-lived high from Talwin and Ritalin can result in a person taking them more often, the use of these drugs can become very expensive.
Interestingly, there is little information about Talwin and Ritalin use in addiction research literature. This lack of research is apparently due to the fact that use of these drugs is limited mainly to Western Canada.
Many of the medical problems associated with Talwin and Ritalin use result from the use of dirty or shared needles. These problems can be relatively minor, such as infected veins, abscesses or superficial skin ulcers. More serious consequences include bacterial infections of the lung, heart, and bones, and viral infections to the liver (hepatitis). In all cases , injecting Talwin and Ritalin with a used needle increases the risk of becoming infected with HIV, the virus that causes AIDS.
In addition to the problems caused by using dirty needles to inject the drugs, Talwin and Ritalin use can cause a number of unpleasant effects, including dizziness, nausea, vomiting, tremors, confusion, constipation, anorexia, insomnia, and paranoia. The "high" created by Talwin and Ritalin is also followed by a "low" manifested by physical and emotional depression. High doses of Talwin and Ritalin can increase blood pressure and cause hallucinations. Very high doses can result in coma and death.
Over the long-term, people who abuse Talwin and Ritalin can develop a toxic psychosis which is characterized by hallucinations, delusions, and confusion. Long-term use of syringes can result in severe damage to veins and other tissue at injection site. As well, the insoluble substance used as filler in Talwin and Ritalin can cause respiratory problems and lung disease.
Tolerance is the body adapting to the presence of a drug. When tolerance to a drug increases, more of the drug is necessary to achieve the same effect. Tolerance to Talwin and Ritalin may develop , leading to higher doses and frequent use. Dependence on either drug, particularly Talwin, may also occur with regular use. Withdrawal occurs as the body adapts to the absence of a drug. Agitation, insomnia, abdominal cramps, nausea, and anxiety are symptoms of Talwin withdrawal. Ritalin withdrawal symptoms include severe emotional depression and exhaustion. Withdrawal from chronic, heavy Talwin and Ritalin use is compounded and more severe because two addictive drugs are involved. Talwin and Ritalin abuse is often part of a more complex pattern of abusing a number of substances. This pattern of abuse may further complicate withdrawal.
Talwin and Ritalin use is relatively less common then other forms of drug abuse. However, it is important to remember that any use of Talwin and Ritalin together is misuse of these drugs. 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.