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Introduction: Painful crisis is the most common manifestation of sickle cell anemia (scA), hence rapid pain control and analgesia should be provided [1, 2]. Pentazocine is a narcotic agonist/antagonist analgesic commonly used in Nigeria for pain management in both medical and surgical conditions. reports on opioid abuse/dependence amongst scA patients are not commonly published, we report on a young scA lady with pentazocine dependence seen at a psychiatric clinic. case report: We report a case of a 17-yearold known scA female with a six-month history of excessive use of pentazocine. she started selfinjection of pentazocine 18 months ago following a bone pain crisis and is said to have a strong desire to use the drug which she uses on daily basis. Initially, she started with 30 mg daily but currently injects 60 mg bd. she has developed hyperpigmented macules with indurations and scarification marks on both forearms. A diagnosis of pentazocine dependence with mild depression in a sickle cell anemia patient was made. she was admitted at the drug unit and managed accordingly. conclusion: Health care