Intended for healthcare professionals

Rapid response to:

Research

Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b2270 (Published 18 June 2009) Cite this as: BMJ 2009;338:b2270

Rapid Response:

Why the delay?

I stopped prescribing co-proxamol some 25 years ago, with the
exception of patients settled on repeat prescriptions who insisted on it
despite my advice of its danger in overdose. I changed my practice after I
read a paper (sorry I can't cite the reference, either BMJ or Lancet late
1970s) stating that it was the most important drug in completed suicide. I
remember reading that it was the dextropoxyphene that did it by causing
respiratory arrest before the ambulance arrived. Codeine or
dihydrocodeine are more likely to cause vomiting.

The deadliness of co-proxamol wasn't a secret. The crime writer P D
James, always one for meticulous research, used it (Distalgesic) as the
mode of (intended and premeditated) suicide for a protagonist in her novel
'Innocent Blood'.

Competing interests:
None declared

Competing interests: No competing interests

27 August 2009
Stephen F Hayes
GP
66A Portsmouth road, Woolston, Southampton S019 9AL