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Dextropropoxyphene deaths: coroner's report.

R M Whittington

    Human Toxicology
    |August 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

    Dextropropoxyphene, often in Distalgesic, is linked to rapid, fatal overdoses, especially with alcohol. This analgesic

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    Area of Science:

    • Toxicology
    • Pharmacology
    • Public Health

    Background:

    • Dextropropoxyphene, particularly in Distalgesic (dextropropoxyphene hydrochloride and paracetamol), saw increased UK prescription as an analgesic.
    • Reports of sudden deaths linked to its misuse have led to declining prescribing rates.

    Purpose of the Study:

    • To compare Birmingham inquest data from 1983 with 1976-1979 to assess trends in dextropropoxyphene-related fatalities.
    • To characterize the pattern and circumstances of fatal overdoses involving dextropropoxyphene.

    Main Methods:

    • Comparative analysis of inquest records from specified periods.
    • Review of drug fatality data, focusing on time to death, fatal dose, and contributing factors.

    Main Results:

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    • Distalgesic remains a leading cause of fatal drug overdose in the West Midlands, UK.
    • Deaths often occur rapidly (within 1 hour of ingestion), frequently before hospital intervention.
    • Fatal doses can be as low as 15 tablets, with alcohol increasing toxicity.
    • Victims include young individuals, some with no suicidal intent; convulsions and respiratory failure are common causes of death.
    • The elderly and those with respiratory issues may be at higher risk of accidental death.
    • Evidence suggests dextropropoxyphene carries a risk of dependence and addiction.

    Conclusions:

    • Dextropropoxyphene, especially in combination products like Distalgesic, poses a significant risk of rapid and fatal overdose.
    • Concurrent alcohol use exacerbates toxicity and increases the likelihood of death.
    • The drug's potential for dependence warrants careful consideration in clinical practice and public health strategies.