Deaths related to propoxyphene overdose: a ten-year assessment

Of 81 fatal overdoses of propoxyphene identified over a ten-year period, suicide accounted for 76.5% and accidents for 23.5%. The incidence sharply increased in 1973 and the death rate has remained constant since then. In two thirds of the suicidal overdose deaths, additional drugs were encountered. Alcohol was detected in an additional 15%, and propoxyphene preparations alone were used in 19%. In the 19 deaths from accidental overdose, six resulted from recreational abuse, and additional drugs were detected in all. Five who dief of propoxyphene preparations alone had significant medical illnesses. Eight nonrecreational users died after taking other drugs or alcohol along with propoxyphene. Only one individual in the entire series was found to be dependent on propoxyphene. Although propoxyphene cannot be regarded as a harmless drug, the study indicates a very low rate of dependency and a low potential for recreational abuse. As with other drugs, adequate warnings concerning dosage abuse and the concurrent use of alcohol and other drugs must be stressed. The suggestion to reclassify propoxyphene to a Schedule II drug does not appear justified.