Removal of Drug Co-proxamol Reduces Death Rate
Every medication on the market has the potential to be used for harm. Some prescription drugs are sold on the street for misuse, and some with legal prescriptions have those prescriptions through several different doctors. In some cases, misuse of a drug can intentionally or unintentionally result in death.
With the global increase over recent years in prescription drug abuse, it is important to understand how individual drugs are being misused. Policymakers and those who develop strategies for drug abuse prevention and intervention must have detailed information about the drugs.
A recent study conducted by researchers at the University of Oxford, UK and led by Keith Hawton examined the impact of removing the analgesic co-proxamol from the market in 2005. The drug’s removal was followed by a drastic reduction in deaths related to the drug, and there were not significant increases reported involving other analgesics.
The study’s findings are published in a recent issue of PLoS Medicine.
The drug co-proxamol is a painkiller that is composed of paracetamol and an opioid, destropropoxyphere. It was involved in approximately 20 percent of suicides that occurred in Wales and England in the years between 1997 and 1999. Because of its association with a high number of suicides, the drug was removed from use in the UK from 2005 to 2007.
Previous research from the same team provided evidence that there were beneficial effects resulting from the removal of the drug, including a lower rate of poisoning deaths related to co-proxamol and no corresponding increase in similar deaths related to other prescription painkillers.
In the current study, the researchers sought to explore whether there were long-term effects related to the three year withdrawal of co-proxamol. The study, with an interrupted time series design, measured the outcome of the withdrawal in Wales and England by examining painkiller prescriptions and suicide rates reported between 1998 and 2004, and then between 2005 and 2010.
The average rate of co-proxamol related suicides from 2008 to 2010 was about 20 deaths each year. This number includes both accidental poisoning deaths and suicides. During the 1990s, the average rate was over 250 per year.
The study did not include analysis of whether suicides involved the misuse of multiple substances or whether suicides involved methods in addition to drugs had increased since the removal of co-proxamol from the market.
There was little evidence to prove a change in the number of poisoning deaths related to other analgesics following the removal of co-proxamol, despite the increased numbers of painkiller prescriptions.
The results of the study provide evidence that there may be a significant improvement in suicide rates if co-proxamol were removed from the market on a global basis, at least when considered on a short-term basis.