Co-proxamol withdrawal has reduced suicide from drugs in Scotland

Br J Clin Pharmacol. 2008 Aug;66(2):290-3. doi: 10.1111/j.1365-2125.2008.03206.x. Epub 2008 Apr 21.

Abstract

Aim: To determine what effect the withdrawal of co-proxamol from the UK market has had on mortality from poisoning in Scotland.

Methods: This was a retrospective, observational study of mortality relating to poisoning by single agents in Scotland for the period 2000-2006. Mortality data were obtained from the General Register Office Scotland, and primary care prescribing data from the Information and Statistics Division of the Scottish Executive Health Department.

Results: A significant reduction in the proportion of poisoning deaths due to co-proxamol was observed following legislation [mean 2000-2004, 37 deaths (21.8% of total poisoning deaths); 2006, 10 (7.8%); P < 0.0001]. The most significant reduction was seen in male out-of-hospital deaths [mean 2000-2004, 17 (21.8%); 2006, two (2.9%); P < 0.0001]. This was associated with a decline in prescriptions by 60% within 6 months of legislation. The total number of poisoning deaths also fell, slightly earlier than the full impact on co-proxamol deaths (mean 2000-2004, 171.2; mean 2005-2006, 129.5; P = 0.005).

Conclusions: Legislation has resulted in a major reduction in the number of deaths associated with co-proxamol poisoning in Scotland, with no compensatory rise in mortality from poisonings from other common analgesics. We estimate from this study that a minimum of 300 lives across the UK will have been saved by the withdrawal of co-proxamol.

MeSH terms

  • Acetaminophen / poisoning*
  • Acetaminophen / supply & distribution
  • Adult
  • Analgesics / poisoning*
  • Analgesics / supply & distribution
  • Dextropropoxyphene / poisoning*
  • Dextropropoxyphene / supply & distribution
  • Drug Combinations
  • Drug Overdose / mortality
  • Female
  • Humans
  • Legislation, Drug
  • Male
  • Middle Aged
  • Registries
  • Retrospective Studies
  • Scotland / epidemiology
  • Suicide / trends*

Substances

  • Analgesics
  • Drug Combinations
  • Acetaminophen
  • acetaminophen, dextropropoxyphene, drug combination
  • Dextropropoxyphene