Co-proxamol and suicide: preventing the continuing toll of overdose deaths.

Restricting means for suicide is a key element in suicide prevention strategies of all countries where these have been introduced. Preventing deaths from analgesic overdoses is highlighted in the National Suicide Prevention Strategy for England. The problem of self-poisoning with the prescription-on...

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Main Authors: Simkin, S, Hawton, K, Sutton, L, Gunnell, D, Bennewith, O, Kapur, N
Format: Journal article
Language:English
Published: 2005
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author Simkin, S
Hawton, K
Sutton, L
Gunnell, D
Bennewith, O
Kapur, N
author_facet Simkin, S
Hawton, K
Sutton, L
Gunnell, D
Bennewith, O
Kapur, N
author_sort Simkin, S
collection OXFORD
description Restricting means for suicide is a key element in suicide prevention strategies of all countries where these have been introduced. Preventing deaths from analgesic overdoses is highlighted in the National Suicide Prevention Strategy for England. The problem of self-poisoning with the prescription-only drug co-proxamol (dextropropoxyphene plus paracetamol) has received attention in several countries. We have conducted a review of the international literature related to possible strategies to tackle this problem. In England and Wales in 1997-1999, 18% of drug-related suicides involved co-proxamol; these constituted 5% of all suicides. Death usually results from the toxic effects of dextropropoxyphene on respiration or cardiac function. Death from co-proxamol overdose may occur rapidly, the lethal dose can be relatively low, and the effects are potentiated by alcohol and other CNS depressants. The majority of co-proxamol overdose deaths occur before hospital treatment can be received. The risk can extend to others in the household of the person for whom the drug is prescribed. While there is limited evidence that educational strategies have been effective in reducing deaths from co-proxamol poisoning, initiatives in Scandinavia, Australia and the UK to restrict availability of co-proxamol have produced promising results. Given the paucity of evidence for superior therapeutic efficacy of co-proxamol over other less toxic analgesics, there are good reasons to question whether it should continue to be prescribed.
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spelling oxford-uuid:6be35c96-5974-437f-beaf-eee33bca33672022-03-26T19:07:08ZCo-proxamol and suicide: preventing the continuing toll of overdose deaths.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6be35c96-5974-437f-beaf-eee33bca3367EnglishSymplectic Elements at Oxford2005Simkin, SHawton, KSutton, LGunnell, DBennewith, OKapur, NRestricting means for suicide is a key element in suicide prevention strategies of all countries where these have been introduced. Preventing deaths from analgesic overdoses is highlighted in the National Suicide Prevention Strategy for England. The problem of self-poisoning with the prescription-only drug co-proxamol (dextropropoxyphene plus paracetamol) has received attention in several countries. We have conducted a review of the international literature related to possible strategies to tackle this problem. In England and Wales in 1997-1999, 18% of drug-related suicides involved co-proxamol; these constituted 5% of all suicides. Death usually results from the toxic effects of dextropropoxyphene on respiration or cardiac function. Death from co-proxamol overdose may occur rapidly, the lethal dose can be relatively low, and the effects are potentiated by alcohol and other CNS depressants. The majority of co-proxamol overdose deaths occur before hospital treatment can be received. The risk can extend to others in the household of the person for whom the drug is prescribed. While there is limited evidence that educational strategies have been effective in reducing deaths from co-proxamol poisoning, initiatives in Scandinavia, Australia and the UK to restrict availability of co-proxamol have produced promising results. Given the paucity of evidence for superior therapeutic efficacy of co-proxamol over other less toxic analgesics, there are good reasons to question whether it should continue to be prescribed.
spellingShingle Simkin, S
Hawton, K
Sutton, L
Gunnell, D
Bennewith, O
Kapur, N
Co-proxamol and suicide: preventing the continuing toll of overdose deaths.
title Co-proxamol and suicide: preventing the continuing toll of overdose deaths.
title_full Co-proxamol and suicide: preventing the continuing toll of overdose deaths.
title_fullStr Co-proxamol and suicide: preventing the continuing toll of overdose deaths.
title_full_unstemmed Co-proxamol and suicide: preventing the continuing toll of overdose deaths.
title_short Co-proxamol and suicide: preventing the continuing toll of overdose deaths.
title_sort co proxamol and suicide preventing the continuing toll of overdose deaths
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