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RESEARCH: Keith Hawton, Helen Bergen, Sue Simkin, Anita Brock, Clare Griffiths, Ester Romeri, Karen L Smith, Navneet Kapur, and David Gunnell Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis BMJ 2009; 338: b2270 [Abstract] [Full text]

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Why the delay?

Stephen F Hayes   (27 August 2009)

Why the delay? 27 August 2009
Stephen F Hayes, GP 66A Portsmouth road, Woolston, Southampton S019 9AL Send response to journal: Re: Why the delay?	I stopped prescribing co-proxamol some 25 years ago, with the exception of patients settled on repeat prescriptions who insisted on it despite my advice of its danger in overdose. I changed my practice after I read a paper (sorry I can't cite the reference, either BMJ or Lancet late 1970s) stating that it was the most important drug in completed suicide. I remember reading that it was the dextropoxyphene that did it by causing respiratory arrest before the ambulance arrived. Codeine or dihydrocodeine are more likely to cause vomiting. The deadliness of co-proxamol wasn't a secret. The crime writer P D James, always one for meticulous research, used it (Distalgesic) as the mode of (intended and premeditated) suicide for a protagonist in her novel 'Innocent Blood'. Competing interests: None declared