Fatal self-poisoning in the UK and the paracetamol/dextropropoxyphene combination. 1984

P S Dwyer, and I F Jones

Coroners' files have been examined to ascertain the numbers of deaths involving self-poisoning with analgesic drugs with specific reference to the paracetamol/dextropropoxyphene combination. The period of study was 1976-1980. This report concentrates on cases in England, although reference is made to similar deaths occurring in Scotland and Northern Ireland. Data have been collected extensively on a wide range of issues concerning fatal self-poisonings mainly by visiting coroners' offices in England to make direct investigation of records. The total number of cases where the paracetamol/dextropropoxyphene combination can be considered as ingested in the self-poisoning episode is underestimated. The number of cases involving alcohol and/or other drugs taken together with the combination product is particularly underestimated. Involvement of people aged 30 years and below comprises 32% of all cases. 'Gesture' overdoses comprise an estimated 14% of all cases in England. An analysis of fatalities from cases where quantities in post-mortem blood of dextropropoxyphene less than 1 microgram/ml and paracetamol less than 50 micrograms/ml are found and of cases where death occurs within 2 h of ingestion of the overdose has been carried out. The results are inconclusive. In most cases alcohol and/or other drugs are found to be involved. Critical inspection of coroners' files shows relatively few of these cases where the combination product is ingested on its own. There is wide variability in the data available in coroners' files. In many cases data of value to this research are not recorded. Medical history and quantitative levels of drugs suspected (particularly dextropropoxyphene) are particular examples of factors which may not be recorded. Office of Population, Censuses and Surveys (OPCS) mortality data are based on certified causes of death. Because of the underestimate of the involvement of this combination product and the under-reporting of other drug and/or alcohol ingestion with the combination, care must be exercised in quoting or drawing conclusions from OPCS statistics.

UI MeSH Term Description Entries
D008297 Male Males
D008499 Medical Records Recording of pertinent information concerning patient's illness or illnesses. Health Diaries,Medical Transcription,Records, Medical,Transcription, Medical,Diaries, Health,Diary, Health,Health Diary,Medical Record,Medical Transcriptions,Record, Medical,Transcriptions, Medical
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011431 Dextropropoxyphene A narcotic analgesic structurally related to METHADONE. Only the dextro-isomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect. D-Propoxyphene,Darvon,Propoxyphene,Propoxyphene Hydrochloride,Propoxyphene Hydrochloride, (R*,R*)-(+-)-Isomer,Propoxyphene Hydrochloride, (R-(R*,R*))-Isomer,Propoxyphene Hydrochloride, (R-(R*,S*))-Isomer,Propoxyphene Hydrochloride, (S-(R*,R*))-Isomer,Propoxyphene Maleate, (+)-Isomer,Propoxyphene Phosphate, (S-(R*,S*))-Isomer,Propoxyphene Sulfate, (S-(R*,S*))-Isomer,D Propoxyphene,Hydrochloride, Propoxyphene
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D005260 Female Females
D006113 United Kingdom Country in northwestern Europe including Great Britain and the northern one-sixth of the island of Ireland, located between the North Sea and north Atlantic Ocean. The capital is London. Great Britain,Isle of Man
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000082 Acetaminophen Analgesic antipyretic derivative of acetanilide. It has weak anti-inflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. Acetamidophenol,Hydroxyacetanilide,Paracetamol,APAP,Acamol,Acephen,Acetaco,Acetominophen,Algotropyl,Anacin-3,Datril,N-(4-Hydroxyphenyl)acetanilide,N-Acetyl-p-aminophenol,Panadol,Tylenol,p-Acetamidophenol,p-Hydroxyacetanilide,Anacin 3,Anacin3
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

Related Publications

P S Dwyer, and I F Jones
July 1981, Journal - Forensic Science Society,
P S Dwyer, and I F Jones
October 1975, Ugeskrift for laeger,
P S Dwyer, and I F Jones
February 1980, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke,
P S Dwyer, and I F Jones
January 2005, Clinical toxicology (Philadelphia, Pa.),
P S Dwyer, and I F Jones
January 1971, Acta pharmacologica et toxicologica,
P S Dwyer, and I F Jones
November 1972, Zeitschrift fur Rechtsmedizin. Journal of legal medicine,
P S Dwyer, and I F Jones
April 1989, Journal of the Royal Society of Medicine,
Copied contents to your clipboard!