måndag 1 oktober 2012

Darvon and Darvocet (Propoxyphene) – the “forgotten” drugs; They could have caused 3 600 - 4 600 fatalities every year during 2003 - 2010

Our CV bit.ly/NUSPQ4

During the years 2003 – 2010 (eight years) The Florida Department of Law Enforcement (FDLE) have reported 64 039 cases of drug related deaths - of a total number of 1 368 500 of deaths in the state during the mentioned eight years.

Of these 64 039 (mean 8 005) drug-related death 2 597 (mean 325) had the painkilling substance Propoxyphene (Darvon and Darvocet) in their blood when they died. The medical examiners in Florida estimated the 657 persons (mean 82/year) died from propoxyphene alone.  The rest 1 941 (mean 243) – had propoxyphene and other drug/drugs in the blood – after death.

It's a really pity that the medical examiners do not report the amount of propoxyphene in the blood, or the amount of ethyl alcohol or the amount of bensodiazepiner - as they found after death.

Ethyl Alcohol in 30 902 cases= 48,3%

But they reported the prevalence of Ethyl Alcohol and bensodiazepines in the blood after death. And we found that there were 30 902 cases (mean 3 863) with Ethyl Alcohol( 48,3%) in the blood, that 20 878 (mean 2 610) had benzodiazepines ( 32,6%) and that there were 2 610  deceased with propoxyphene (mean 325) which was mean 4,1%. It is well know from the scientific literature that Ethyl Alcohol and Benzodiazepines strengthens the prevalence of Propoxyxphene.

-       Early in the 1970s there was warnings about the risk of Propoxyphene toxicity and about the potentiating action of alcohol on the propoxyphene effect were issued in the US on the basis of clinical reports. (Sturner WQ, Garriott JC. Death involving propoxyphene, a study of 41 cases over a two-year period (JAMA 1973;223:1125-1130) and (Fatalitied due to use or misuse of painkillers. Birgitta Jonasson, Ulf Jonasson, Stockholm, 2001, ISBN 91-38-31848-2) page 18.

In our study “The prevalence of dextropropoxyphene in autopsy blood samples. Forensic Science Int. 1998;96:135-142, we investigated a forensic medicine material from the years 1992-1996.The analysis were made on 23 691 blood-samples from 1992-1996. Propoxyphene was found in 1 782 (7,5%) cases - around 200 per year.

60% men and 40% women

The mean blood DXP concentration in the Swedish study was 1,62 µg/g - the DXP level in the blood corresponding to therapeutic doses ranges from 0.05 – 0.75 µg/g . Of the 1 782 cases, 60% were men and 40% women.

A significantly higher DXP level (2,36 µg) was found in the group aged younger than 50 years compared with the cases  older than 50 years of age (1.04 µg /g)

Paracetamol was found in 53% of the 1 782 cases (mean 75 µg/g), therapeutic level 2.5-25 µg/g.

Alcohol was found in the blood in 43% of the 1 782 cases (mean blood alcohol concentration 0.14%. 

Back to the FDLE – data.

We know that 656 cases (82/a year) died from Propoxyphene – alone - as cause and that 1 941 (243) cases had Propoxyphene + some other dug/drugs in their blood when they died. We do not know how much Propoxyphene anyone had in their blood – as we did in Sweden. We neither didn´t know how much Ethyl Alcohol and Benzodiazepines they had in their blood when they died – but we know from Sweden it was quite high doses. We also know that 48,3% of the deceased had Ethyl Alcohol in the blood and 32,6% had Bensodiazepines.

Therefore it is reasonable that we make an assumption by applying a portion of the Swedish data to the American society - in this case data from Florida.

We have an average of 82 deaths in the Florida data - every of the eight years - due to poisoning to death by Propoxypohe alone – and of the reminding 243 fatalities we estimate that 25% also could have cause death where Propoxyphene was involved.(comparing with Swedish data)

Therefore, we get the following figures: 25% of 243 is 61. The new figure we now get is, 82+61=103

Counties in Florida and US

In Florida there are 67 counties and there are 3 033 counties in the whole US, it makes that 2,2% of the counties are in Florida. The mean population for Florida from 2003 to 2010 was 17,8 million inhabitants, which is 5,9% of the mean population in US during the years 2003-2010 was 300,4 million inhabitants.

The data mentioned above gives us the following equation; 67 counties in Florida, 3 033 counties in US, 82 deaths due to Propoxyphene alone and the factor X – the number of fatalities in US.  67/3 033 = 82/X – which makes the numbers of death due to propoxyphene in the whole US is 3 712.

When we use the new data:  82 + 25% of the “present” data. 67 counties/3 033 counties = 103/X which gives you 4 640 fatalities/every year during 2003-2010,


During the years 2003-2010 there could be 8 x 3 712 fatalities = 29 686 deceased – that means they were poisoned to death due to Propoxyphene.

During the years 2003-2010 there could be 8 x 4 640 fatalities = 37 120 deceased – that means they were poisoned to death due to Propoxyphene.

These are really scary numbers. And we are just able to estimate 8 years of the 53 years that propoxyphene has been around (from 1957 – 2010).


We have earlier presented the numbers of prescriptions on Propoxyphene during  the years 2003 - 2010. There were a total of 165 305 000 prescriptions on Propoxyphene in eight years, where the mean was 20 663 000. The highest number of prescriptions was 2003 with 24 015 000 prescriptions and the lowest was 2010 with 14 275 000.

We could also mention the yearly consumption of Propoxyphene 2003-2010. For US it was a total of 617 713 kg (mean was 77 214 kg/year). These figures we now present are from 2003 – 2010. You can imagine what the drug has done and how many fatalities it has caused from the year 1957 – 2010 when it was banned in US.

How could all this be possible?

Propoxyphene is considered a mild drug, and the drug companies - primarily Eli Lilly - has encouraged this approach and both public authorities and the majority of the medical profession have - over the years believed that Darvon and Darvocet are harmless drugs.

During the past few years - then still the analgesic drugs has been highlighted part - has been presented several reports of drugs danger.

I have recently discovered new data from FDLE showing on statistics from 2001 - 2010, (10 years) but but it turns out that neither the “2001 Report of drugs” nor “the 2002 Report of Drugs” there is not a single word about Propoxyphene with. Not a single word, although in 2001 were prescribed 27,315,000 recipes Propoxyophene, 2002 were prescribed 25,197,000 prescriptions.

During the year 2003 - when Propoxyphene occurs for the first time – it was recorded 356 cases of Propoxyphene which 108 are cause.

The consumption of propoxyphene was very high, in 2001some 97 208 kg was consumed and 2002 the consumption was 110 041 kg in the US - the highest figure during the last 10-12 years.

Propoxyphene since 1957 – 53 years

Propoxyphene has thus been in the U.S. since 1957 and it has been one of the best selling preparations for many years, and it has caused a great many people deaths. I consider Propoxyphene as the forgotten drug, the legal drugs that was likely to have has caused most deaths in the U S and the world in general. It is also the most dangerous drug of the prescribed drugs of the legal drugs.

An American disaster

Overall, it's a disaster for the American society and for them - perhaps hundreds of thousands of people - whom lost their lives and their families that lost one loved person.

It is also therefore the substance Propoxyphene was banned in US November 19th 2010.

Swedish data – compared to US data:

During the years 1992-1999 we found that 200 persons were poisoned to death due to (Dextro) Propoxyphene (DXP) in Sweden. During the years 2003 – 2010 we estimate the fatalities in US due to DXP had a mean of 3 600 – 5 500/year.

During these years Sweden had an average consumption of DXP of 2 400 kg (US had – during the years 1982 – 2003 - a consumption of 87 360 kg/year, (36 times more in US) and our country had then around 8,5 millions habitants. US had around 275 millions. (32 times higher in US). The average prescription was in Sweden around one million prescriptions, and in US it was - 2000-2010 – 22 256 000 prescriptions in US (22 times higher in US).

Some interesting links:

Florida Drug reports from 2001 – 2010 http://fameonline.org/fame-documents/19-drug-report

International National Control Board in Vienna - Narcotic Drugs - Technical Reports from 2001 – 2010 http://www.incb.org/incb/en/narcotic_drugs_reports.html

Personal data from INCB, 2003 from Herbert Schaepe and Pavel Pachta.

drugtopics.modernmedicine “2010 Top 200 generic drugs by total prescriptions – this link is for 2010”