Unique Swedish data influenced the banning of Dextro-Propoxyphene in the world

PREFACE to the report " Restrictions on the prescribing of DextroPropoxyphene (DXP) – effects on sales and cases of fatal poisoning" http://bit.ly/1O6QwOa 

Regarding the analgesics compound (Dextro) Propoxyphene since 1991, when the four branches of forensic science in Sweden (medicine, psychiatry, chemistry and genetics) were organized into one authority, the National Board of Forensic Medicine, an extensive database has been set up for forensic medical and toxicological information. 

Consequently, we have unique opportunities in Sweden to follow developments within these fields at a comprehensive national level. 

Forensic research based on our four registers has demonstrated that 1 592 persons (200 persons a year) in Sweden were fatally poisoned by the analgesic compound (Dextro) Propoxyphene (DXP) between 1992 and 1999. The problems with DXP poisonings were already noted during 1970´s. 

The Swedish research on DXP – which has attracted a great deal of attention in the media as well as in political circles – has contributed to the decision made by the Swedish Medical Product Agency to issue special restrictions effective from June 15, 2001. This means that DXP agents today have to be prescribed on a specific form, which in practice signifies a narcotic classification. In Denmark and Norway, however, restrictions similar to those introduced in Sweden 2001 have been force since the 1980´s. 

In April 2003 a Swedish member of the European Parliament, Dr Marit Paulsen, raised a question in the Parliament concerning the risk of DXP poisoning. She asked if the Commission was aware of the problems with DXP in Sweden and pointed out that the DXP problems are probably worse in two other EU countries namely the United Kingdom and France. The question is at present prepared by EMEA – The Medical Products Agency of the European Union – and one of their subcommittees. 

This present study – Restrictions on the prescribing of dextropropoxyphene(DXP) – effects on sales and cases of fatal poisoning – is written by Ulf Jonasson, Doctor of Public Health and Birgitta Jonasson, PhD, on behalf of The National Board of Forensic Medicine and The Medical Products Agency in cooperation with The National Board of Social Insurance Board and The Swedish Poisons Information Centre. 

Ulf Westerberg 

Director General National Board of Forensic Medicine