Darvon sure has been taking its
were fine for a while, and Darvon, which was introduced in the
United States in 1957, kept plugging along, year after year,
near the top of the list of most-prescribed medications.
two decades, it ranked right behind Valium and Librium as one
of America's most popular prescription drugs, averaging 39 million
prescriptions a year between 1973 and 1975.
began to go sour.
when propoxyphene (the generic name for Darvon) was cited in
589 overdose deaths in 23 U.S. cities. This led the Ralph Nader-affiliated
Health Research Group to demand a federal ban on use of the painkiller.
"the deadliest prescription drug in the United States,"
the group argued that propoxyphene figures into thousands of
deaths and medical emergencies each year -- many of them accidental
when the 1989 Darvon-related death of former NFL great John Matuszak
prompted the group to renew its demand for removal of the drug
from the U.S. market.
between, the U.S. Food and Drug Administration stepped up its
campaign against Darvon, limiting how and when and for how long
doctors could prescribe the drug.
So what's everybody
got against Darvon, anyway? And why, in spite of a lot of people's
best efforts, won't it (and other propoxyphene-based drugs like
it) go away?
But to answer them fully we first have to look closely at the
make-up and properties of the drug itself: the chemical propoxyphene.
..What it is, what it isn't
So what is
it's a relative of the synthetic narcotic, methadone. It's prescribed
in two forms -- propoxyphene hydrochloride and propoxyphene napsylate
-- for relief of mild to moderate pain.
slight differences -- the napsylate (or N-form) of propoxyphene
is more slowly absorbed in the body and so has a longer duration
of action -- the two drugs are identical. Both are found in a
number of prescription pain medications, including:
- Darvon and Darvon-N (propoxyphene
- Darvon with A.S.A., Darvon-N
with A.S.A. (with aspirin)
- Darvocet, Darvocet-N, Wygesic
- Darvon Compound, Darvon Compound-65
(with aspirin and caffeine)
But in whatever
form, propoxyphene is prescribed and sold as a mild analgesic
for pain that won't stop with aspirin.
So why all
For one thing,
Darvon doesn't work -- at least not as well as it was supposed
to when it was introduced back in 1957. At that time, its manufacturer,
Eli Lilly and Company, promoted it as a safe, non-addicting substitute
But the closer
people looked, the less Darvon looked like a safe, non-addicting
substitute for anything. In fact, in 1972, after clinical studies
qued propoxyphene's effectiveness as a pain reliever, Lilly was
required to release a statement backing off some of its earlier
claims on behalf of the drug.
that "the preponderance of evidence indicates that it may
be somewhat less potent than codeine," Lilly even conceded
in its retraction there was "no substantial evidence to
demonstrate that 65mg of Darvon is more effective than 650mg
of aspirin [two standard tablets]."
No more effective
than aspirin? Some authorities, including the American Medical
Association's Drug Evaluations, went a step further, arguing
that a dose of propoxyphene is actually less effective than a
normal dose of aspirin.
Okay, so if
propoxyphene is less effective and less potent than codeine and
no better than two aspirin in relieving pain, what good is it,
question, and one that gets more interesting the closer you get
to the serious hazards associated with propoxyphene.
..Risks & Realities
run into problems with propoxyphene, it's often due in large
part to the drug's ineffectiveness.
most often prescribed for relief of pain, propoxyphene can easily
be misused -- particularly when relief does not appear to be
fast or forthcoming. But pain sufferers who self-prescribe a
double dose of Darvon when a first dose fails may be writing
themselves a prescription for trouble.
around unusual properties of the drug itself.
For one thing,
the gap between a therapeutic dose and an overdose is small.
This margin of safety is so slight, in fact, that as little as
four times the standard dose can trigger a dangerous slowing
of breathing and heart rate. Six times a therapeutic dose can
cause seizures and symptoms of toxic psychosis.
safety margin shrinks further if the drug is taken with alcohol
or other depressants.
In fact, more
than 93 percent of all propoxyphene-related deaths in a single
recent year were the result of interactions with other drugs
-- more than half involving alcohol or diazepam. (Valium)
..Addiction and Other Dangers
similarities to methadone, it's not surprising that the drug
is as addictive as it is.
In fact, the
medical journal Clinical Pharmacology even argued that
propoxyphene's "most prominent effect...may be its addictive
And that danger
hasn't been lost on a generation of users, either.
psychological and physical dependence like other narcotics, and
treatment for Darvon dependence is much the same, too.
are tied to the presence of substances often found in propoxyphene
preparations. Aspirin and acetaminophen are particularly dangerous
since they can damage the liver and kidneys when overused.
heavy doses of caffeine (found in Darvon Compound and Darvon
Compound-65) can cause jitteriness, insomnia, and anxiety --
which some users relieve by taking tranquilizers or sleeping
pills, which further compounds the risk of overdose.
us to a final danger of Darvon that's confronted too many users
over the years: a potentially-fatal overdose syndrome.
similar to other narcotics overdoses, and include convulsions,
stupor, pinpoint pupils, respiratory depression, and coma.
overdoses are double trouble -- and often deadly -- because they
happen so quickly. In fact, one study has shown that 20 percent
of fatal overdoses occur in the first hour after ingesting the
Due to the
rapid onset of symptoms, medical help should be sought immediately.
Given the lumps
that Darvon's taken lately, it would seem to follow that it would
have disappeared as a drug problem by now, right?
Because propoxyphene figured into an estimated 5,625 emergency
room admissions nationwide in 2008. And, according to the advocacy
group Public Citizen, a main reason is that the drug breaks down
in the body into a metabolite that's even more toxic (and longer-acting)than
And that means
potential trouble for everyone who takes it.
..The problem that won't quit
So what's a
troubled pain sufferer to do?
Well, if you're
routinely taking Darvon (or any of the other propoxyphene drugs)
for everyday aches or pains, and you've been taking it for some
time, you might look seriously at giving it up -- or at least
talking over your situation with a physician.
If you've been
prescribed propoxyphene for a brand-new pain, take the drug only
as directed and stop at your first opportunity.
And if you're
taking Darvon because you're addicted to it (or you think you
might be), contact a local drug treatment facility to get some
help for yourself.
spite of all the lumps it's taken, Darvon is still all too capable
of inflicting a few lumps of its own, particularly to people
who don't know what they're dealing with.
And while ignorance
about some things can be bliss, with a drug as potentially dangerous
as Darvon, ignorance is only ignorance.
..Sidebar | Rx:
A number of
Darvon-like natural and synthetic narcotics are widely used as
pain relievers today. When used properly, these drugs can mean
the difference between incapacitating pain and normal functioning.
But when overused or used improperly, they can produce the same
problems as propoxyphene: overdose, addiction, and other health
The most common
side effects of the prescription pain relievers listed below
are a group of symptoms that include dizziness, sedation, and
nausea or vomiting. Other effects include flushing or tingling
of the skin, dry mouth, lethargy, impaired concentration, and
constipation. Like propoxyphene, all produce varying degrees
of physical and psychological dependence. Each also produces
tolerance, or a need to boost dosage in order to achieve similar
drugs have a broad range of effects and abuse potential, they
share one thing in common: a nasty overdose syndrome that can
be life threatening. Symptoms of overdose include pinpoint pupils,
muscle flaccidity, depression of breathing and heart rate, stupor,
and coma. Medical intervention is essential.
best advice to follow with all prescription narcotics is to take
them with a healthy dose of caution. Because while their effects
-- and dangers -- can range from very mild to very severe, they
all can take away something infinitely more important than pain
when used incorrectly. And they can all be used incorrectly.
||Other Drugs Present