Darvocet is the brand name for a medication with active ingredient dextropropoxyphene, a substance so plagued by health and safety issues among consumers that medications containing this analgesic have been removed from the US and European markets. However, the drug was only banned in 2010, so illicit versions of the substance can still be found.
Dextropropoxyphene itself is a weak opioid, much like codeine, and lax prescribing practices, starting in 1999 according to the Centers for Disease Control and Prevention (CDC), contributed to the growing opioid abuse epidemic. Currently, 91 Americans die every day from opioid overdoses, and weak opioids like Darvocet have contributed as gateway drugs to addiction and abuse of more potent opioids.
Darvocet Addiction, the Ban, and Ongoing Opioid Abuse
Darvocet was approved for prescription use in the US in 1957. As early as 1976, Public Citizen formally requested that the drug be removed from use because of the dangers associated with it. Dangers include overdose, heart failure, and liver damage from acetaminophen. Public Citizen again filed for the drug to be removed in 2006.
As late as 2004, drugs containing propoxyphene were the 12th highest selling painkillers in the US; however, the UK banned these substances in 2005, and there were many calls to lawmakers in the US to ban drugs like Darvocet after the UK led the way. Some medical experts argued, however, that Darvocet did not cause the same stomach problems as codeine or other opioids, and it was one of the few painkillers safe to give to people who were allergic to morphine and morphine-derivatives.
When Darvocet was banned in 2010, there were about 10 million people in the US with prescriptions for the drug. Several people who took Darvocet, and many who struggled with abuse of Darvocet, not only developed an opioid addiction but also had serious cardiovascular side effects. A five-year review of information collected by the Food and Drug Administration (FDA) found that Darvocet and similar analgesics were associated with higher rates of death compared to tramadol and hydrocodone. Prescription hydrocodone was found to have eight deaths for every 100,000 prescriptions; tramadol had 10 deaths per 100,000 people, and but Darvocet had 16 deaths for every 100,000 people.
Unfortunately, since Darvocet has been banned, people who struggled with addiction to this substance have likely moved on to another opioid drug, likely acquired on the black market.
Darvocet Abuse and Dangers
If a person developed an addiction to Darvocet before it was banned, they no longer have access to this opioid medication. Tramadol and codeine, two weaker opioid drugs, are still available by prescription, but most states have implemented prescription monitoring systems to prevent substance abuse among those receiving opioid drugs. If a person fills a prescription too soon or tries to fill multiple prescriptions, a prescription monitoring program will likely catch that person. Because of these programs, and improved opioid prescribing guidelines, people who struggle with any opioid addiction are turning to illicit sales. This is extremely dangerous.
Symptoms of addiction to opioids like Darvocet will include appearing intoxicated, exhausted, and lacking motivation. Other symptoms include:
- Difficulty at work or school
- Trouble with physical health
- Neglecting appearance
- Behavioral changes, especially neglecting family and friends
- Drug-seeking behaviors, lying, or stealing
- Becoming defensive when confronted about potential substance abuse
- Financial problems from spending too much money acquiring drugs
The CDC has found that currently, the most abused prescription opioids are methadone, oxycodone, and hydrocodone, which are widely prescribed to treat pain. Darvocet is no longer on that list because it is not used in the US, but many people who took the drug before it was banned likely still struggle with substance abuse that developed while using the prescription narcotic. More potent narcotics like fentanyl, and stronger analogs like “pink” and “gray death” are being sold in place of, or mixed into, illicit drugs like heroin. This has dramatically increased the number of overdoses from opioids.
Side Effects and Physical Harm
The most common side effects from taking Darvocet, especially if it is abused for nonmedical reasons, are:
- Nausea and vomiting
- Other gastrointestinal problems
- Skin rashes
- Physical weakness
- Elation or euphoria
- Hallucinations, including visual, auditory, or tactile hallucinations
- Blurry vision
Some versions of Darvocet contain acetaminophen, so abusing Darvocet puts a person at risk for acetaminophen poisoning, which can damage the liver. The body can also develop physical dependence on and tolerance to the drug, so a person who took Darvocet as prescribed would likely need to increase their dose to achieve the original analgesia. People who struggle with Darvocet abuse are more likely to up their dose quickly, which puts them at risk for overdose on both the narcotic and the acetaminophen.
Darvocet was removed from the US market because of the number of deaths associated with the drug. Many people accidentally overdosed on Darvocet, but several people also struggled with mental health problems and took too much Darvocet on purpose. In addition to opioid overdose dangers like respiratory depression and oxygen deprivation, Darvocet was also found to be responsible for several cardiac arrests.
Withdrawing from Darvocet Requires Medical Help
Like other opioids, Darvocet withdrawal is generally uncomfortable, but not fatal. Symptoms of opioid withdrawal syndrome include:
- Watering eyes
- Runny nose
- Excessive yawning
- Pupil dilation
- Back aches
- Irritability and mood swings
- Joint and muscle pain
- Abdominal cramps
- Loss of appetite
- Increased blood pressure
- Faster breathing
It is possible for a person to struggle with Darvocet addiction for so long that they develop abstinence syndrome, or protracted withdrawal syndrome (PAWS). This condition involves the prolonged experience of withdrawal symptoms, especially psychological symptoms like depression, anxiety, insomnia, and cravings. To reduce the risk of developing PAWS in withdrawal, it is important to work with a medical professional who can prescribe medication-assisted therapies like buprenorphine and slowly taper use of that medication until the body is no longer dependent on the substance.
Overdose Deaths from Darvocet
According to the FDA’s warnings, an overdose of Darvocet can cause death within one hour. Unlike other opioid analgesics, there are no good overdose reversal drugs for propoxyphene. It is extremely important to contact 911 if a person overdoses on Darvocet because emergency medical attention is the only way for them to survive.
Signs of a Darvocet overdose include:
- Extreme sleepiness
- Unresponsiveness to others, either while awake (stupor) or asleep
- Difficulty breathing
- Stopped breathing
- Blood pressure changes
- Heart rate changes
- Nausea and vomiting
- Loss of appetite
- Abdominal pain
Overdose becomes more likely if a person consumes alcohol, sedatives like benzodiazepines, or tranquilizers like barbiturates. Other overdoses have involved psychotic and delusional symptoms associated with mixing Darvocet and antidepressants, muscle relaxants, or other central nervous system (CNS) depressants.
Darvocet Addiction Treatment
There are several resources available to help people struggling with opioid drugs or who may still be struggling with Darvocet addiction. For example, the Affordable Care Act (ACA) requires health insurance companies to cover some detox and drug rehabilitation options; those seeking help overcoming opioid addiction can ask their insurance company what options are available. To find treatment nearby, the Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a treatment finder online that offers a wide range of mental and behavioral health services. This can include insurance coverage and sliding scale payment options. SAMHSA also has a hotline for individuals in crisis, or family and friends in crisis, who are seeking treatment resources.
Men and women who served in the Armed Forces can get nearly any kind of medical care through the Office of Veterans Affairs (VA), including behavioral health services. Qualifying individuals may find opioid treatment through Medicaid. Medicare covers treatment for older adults who are vulnerable to overdose because they likely take more medications than younger people. For those seeking longer-term social support, Narcotics Anonymous (NA) meetings are free, and based on the 12-Step model.
The American Society of Addiction Medicine (ASAM), the National Association for Addiction Professionals (NAADAC), and the National Coalition Against Prescription Drug Abuse (NCAPDA) all maintain lists of resources to get help overcoming addiction.
ASAM found, in 2013, that access to government programs like Medicaid significantly improved access to treatment for people, although evidence-based treatment is still underutilized by these options. The National Institute on Drug Abuse (NIDA) refers to the treatment gap – the millions of people who struggle with addiction but do not get help – and ways to close that.
In addition to government and nonprofit resources, NIDA keeps a list for family and friends to contact for help. This is an important list, as people struggling with substance abuse may not be aware enough to contact these resources themselves. Workplaces with Employee Assistance Programs (EAPs) can help people who may be suffering at work. The criminal justice system sees thousands of people enter prison because of drug abuse, so reforms to their program offerings can help to keep people away from criminal activity when they exit the system by maintaining sobriety.