Co-proxamol ban not the main culprit
The withdrawal of co-proxamol in the UK has saved approximately 300 lives per year and there is no evidence that the death rate due to other analgesics is increasing ('Prescriptions for opioids jump following co-proxamol ban').
Prior to the withdrawal of co-proxamol, the MHRA issued guidance on pain management from the former Committee on Safety of Medicines (now known as the Commission on Human Medicines) to help doctors find the best options for individual patients, setting out a graduated range of possible therapeutic interventions.
It is true that opioid prescribing has increased in recent years, but we believe there are a variety of reasons for this, and that the withdrawal of co-proxamol is unlikely to be among the most significant of them.
We do not have evidence that patients are being switched from co-proxamol to other opioids, although our experts did recognise this as a possibility. Even though opioid prescriptions have increased steadily over the last five years they still make up a very small proportion of the overall prescriptions for painkillers.
There were increases in the numbers of prescriptions of paracetamol and of co-codamol around the time of the co-proxamol withdrawal.
These increases were sufficiently large to suggest that patients may have been switched from co-proxamol.
A research project to look at the analgesics that patients have been switched to will be started shortly.
From Shirley Norton, deputy director, vigilance and risk management of medicines, Medicines and Healthcare Products Regulatory Agency