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Darvocet contains two medications: acetaminophen and propoxyphene. Acetaminophen is a nonprescription pain reliever and fever-reducing medication that is available in medications like Tylenol. Propoxyphene is an opioid drug that is typically used in the suppression of pain and as a cough suppressant. The acetaminophen in Darvocet assists with the pain-relieving effects of the propoxyphene. Darvocet was typically designed to treat mild to moderate pain that occurred in individuals with or without fever.
Darvocet’s main medicinal use is for the relief of pain. Because propoxyphene is an opioid drug, it is an effective pain suppressor; however, it also produces feelings of sedation, wellbeing, and euphoria. When taken for lengthy periods, it can produce physical and psychological dependence.
There were also other potential side effects associated with using Darvocet. The Food and Drug Administration (FDA) released a listing of the side effects of Darvocet in 2009 that included:
Other possible problems that were considered to be relatively rare were noted, such as the potential for severely decreased respiration that could be dangerous or even fatal, a potentially dangerous drop in blood pressure, the development of seizures that could also be potentially fatal, and liver damage as a result of using high amounts of acetaminophen.
The potential for propoxyphene to cause physical dependence is generally considered to be less severe than for other more potent opiate drugs, such as morphine or oxycodone. Nonetheless, as mentioned above, chronic use is associated with the development of physical dependence, and the drug is easily abused due to the mild euphoric effects it produces. Physical dependence consists of both the symptoms of tolerance and withdrawal.
Tolerance occurs very rapidly with opioid drugs. The development of tolerance represents the need to use higher amounts or doses of a drug to achieve the same effects that were once achieved at much lower doses. As tolerance increases, individuals who abuse drugs like Darvocet use more and more in an attempt to experience the euphoric effects they got when they first took the drug; however, the initial level of the euphoria is never reached again.
As an individual takes higher doses of the drug and takes it more frequently, the person’s system begins to adjust to having levels of the drug present. This results in the development of a potential withdrawal syndrome. If levels of the drug decline, this will throw the person’s system out of balance, and the person will experience uncomfortable physical and emotional symptoms.
The withdrawal symptoms associated with Darvocet are considered to be milder than the withdrawal syndrome that occurs with other opiate drugs; however, they can include issues with irritability, restlessness, insomnia, sweating, nausea, vomiting, depression, anxiety, the development of hallucinations (rare), seizures (rare), and extreme cravings to take the drug.
Withdrawal from opioid drugs like Darvocet is not considered to be potentially dangerous; however, some individuals could potentially become very distraught and be at risk for accidents due to poor judgment or even intentional self-harm. In addition, individuals who have developed physical dependence on drugs have significant issues with attempting to stop use because the withdrawal process is a significant negative reinforcer for drug use. When an individual begins to experience withdrawal symptoms, one of the most effective ways to eliminate the withdrawal symptoms is to use the drug. When unpleasant or negative repercussions are eliminated through a specific behavior, the probability that the behavior will be repeated is increased (negative reinforcement). Over time, individuals begin using the drug just if they anticipate that they are about to experience withdrawal symptoms. This strengthens their substance use disorder.
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Propoxyphene was the subject of significant controversy due to its potential for the development of abuse and physical dependence; claims that it made elderly patients who used it suicidal; its use being associated with cardiac arrest; its potential for overdose; and other issues associated with its use. Many physicians freely prescribed it for the treatment of mild to moderate pain and diarrhea, whereas other physicians reported that it had limited effectiveness and used other drugs like codeine. However, research that indicated that even individuals who used it according to its prescribed instructions were at an increased risk for the development of potentially fatal cardiac issues eventually became the focus of the controversy. In 2010, the FDA banned the sale of all Darvocet and a related drug Darvon.
For a short period of time following this ban, there were illegal stockpiles of the drug that were available to recreational users; however, the drug is not currently readily available in the United States. There still might be small stockpiles of the drug present; however, Darvocet is no longer considered to be a major drug of abuse since it is not readily available in the United States. It is extremely rare to see an individual with a substance use disorder as a result of Darvocet abuse these days.
Some online sources mention that there are black markets available for the drug. While this may be true, given the extreme popularity of other prescription opiate drugs, such as Vicodin, OxyContin, Norco, etc., it is highly unlikely that a majority of individuals would pay black market prices for a much weaker narcotic when these very potent drugs are available. Drugs that appear to have replaced Darvocet in both its medicinal and recreational uses include the above-mentioned narcotics and drugs such as tramadol.
Treatment for an individual who has developed a substance use disorder as a result of abusing Darvocet would follow the same protocol as the treatment for opioid use disorders to other drugs including Vicodin, OxyContin, etc.
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