Propoxyphene suicides. Report of nine cases

Propoxyphene hydrochloride poisoning rapidly causes respiratory depression, coma, and convulsions. Data presented from nine autopsied victims and one survivor suggest that death results from anoxia, with pulmonary edema and vascular congestion. Tissue concentrations of propoxyphene reached 27.3 mg/100 gm in the liver of one subject, and 13.0 mg/100 gm in the brain of another. Blood levels of the drug were generally miniscule, due to rapid sequestration in tissue. Victims brought immediately to the hospital can survive if treated with respiratory support and nalorphine hydrochloride.