Dear Dr. Roach: What happened to Darvon? It wasn’t addicting and didn’t cost much, and I never heard any reason why it was withdrawn except that “it didn’t work.” It sure worked for me, and when they took it away, I ended up on Oxycontin because everything else that wasn’t more dangerous made me vomit!

I have fibromyalgia. After I had my daughter, I could no longer lift weights or do cardio as I had before. I know I could get off of Oxycontin if I had Darvon.

— K.T.

Answer: Propoxyphene (Darvon) is a pain reliever of the opiate class that is structurally related to methadone. The drug was withdrawn from the United States in 2010, but it had already been banned in the United Kingdom and Europe.

It wasn’t withdrawn because it didn’t work. It certainly worked for some as your letter shows, but in general, it was more toxic and didn’t work better than any other opiate. The Food and Drug Administration voted to remove the drug from the market after studies showed the potential for serious heart toxicity.

One expert wrote at the time that it was “the worst drug in history” and that “no single drug has ever caused so many deaths.” Of course, this was before fentanyl, which caused over 70,000 deaths in the U.S. in 2023 alone.

I understand your frustration that nothing else has worked as well for you. Fibromyalgia can be difficult to treat. However, most experts in fibromyalgia treatment do not recommend the long-term use of any opiate such as Oxycontin. All opiates have the risk of becoming habit-forming.

Non-pharmacologic treatment including physical activity, nutrition, psychological interventions such as cognitive-behavioral therapy, and careful attention to sleep habits are the mainstays of treatment. Medications are not terribly effective in fibromyalgia. Less than half of fibromyalgia patients benefit enough from medication to keep taking it for more than a few months. Still, medicines that help both sleep and pain, like amitriptyline, gabapentin and venlafaxine, may be of some benefit.

If you haven’t seen an expert in fibromyalgia or pain medicine, this would be very helpful.

Dear Dr. Roach: I am 78 and mostly healthy; I am not diabetic or overweight. I often have a craving for something bad and delicious as a treat. Which do you think is worse for a person: a 12-ounce can of soda or a 4-ounce glass of Irish cream liqueur?

I was thinking about the sugar, fat and calories, but it felt overwhelming to try to put it all together and make the least-awful choice. Please don’t tell me I should have a glass of tea. I already know this.

— D.B.

Answer: Well, since you insist I choose between these two options, I choose the soda. Four ounces of Irish cream liqueur has 22 grams of sugar, 14 grams of fat, and 19 grams of alcohol. In my opinion, this is worse for you than the 39 grams of sugar (but no fat or alcohol) in a typical 12-ounce can of soda.

That being said, if you wanted to have an occasional Irish cream liqueur at age 78, I wouldn’t berate you, but I might recommend a 2-ounce serving instead.

Contact Dr. Roach at ToYourGoodHealth@med.cornell.edu.