Sir, The Committee on Safety of Medicines (CSM) advised withdrawal of co-proxamol in January 2005 as it was judged that the risk of accidental death by overdose and the drug's frequent use in suicide outweighed its benefits as a painkiller. We were struck by the number of patients who seemed to be coming to the clinic complaining that they were unable to find an effective alternative. A typical complaint would be that they had been on co-proxamol for 20 yrs and found it very satisfactory. They had been tried on co-codamol and tramadol without nearly as good a benefit and wanted their co-proxamol back. We felt that an audit of what had happened to all the patients on co-proxamol was necessary to see if the impression that they were dissatisfied with the alternatives was true.