Healthy Skepticism Library item: 9108

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Publication type: Journal Article

Bateman DN, Gorman DR, Bain M, Inglis JH, House FR, Murphy D.
Legislation restricting paracetamol sales and patterns of self-harm and death from paracetamol-containing preparations in Scotland.
Br J Clin Pharmacol 2006 Nov; 62:(5):573-81
http://www.blackwell-synergy.com/doi/full/10.1111/j.1365-2125.2006.02668.x

Abstract:

AIMS: To describe how changes in legislation to restrict paracetamol sales have affected overdose discharges and death associated with the drug in Scotland.

METHODS: A descriptive analysis of routine death and hospital discharge data for the entire Scottish population between 1995 and 2004. Patients in Scotland participated who were discharged from hospital with a diagnosis of poisoning; deaths in Scotland from diagnosis of poisoning 1995-2003 were also analysed. Outcome measures were changes in mortality and overdose due to poisoning involving paracetamol. A comparison was made of in-hospital and out-of-hospital mortality in fatalities involving paracetamol.

RESULTS: The majority of paracetamol-associated deaths were due to co-proxamol. Deaths associated with paracetamol alone or with ethanol occurred principally in hospital and were a minority of deaths overall. The proportion of in-hospital deaths attributed to paracetamol increased (post/pre ratio 1.347; 95% confidence interval 1.076, 1.639; P = 0.013). Overall numbers of cases discharged with poisoning fell. The proportion of these involving paracetamol in any form increased significantly in all groups except young men aged 10 to <20 years.

CONCLUSIONS: Legislation has not reduced mortality or proportional use of paracetamol in overdose, both of which appear to have increased in Scotland since pack-size limitations. Other approaches are necessary to reduce the death rate from overdoses involving paracetamol.

Keywords:
MeSH Terms: Acetaminophen/poisoning* Acetaminophen/supply & distribution Adolescent Adult Aged Aged, 80 and over Analgesics, Non-Narcotic/poisoning* Analgesics, Non-Narcotic/supply & distribution Child Drug Packaging/legislation & jurisprudence* Female Humans Legislation, Drug/statistics & numerical data* Male Middle Aged Overdose/mortality Scotland/epidemiology Suicide/statistics & numerical data* Suicide/trends Suicide, Attempted/statistics & numerical data Substances: Analgesics, Non-Narcotic Acetaminophen