Self-poisoning and the general hospital

Paracetamol pack size restriction: the impact on paracetamol poisoning and the over-the-counter supply of paracetamol, aspirin and ibuprofen

PURPOSE

Self-poisoning occurs with over-the-counter (OTC) drugs, particularly paracetamol (acetaminophen). In 1998, OTC pack sizes of paracetamol were reduced. We have studied the effect of this pack size restriction on OTC supply of paracetamol, aspirin and ibuprofen.

METHODS

IMS Health UK provided data on the UK sales of paracetamol, aspirin and ibuprofen. The total mass and number of packs of each drug supplied were compared for the years 1998, 1999 and 2000.

RESULTS

The mass of aspirin and paracetamol sold fell, that of ibuprofen increased. The number of paracetamol packs sold was unchanged, the analgesic dose of aspirin fell and ibuprofen supply increased.

CONCLUSIONS

It seems that the paracetamol pack size reduction has not achieved as large an overdose rate reduction as might have been expected. Instead, a shift to the use of ibuprofen may lead to an increase in gastrointestinal adverse events and continue the burden on healthcare resources.

[Suicide attempts attended at a health centre]

OBJECTIVE

To describe the characteristics of the suicide attempts attended in a health district over 10 years (June 1989 to December 1998).

DESIGN

Cross-sectional, descriptive study.

SETTING

Primary care, rural health district.Patients. Everyone attended after a suicide attempt (55 cases).

MAIN MEASUREMENTS AND RESULTS

Data of the following variables were obtained from the legal reports: sex, age, place of residence, prognosis, means used and year of attempt. 51% were women and 49% men. Average age was 34.07, SD 3.82. 96% occurred in the health district. 38% had light prognosis, 49% serious, 7% very serious and 4% uncertain. The means used was ingestion of drugs in 44% of cases. 72% of the attempts occurred in the last 5 years.

CONCLUSIONS

There were no differences between the sexes. Most of the patients were under 35. Drug overdose was the method of choice. Suicide attempts are on the up. Primary care authorities and doctors need to become more conscious of potentially suicidal conduct.