Fall in paracetamol deaths 'linked to pack limits'

 
Paracetamol tablets Further reducing the limit on paracetamol tablets in each pack could be needed, the study says

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Deaths from paracetamol overdoses fell by 43% in England and Wales in the 11 years after the law on pack sizes was changed, according to a study.

But the number of people taking paracetamol overdoses had not declined, says the Oxford University study published in the BMJ.

In 1998, the government restricted pack sizes in the UK to 32 tablets in pharmacies and 16 in other shops.

Researchers say the figures should not lead to "complacency".

Paracetamol overdoses are a common method of suicide and a frequent cause of liver damage.

Previous studies suggested the decision to restrict the size of packs of paracetamol sold over the counter showed initial benefits in both these areas, but there was no data on the long-term impact.

Using figures from the Office for National Statistics, the Oxford researchers looked at deaths involving paracetamol in people aged 10 years and over between 1993 and 2009.

Start Quote

More needs to be done to reduce the toll of deaths from this cause”

End Quote Prof Keith Hawton Oxford University

They found there were 765 fewer deaths after the legislation was introduced in 1998 than would have been predicted based on trends dating back to 1993.

This equated to an average of 17 fewer deaths every three months after 1998.

The study also found that patients registered for a liver transplant because of a paracetamol overdose had reduced by 61% following the legislation. This was equivalent to 482 fewer registrations over 11 years.

More to do

Prof Keith Hawton, lead researcher from the University of Oxford Centre for Suicide Research, said lives had been saved since the change in the law.

"While some of this effect could have been due to improved hospital management of paracetamol overdoses, we believe that this has in large part been due to the introduction of the legislation.

"We are extremely pleased that this measure has had such benefits, but think that more needs to be done to reduce the toll of deaths from this cause."

graph from the BMJ report

Despite the reduction in deaths from paracetamol, the study found there had been no decline in overdose cases after 1998.

The study added that additional measures would be needed to reduce the death toll, such as further lowering the limit on tablets in packs, reducing the paracetamol content of the tablets and enforcing the legislation more effectively.

'Encouraging'

Catherine Johnstone, chief executive of Samaritans said: "When a person is in suicidal crisis, they will often think of a method that is easily available to them.

"It is during this time, we need to make sure that there are no barriers to seeking help aiming to widen the gap between thought and action in the hope that the crisis period will pass before a suicide attempt is made.

"This is the basic reasoning behind the reduction in the numbers of paracetamol pills sold in a pack and it's encouraging to see that legislation can have an effect on reducing suicides.

"The very act of calling an organisation like Samaritans can be sufficient to get a person through a difficult period and the experience of having another human being listen to your problems, in absolute confidence, can give someone the strength to see other choices."

Ged Flynn - from the suicide prevention charity, Papyrus - said the findings support the point that people are less likely to end their lives, if access to harmful things is made harder.

"An example would be, from our point of view, reducing access to information online, which is dangerous to young, vulnerable people."

Crisis point

Paul Farmer, from mental health charity Mind, said that despite the significant impact of paracetamol packaging, there was a bigger issue at stake. The latest statistics showed an overall increase in the number of people taking their own lives since the start of the recession.

"Now more than ever there is urgent need for support, to prevent people with mental health problems ever reaching crisis point.

"We need to see suicide training for GPs, better access to a range of therapies and, crucially, inadequacies in crisis care services must be addressed. People must be able to get the help they need when they need it the most."

A Medicines and Healthcare Products Regulatory Authority spokesperson said: "We welcome the findings of the study and the positive changes that resulted from the pack size restrictions implemented in 1998.

"The MHRA continuously monitors the safety of all marketed medicines and takes action as necessary. For paracetamol, this has included updating warnings to ensure they are well understood and improving the way paracetamol is given to children.

"The benefits associated with using paracetamol far outweigh the risk of serious side effects and we will closely review all options to manage the risks and benefits of medicines."

 

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  • rate this
    +1

    Comment number 337.

    #332 old before my time

    Oh dear - the pharmacy need to educate their staff then. You can legally purchase (and I have done so) packs of 32 in a pharmacy, packs of 16 elsewhere (but you may buy 2 packs).

    #331.John

    I'm not 100% but wouldn't be surprised if the checkout operator risked getting their wrists severely slapped for that one.

  • rate this
    +2

    Comment number 336.

    Why should those who use paracetamol as intended be inconvenienced by the small minority who use it to commit suicide? I thought that this was a democracy, which means it's the majority, not a minority, who decide how things work.

  • rate this
    +2

    Comment number 335.

    @321.SeeDubya
    Well said & spot on! This impotent so called government has a lot to answer for & if there really is justice, they will do!

  • rate this
    +2

    Comment number 334.

    297.Odd Fred "when the BMJ study and statistics in this article clearly shows that it does."

    Not necessarily - it's another example of bad science that assumes that because there is correlation then there must be causation. it's likely, but not certain unless ALL other factors are taken into account.

    Suicide is increasing again, so I wonder what the preferred method is now?

  • rate this
    -3

    Comment number 333.

    All the would be suicide needs to do is go to two different chemists and get the amount they need from each chemist. Now that Oxford University has publicised the fact that their is not enough tablets in one packet to do the job you may well see the suicide rate go up. Well done Oxford for helping the suicide rate possible go up.

  • rate this
    0

    Comment number 332.

    330

    I recently tried to buy 32 tablets for my Father at a Pharmacy & was told that the maximum allowed was 16 tablets.

  • rate this
    0

    Comment number 331.

    I recall seeing a woman attempting to buy 4 packs of paracetamol and being told there was a limit of 2 per transaction. She reached out, picked up a next customer divider and was sold all 4 in 2 separate transactions.

  • rate this
    +1

    Comment number 330.

    325. old before my time

    A pack of 32, available over the counter at a chemist, will keep anyone going for 4 days unless they overdose. Alternate between paracetamol and ibuprofen or aspirin and you're sorted for a week or longer without having to leave the house.

  • rate this
    -1

    Comment number 329.

    This is welcome news and the Labour Party should be commended for introducing the law whilst they were in governement.

  • rate this
    +1

    Comment number 328.

    Of course, it couldn't possibly down to advances in medical science or training in our healthcare professionals, it's all down to decisive government action.

  • rate this
    +1

    Comment number 327.

    My CPN once removed 150 tablets from my home when I was suicidal. Within an hour determined to die I had bought 10 more boxes from three different shops. If someone wants to harm themselves with this drug, they will find a way, for me I ended up on parvolex for three days and then sectioned for six months. That was 12 months ago.

  • Comment number 326.

    All this user's posts have been removed.Why?

  • rate this
    -1

    Comment number 325.

    People use paracetamol to help ease the symptons of colds/flu.

    The elderly are told to stay indoors & keep warm. How can they if they can't purchase 4/5 days worth of tablets at the first signs of a cold?

  • rate this
    +3

    Comment number 324.

    Many people underestimate how dangerous a drug paracetamol can be. Ever washed down 2 paracetamol with a lemsip? You honestly only need to do that a couple of times and it is possible to overdose. Worse is people who take paracetamol on a very regular basis as this doesn't give the liver time to recover between doses. If paracetamol were invented today it would never be an OTC drug. Be careful!

  • rate this
    +3

    Comment number 323.

    Surely the solution to the problem of suicide is to address the reasons and not the methods?

  • rate this
    0

    Comment number 322.

    Keep tightening the stranglehold on the already-limited availability of essential pain medication, and you will force people to buy from unscrupulous dealers online instead.

  • rate this
    +11

    Comment number 321.

    The suicide rate shot up by 437 between 2011 and 2012 after many years of continual fall. If anything wants banning it is David Cameron.

  • rate this
    +1

    Comment number 320.

    We self medicate for pain, for small cuts, for viruses and bacterial infection, and yet we cannot self medicate for mental problems. In fact, the medication most people use is alcohol, which only makes matters worse

    Two weeks of antidepressants would help. Even addiction would be better than death. The stigma of seeing a doctor for these pills is too much for some. This is what needs addressing

  • rate this
    +1

    Comment number 319.

    I simply cannot believe that the restrictions have saved any lives. The statistics show correlation, not prove causation.

    I find the restrictions intensly irritating, iboth n themselves (not being able to buy as much as I need), and in principle (nanny state).

  • rate this
    +3

    Comment number 318.

    #296 "Why should the consumer be forced to buy a minimum of 16.."

    Funny I was thinking the same thing when I went to the shop for an egg for my breakfast tomorrow, and a slice of bread for my soldiers. Great minds eh!

 

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