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Paracetamol Self-Poisoning Characteristics, Prevention and Harm Reduction

Published online by Cambridge University Press:  02 January 2018

Keith Hawton ,
Christopher Ware ,
Hamant Mistry ,
Jonathan Hewitt ,
Stephen Kingsbury ,
Dave Roberts  and
Heather Weitzel
Keith Hawton*
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford
Christopher Ware
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford
Hamant Mistry
Affiliation:
Barnes Unit, Department of Psychological Medicine, John Radcliffe Hospital, Headington, Oxford
Jonathan Hewitt
Affiliation:
Barnes Unit, Department of Psychological Medicine, John Radcliffe Hospital, Headington, Oxford
Stephen Kingsbury
Affiliation:
University Department of Psychiatry, Warneford Hospital, Oxford
Dave Roberts
Affiliation:
Barnes Unit, Department of Psychological Medicine, John Radcliffe Hospital, Headington, Oxford
Heather Weitzel
Affiliation:
Barnes Unit, Department of Psychological Medicine, John Radcliffe Hospital, Headington, Oxford
*
Dr K. Hawton, University Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX
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Abstract

Background

Paracetamol is now the most common drug used for self-poisoning in the UK and is associated with potentially fatal liver damage. Patients admitted to hospital because of paracetamol overdoses were studied in order to determine their characteristics and factors which might have deterred them from taking paracetamol or reduced the dangers of the overdose.

Method

Eighty patients were studied in hospital using a structured interview schedule, measures of depression and suicidal intent, information collected through the Oxford Monitoring System for Attempted Suicide, and the results of liver function tests.

Results

Acute liver dysfunction (25 patients) was associated with consumption of more than 25 tablets (odds ratio 4.46, 95% CI 1.31 to 17.41, P = 0.014). The proportionate use of tablets from blister packs (60%) and loose preparations (46%; 5 patients using both types) reflected their general availability. More of those who took tablets from a loose preparation consumed 25 or more tablets (69%) than those who used a blister-pack preparation (40%; odds ratio = 3.0, 95% CI 1.12 to 9.95, P = 0.028). Only 20 patients thought that any type of warning label would have deterred them from taking a paracetamol overdose.

Conclusions

Establishing a maximum number of tablets (e.g. 25) that can be available in individual preparations is likely to reduce the dangers of paracetamol self-poisoning. The potential effects of other measures are uncertain.

Type
Papers
Information
The British Journal of Psychiatry , Volume 168 , Issue 1 , January 1996 , pp. 43 - 48
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Augustin, C. & Schmoldt, A. (1991) Zunahme der Paracetamolintoxikationen. Beitrag Gerichtliche Medizin, 49, 127–131.Google Scholar
Bancroft, J., Hawton, K., Simkin, S., et al (1979) The reasons people give for taking overdoses: a further enquiry. British Journal of Medical Psychology, 52, 353–365.CrossRefGoogle Scholar
Beck, A. T., Schuyler, D. & Herman, I. (1974) Development of suicidal intent scales. In The Prediction of Suicide (eds Beck, A. T., Resnick, H. L. P. & Lettieri, D. J.), pp. 45–56. Philadelphia: Charles Press.Google Scholar
Bray, G. P. (1993) Liver failure induced by paracetamol. British Medical Journal, 306, 157–158.CrossRefGoogle ScholarPubMed
Dean, A. G., Dean, J. A., Burton, A. H., et al (1990) Epi Info, Version 5: A Word Processing, Database, and Statistics Program for Epidemiology on Microcomputers. Georgia: USD.Google Scholar
Gazzard, B. G., Davis, M., Spooner, J., et al (1976) Why do people use paracetamol for suicide? British Medical Journal, 1, 212–213.Google Scholar
Hawton, K. & Catalan, J. (1987) Attempted Suicide: A Practical Guide to its Nature and Management (2nd edn). Oxford: Oxford University Press.Google Scholar
Hawton, K. & Fagg, J. (1992a) Trends in deliberate self-poisoning and self-injury in Oxford, 1976–1990. British Medical Journal, 304, 1409–1411.Google Scholar
Hawton, K. & Fagg, J. (1992b) Deliberate self-poisoning and self-injury in adolescents: a study of characteristics and trends in Oxford, 1976–1989. British Journal of Psychiatry, 161, 816–823.Google Scholar
Hawton, K., Ware, C., Mistry, H., et al (1995) Why patients choose paracetamol for self-poisoning and their knowledge of its dangers. British Medical Journal, 310, 164.CrossRefGoogle ScholarPubMed
Mitchell, J. R., Thorgeirsson, S. S., Potter, W. Z., et al (1974) Acetaminophen-induced hepatic injury. Protective role of glutathione in man and rational for therapy. Clinical Pharmacology and Therapeutics, 16, 676–684.CrossRefGoogle Scholar
Montgomery, S. A. & Asberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
O'Grady, J. G., Wendon, J., Tan, K. C., et al (1991) Liver transplantation after paracetamol overdose. British Medical Journal, 303, 221–223.CrossRefGoogle ScholarPubMed
Ott, P., Dalhoff, K., Hansen, P. B., et al (1990) Consumption, overdose and death from analgesics during a period of over-the-counter availability of paracetamol in Denmark. Journal of Internal Medicine, 277, 423–428.Google Scholar
Prescott, L. F. (1983) Paracetamol overdosage: pharmacological considerations and clinical management. Drugs, 25, 290–314.Google Scholar
Secretary of State for Health (1992) The Health of the Nation: A Strategy for Health in England. London: HMSO.Google Scholar
Spooner, J. B. & Harvey, J. G. (1993) Paracetamol overdosage – facts not misconceptions. Pharmaceutical Journal, 250, 706–707.Google Scholar
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