A study has found that smaller packs of paracetamol have reduced deaths by over a third.
The research, done by the Centre for Suicide Research at Oxford, examined data on poisoning deaths from 1993 to 2009.
It found that, since 1998, when new legislation was introduced that limited the size of packs of paracetamol that could be sold, there have been over 600 fewer deaths from paracetamol overdoses than would have been expected based on previous trends.
The legislation placed a limit on packs of paracetamol sold in pharmacies to 32 tablets, and 16 elsewhere.
The lead researcher, Professor Keith Hawton, believes that one possible explanation for the decrease, along with improved hospital management, is that people take paracetamol overdoses impulsively, and that the reduction in the number of pills sold in a packet means that they were less likely to be able to take a lethal dose.
Professor Hawton said: “Paracetamol overdoses result in some 100 to 200 deaths per year. While it is not the most common method of suicide, it is an important one in that deaths often result from impulsive acts where death may not be intended.”
Paracetamol overdoses cause severe liver damage, which can lead to acute liver failure. It can also lead to kidney failure. Death normally occurs three to five days after a large overdose, as liver failure can cause multiple organ failure.
An overdose is treated with an antidote, which is at its most effective within the first twelve hours, but can still be of use 24 hours after taking the tablets. Liver transplants may be necessary in cases of acute liver failure.
Suicide by paracetamol overdoses is fairly common within the UK, because of the ubiquity of the drug. Even after the fall in the rate of deaths the researchers recorded, there is still an average of 121 deaths a year due to paracetamol poisoning in England and Wales. As a result, the researchers said that the benefits of the legislation should not lead to complacency.
Professor Hawton said: “While suicide is a complex phenomenon requiring a range of strategies to achieve meaningful prevention, the relative success of restricting pack sizes of paracetamol shows that even simple approaches like this can help prevent some deaths, especially those where people take overdoses on impulse which they might later regret.”
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