After finding out how paracetamol has become the “drug of choice for self-harm” in their hospital study, particularly among teenage girls, two medical researchers are pushing for stronger drug use regulation.
The findings was published on Oct. 30 in the New Zealand Medical Journal, Nadia Freeman and Paul Quigley showed paracetamol overdose was the most common reason behind drug poisoning – 23 percent of incidents – in patients at the emergency room of Wellington Hospital in New Zealand (NZ) between 2007 and 2012.
The new study is part of mounting research raising awareness on the overuse of paracetamol, which is available with prescription, from pharmacies and supermarkets, and even in gas stations and online drug dispensers.
While generally deemed safe as pain reliever, paracetamol can cause liver damage and death in excess amounts.
Out of the 879 overdose cases in 2013 at the said emergency department, 123 were from paracetamol. Of total paracetamol overdoses, a staggering 86 percent were due to deliberate self-harm and attempted suicide – 80 percent were female and about half were below age 20.
The findings prompted the researchers to call for restricting the amount of paracetamol that can be bought in New Zealand, which currently carries no limit on how many packets may be purchased. They cited the United Kingdom’s general sales limit of 16 tablets and pharmacy limit of 32 – with discretionary selling of up to 100 at pharmacies.
However, they noted conflicting outcomes in the UK based on other studies: while paracetamol-related admissions or suicides remain the same in Scotland, there was a 20 percent decreased number of paracetamol-linked overdoses, a 22 percent death incidence reduction, and a 30 percent liver unit-admissions reduction.
Freeman and Quigley also recommended looking at an age limit for purchasing paracetamol, given high rates of overdose among the under-20 age group.
Toxicologist John Fountain of the National Poisons Centre revealed paracetamol was the biggest driver behind acute liver transplants, causing “a lot of injuries” that renders the concern “not insignificant.”
Fountain warned, though, that patients who use the drug safely for pain management may be negatively affected by restrictions.
Some industry groups in NZ argued drug restrictions are already relatively tight, and that the determination to overdose would outdo selling limits.
“If somebody wants to do it, they will find a way,” said Tim Roper, executive director of Self Medication Industry Association.
Panadol is the widely available paracetamol brand but many generics are also vying for attention. Paracetamol is sometimes combined with more potent pain relief, is a base ingredient in many medications for the cold, and is not really an anti-inflammatory like ibuprofen but can be used for treating mild and moderate pain.
Australia has similar drug selling controls as NZ but non-pharmacy sources can sell 12.5 grams. NZ groups have lobbied for the limit to be raised to Australia’s level but still unsuccessfully at present.
In the United States, a 1,000-pill painkiller tub can be purchased “from a department store, with no questions asked.”
Photo: David Pacey | Flickr
