Reducing paracetamol overdoses

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7082.750a (Published 08 March 1997) Cite this as: BMJ 1997;314:750

Provide hurdles to overdosing

  1. Simon J Taylor, Senior registrar in pyschiatrya
  1. a Whitely Wood Clinic, Sheffield S10 3TL
  2. b 34 The Fairway, Sherburn in Elmet, Leeds LS25 6LN
  3. c Department of Forensic Medicine, Royal Infirmary, Dundee DD1 9ND
  4. d St George's Hospital Medical School, London SW17 0RE

    Editor—Elizabeth Fagan and Gary Wannan say that the public should be educated about the toxicity of paracetamol in overdose.1 This may be done paradoxically, simply providing an advertisement for an accessible suicide method. School education programmes may miss, for example through truancy, those who would most benefit; such programmes would need careful evaluation and monitoring in view of the concern voiced about suicide prevention programmes in some schools in the United States.2

    Knowledge that paracetamol overdose can kill did not stop 77% of such overdoses in Oxford.3 This is not surprising—firstly, because two thirds had wished to die or had been ambivalent to the outcome,4 and, secondly, because of the impulsive nature of many of the overdoses. Indeed the finding that 74% of paracetamol overdoses had premeditation of less than three hours and 41% of such patients had obtained tablets less than an hour before4 emphasises the potential benefits of putting hurdles in the way of obtaining large amounts of paracetamol. The strategy of limiting availability has been effective in reducing barbiturate and benzodiazepine overdoses,5 and any hurdle may give time for reflection …

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