Abstract | OBJECTIVE: To evaluate the effects on suicidal behaviour of legislation limiting the size of packs of paracetamol and salicylates sold over the counter. DESIGN: Before and after study. SETTING: UK population, with detailed monitoring of data from five liver units and seven general hospitals, between September 1996 and September 1999. SUBJECTS: MAIN OUTCOME MEASURES: RESULTS: Numbers of tablets per pack of paracetamol and salicylates decreased markedly in the year after the change in legislation on 16 September 1998. The annual number of deaths from paracetamol poisoning decreased by 21% (95% confidence interval 5% to 34%) and the number from salicylates decreased by 48% (11% to 70%). Liver transplant rates after paracetamol poisoning decreased by 66% (55% to 74%). The rate of non-fatal self poisoning with paracetamol in any form decreased by 11% (5% to 16%), mainly because of a 15% (8% to 21%) reduction in overdoses of paracetamol in non-compound form. The average number of tablets taken in paracetamol overdoses decreased by 7% (0% to 12%), and the proportion involving >32 tablets decreased by 17% (4% to 28%). The average number of tablets taken in salicylate overdoses did not decrease, but 34% fewer (2% to 56%) salicylate overdoses involved >32 tablets. After the legislation mean blood concentrations of salicylates after overdose decreased, as did prothrombin times; mean blood concentrations of paracetamol did not change. CONCLUSION: Legislation restricting pack sizes of paracetamol and salicylates in the United Kingdom has had substantial beneficial effects on mortality and morbidity associated with self poisoning using these drugs.
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Authors | K Hawton, E Townsend, J Deeks, L Appleby, D Gunnell, O Bennewith, J Cooper |
Journal | BMJ (Clinical research ed.)
(BMJ)
Vol. 322
Issue 7296
Pg. 1203-7
(May 19 2001)
ISSN: 0959-8138 [Print] England |
PMID | 11358770
(Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents, Non-Steroidal
- Salicylates
- Acetaminophen
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Topics |
- Acetaminophen
(blood, poisoning, supply & distribution)
- Analgesics, Non-Narcotic
(blood, poisoning, supply & distribution)
- Anti-Inflammatory Agents, Non-Steroidal
(blood, poisoning, supply & distribution)
- Drug Overdose
- Drug Packaging
(legislation & jurisprudence)
- Humans
- Liver
(drug effects, physiopathology)
- Liver Function Tests
- Liver Transplantation
(statistics & numerical data)
- Morbidity
- Salicylates
(blood, poisoning, supply & distribution)
- Suicide, Attempted
(statistics & numerical data)
- United Kingdom
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