Legislation restricting paracetamol sales and patterns of self-harm and death from paracetamol-containing preparations in Scotland
Article first published online: 21 APR 2006
British Journal of Clinical Pharmacology
Volume 62, Issue 5, pages 573–581, November 2006
How to Cite
Bateman, D. N., Gorman, D. R., Bain, M., Inglis, J. H. C., House, F. R. and Murphy, D. (2006), Legislation restricting paracetamol sales and patterns of self-harm and death from paracetamol-containing preparations in Scotland. British Journal of Clinical Pharmacology, 62: 573–581. doi: 10.1111/j.1365-2125.2006.02668.x
- Issue published online: 26 APR 2006
- Article first published online: 21 APR 2006
- Received 6 July 2005Accepted7 March 2006Published OnlineEarly21 April 2006
- paracetamol poisoning;
To describe how changes in legislation to restrict paracetamol sales have affected overdose discharges and death associated with the drug in Scotland.
A descriptive analysis of routine death and hospital discharge data for the entire Scottish population between 1995 and 2004. Patients in Scotland participated who were discharged from hospital with a diagnosis of poisoning; deaths in Scotland from diagnosis of poisoning 1995–2003 were also analysed. Outcome measures were changes in mortality and overdose due to poisoning involving paracetamol. A comparison was made of in-hospital and out-of-hospital mortality in fatalities involving paracetamol.
The majority of paracetamol-associated deaths were due to co-proxamol. Deaths associated with paracetamol alone or with ethanol occurred principally in hospital and were a minority of deaths overall. The proportion of in-hospital deaths attributed to paracetamol increased (post/pre ratio 1.347; 95% confidence interval 1.076, 1.639; P = 0.013). Overall numbers of cases discharged with poisoning fell. The proportion of these involving paracetamol in any form increased significantly in all groups except young men aged 10 to <20 years.
Legislation has not reduced mortality or proportional use of paracetamol in overdose, both of which appear to have increased in Scotland since pack-size limitations. Other approaches are necessary to reduce the death rate from overdoses involving paracetamol.