Selling smaller packs of painkillers slashes suicide risk

UK legislation on analgesic packs: before and after study of long term effect on poisonings BMJ Online First

Selling paracetamol and other painkillers in smaller pack sizes has slashed rates of suicide and damage to the liver from paracetamol poisoning, concludes a study on bmj.com this week. Suicides from overdoses of paracetamol or aspirin dropped nearly a quarter in the three years following new legislation in 1998, which cut pack sizes and limited how many tablets a retailer was allowed to sell.

The researchers also found that numbers of tablets taken in non-fatal overdoses of aspirin and paracetamol fell significantly after the legislation. As a result admissions to liver units for paracetamol poisoning, and numbers of related liver transplants also dropped heavily – down by nearly a third (30%) in the four years after the laws came into force.

Researchers analysed rates of suicides and non-fatal overdoses from paracetamol, salicylates (aspirin) and ibuprofen across the UK between 1993 and 2003. While overdosing from paracetamol and salicylates – both covered by the new laws – decreased, patterns of overdosing from ibuprofen, which was not targeted in the legislation, remained roughly the same.

Although smaller pack sizes do not prevent someone from buying multiple packs from various retailers, many of those who overdose do so impulsively – using tablets to hand in the home, say the authors.

Smaller pack sizes will prevent deaths, say the authors. Their research provides a persuasive argument to reduce pack sizes still further, they conclude.