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Smaller packs of analgesics have reduced overdose deaths

Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study

The number of deaths from self poisoning with paracetamol and salicylates has decreased significantly since legislation limiting the number of tablets per pack was introduced in the United Kingdom in 1998, finds a study in this week's BMJ.

Data including drug related deaths, cases of liver poisoning, numbers of liver transplantations, and sales data, were used to assess the impact of the legislation. The number of tablets in packets of paracetamol and salicylate preparations decreased markedly in the 12 months after the legislation. The annual number of deaths from paracetamol poisoning decreased by 21% and the number from salicylates decreased by 48%.

There was also a decrease in the number of liver transplants and admission to liver units with paracetamol poisoning, and in the number of overdoses of paracetamol and salicylates in which large numbers of tablets were taken.

The legislation has been relatively successful, say the authors, with the results indicating that the main factor was the reduction in the number of tablets per pack. An even smaller maximum pack size for pharmacy sales might have had a greater impact still, they conclude.

Contact:

Keith Hawton, Professor of Psychiatry, Centre for Suicide Research, Warneford Hospital, Oxford, UK Email: keith.hawton@psych.ox.ac.uk

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