Worrying increase in paracetamol poisoning cases

In little more than a decade, the annual number of paracetamol poisoning cases has increased by 44.3 per cent, while cases of toxic liver diseases due to paracetamol overdose have more than doubled, according Australian researchers.

Paracetamol is a popular OTC painkiller, but increasing numbers of both overdose and liver failure linked to the drug have led to recommendations intended to address the trends.

The researchers, led by Director of Research at the NSW Poisons Information Centre and the University of Sydney, Dr Rose Cairns, say public health measures that restrict the availability of paracetamol, such as reducing non-prescription pack sizes, are needed to stem the increasing number of paracetamol overdoses.

After analysing data on paracetamol-related exposures, hospital admissions, and deaths from the Australian Institute of Health and Welfare National Hospital Morbidity Database, the NSW Poisons Information Centre, and the National Coronial Information System from 2007-08 to 2016-17 (the study period), Dr Cairns and colleagues found that:

  • There were 95,668 admissions with paracetamol poisoning diagnoses.
  • The annual number of cases increased by 44.3 per cent.
  • Toxic liver disease was documented for 1816 of these patients; the annual number increased by 108 per cent.
  • About 70 per cent of paracetamol overdoses involved women.
  • 22,997 reports of intentional overdose with paracetamol.
  • The annual number of intentional overdoses increased by 77.0 per cent.
  • The median number of tablets taken increased from 15 in 2004 to 20 in 2017.
  • Modified release paracetamol ingestion report numbers increased 38 per cent per year.

The report, published in MJA, concluded by saying, “access restrictions, including reduced pack sizes, could reduce the harm caused by paracetamol overdoses in Australia, and should be considered, together with other policy changes, to curb this growing problem”.

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