'Growing concern' over paracetamol overdoses among young people

The study found increasing numbers of paracetamol-related overdoses in young people, in particular in young woman. File picture

New research has flagged a 'growing concern' over intentional drug overdoses using paracetamol among young people, some as young as 10, with calls to limit the sale of the product just to pharmacies.

The paper, titled 'Paracetamol‑related intentional drug overdose among young people: a national registry study of characteristics', incidence and trends, 2007–2018, used data from the National Self-Harm Registry Ireland on hospital-presenting self-harm by individuals aged 10 to 24 years over that period.

A total of 10,985 paracetamol-related IDOs (intentional drug overdoses) were recorded and there was a 9% increase in such IDOs in that period.

The authors, including from the National Suicide Research Foundation (NSRF), compared the rates of paracetamol-related IDOs between the first and second half of the study period (2007–2012 as against 2013–2018) to estimate the excess number of presentations accounted for by paracetamol-related IDOs. 

Rates for these periods were calculated based on the total number of presentations for the respective time period as well as the sum of the annual population estimates for each year in that period.

According to the study: "The incidence of paracetamol-related IDO among young people increased by 9% between 2007 and 2018, with the highest annual percentage change in females aged 18–24 years."

Conversely, rates of paracetamol-related IDO among males aged 18–24 years decreased significantly.

"Between 2013 and 2018, excesses of 386 and 151 paracetamol-related IDOs were observed in females aged 10–17 and 18–24 years, respectively, and 42 excess presentations were observed for males aged 10–17 years. There were 107 fewer presentations than expected for males aged 18–24 years."

It said: "The increase in paracetamol-related IDO among specific groups of young people, particularly young females is an issue of growing concern."

Interventions targeting IDO among young people are needed, incorporating measures to address the availability of paracetamol and aftercare following IDO.

Analysis of the data showed that one-in-five male presentations were made by those aged 10–17 years, compared with 39.2% of female IDOs of the same age.

Paracetamol-related IDO was most common in presentations by females aged 18–24 years.

Three-quarters of all young people received a mental health assessment after their presentation to hospital and alcohol was involved in one-quarter of paracetamol-related IDOs by young people and was significantly higher for males than females within both age groups.

Regarding the 9% increase over the period, for females aged 18–24 years the rate increased by 1.2% each year of the study period and slight increases of 0.8% each year were reported for females and males aged 10–17 years.

Legislation places limits on the sale of over-the-counter paracetamol but the authors said the increases in paracetamol-related overdoses suggests this legislation needs to be reviewed.

It also said there was evidence of poor adherence to retail rules and "restricting the sale of paracetamol to pharmacy outlets only could have a positive impact on rates of paracetamol-related IDO".

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