Legislation that controls the sale of paracetamol in Ireland appears to have reduced the severity of deliberate paracetamol overdoses here, according to a new study published in the Irish Journal of Medical Science (IJMS).
The survey, carried out by the National Poisons Information Centre (NPIC) at Beaumont Hospital, looked at reported cases of acute, deliberate paracetamol overdose in two-year periods before and after the legislation was introduced in October 2001.
The law, which was brought in following pressure from the Irish Medicines Board, governs the sale of paracetamol in non-pharmacy outlets. It limits single ingredient paracetamol preparations to 12 tablets per pack, and only one pack can be sold per transaction.
Previously, individual packs of 24 tablets were available in non-pharmacy outlets here.
"We are always keeping an eye on paracetamol and we were curious to see if there had been any effect or benefit of the legislation," said Elaine Donohoe, a specialist in poisons information at the NPIC and lead author on the IJMS study.
The overall number of paracetamol overdose cases reported to the NPIC did not change substantially following the pack-size restriction, said Ms Donohoe.
Paracetamol overdose accounted for about 14 per cent of all deliberate poisonings reported to the NPIC in the study periods both before and after the legislation was introduced.
But the study found that the 2001 legislation affected the severity of reported deliberate paracetamol overdoses.
"It's important to look at severity because if people are taking smaller doses of paracetamol they are less likely to develop liver damage or failure," Ms Donohoe added.
The researchers compared the number of tablets taken in 1,198 acute overdose cases before the controlling legislation with 934 comparable cases after the law was introduced.
There was little change in the number of cases involving fewer than 12 tablets, but the number of cases involving 13 or more tablets fell significantly after October 2001, they reported.
The study's findings mirror trends seen in other countries, such as France and the UK, where similar legislation on paracetamol pack size has been introduced, according to Ms Donohoe. It appears that legislating on pack size can reduce the severity of paracetamol overdose, Ms Donohoe added.
"There has been a drop, and it would reflect the findings that have been published in other countries," she said. "The UK has done a lot of work on this and they found a fall in the number of tablets [ following pack-size legislation] as well."
