Centre for Suicide Research, University of Oxford, Department of Psychiatry, Warneford Hospital, Headington, Oxford, OX3 7JX, UK.
QJM. 2012 Jan;105(1):41-51. doi: 10.1093/qjmed/hcr135. Epub 2011 Aug 19.
Paracetamol (acetaminophen) is the most common self-poisoning agent in the UK and a leading cause of fatal hepatotoxicity. Following legislation in 1998 to limit pack sizes, beneficial effects on paracetamol-related mortality and morbidity were reported in England. However, there are still over 100 deaths a year and evidence of breaches of sales guidelines.
To investigate characteristics of people taking larger paracetamol overdoses and compliance with sales guidelines, to inform possible further initiatives to reduce paracetamol fatalities.
Interview study of 60 general hospital patients who took overdoses of over 16 paracetamol tablets (8 g).
Half of all paracetamol overdoses involved over 16 tablets. Patients were predominantly young (three-quarters aged 16-40 years) and female (58.3%); over half (53.3%) had taken a previous paracetamol overdose. Three-quarters said they wanted to die. Half took the overdose within an hour of first thinking of it, half (53.3%) took tablets already in the home and 58.3% bought tablets specifically for the overdose. Ten people tried to buy more than 32 tablets in one transaction; four succeeded. Most knew that a paracetamol overdose could cause death or permanent damage (88.3%) and harm the liver (80.0%) but 70.0% thought they would lose consciousness. Warnings on packs had little deterrent effect. Media and internet influences were identified. Patients chose paracetamol because it was cheap and easily available.
Further measures to reduce breaches of sales guidelines and the dangers of paracetamol overdose are required. Media and internet site producers should follow guidelines on reporting suicide.
对乙酰氨基酚（扑热息痛）是英国最常见的自我中毒药物，也是导致致命性肝毒性的主要原因。1998 年立法限制包装尺寸后，据报道，英格兰与对乙酰氨基酚相关的死亡率和发病率有所下降。然而，每年仍有超过 100 人死亡，且有销售指南违规的证据。
调查服用大剂量对乙酰氨基酚过量的人群特征及销售指南的遵守情况，为进一步减少对乙酰氨基酚死亡人数提供依据。
对 60 名在综合医院就诊的大剂量对乙酰氨基酚过量服用者进行访谈研究，这些患者的对乙酰氨基酚用量超过 16 片（8 克）。
所有对乙酰氨基酚过量服用者中，有一半服用了超过 16 片。患者主要为年轻人（75%年龄在 16-40 岁）和女性（58.3%）；超过一半（53.3%）之前有过对乙酰氨基酚过量服用史。三分之二的人表示想要自杀。半数人在第一次有自杀念头后 1 小时内服药，半数（53.3%）服用的是家中已有的药片，58.3%是专门为此次服药而购买的药片。有 10 人试图一次性购买超过 32 片，其中 4 人成功。大多数人知道对乙酰氨基酚过量服用可能导致死亡或永久性损伤（88.3%）和肝损伤（80.0%），但 70.0%的人认为自己会失去意识。包装上的警告对他们几乎没有威慑作用。调查发现媒体和互联网的影响。患者选择对乙酰氨基酚是因为它价格便宜且易于获取。
需要采取进一步措施减少销售指南违规和对乙酰氨基酚过量服用的危险。媒体和互联网网站制作方应遵循关于自杀报道的指南。
