Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA.
Pharmacoepidemiol Drug Saf. 2020 Sep;29(9):1011-1021. doi: 10.1002/pds.4997. Epub 2020 Jul 26.
To investigate suicide-related over-the-counter (OTC) analgesic medication exposures among individuals ≥6 years old reported to United States (US) poison control centers.
Data from the National Poison Data System for the years 2000-2018 were retrospectively analyzed.
From 2000 to 2018, US poison control centers recorded 549 807 suicide-related cases involving OTC analgesics, including 327 781 cases (59.6%) admitted to the hospital and 1745 deaths (0.3%). Most cases involved a single substance (67.5%) and occurred among females (72.7%) and individuals 6-19 years old (49.7%). Overall, the rate of exposures increased significantly by 33.5% from 2000 to 2018, primarily driven by the increasing exposure rate among 6- to 19-year-old females. From 2000 to 2018, exposure rates for acetaminophen and ibuprofen increased, while that for acetylsalicylic acid decreased. Additionally, the proportion of cases resulting in a serious medical outcome or healthcare facility admission increased for all types of OTC analgesics. Acetaminophen and acetylsalicylic acid accounted for 48.0% and 18.5% of cases, respectively, and 64.5% and 32.6% of deaths, respectively. Both acetaminophen and acetylsalicylic acid had greater odds of healthcare facility admission (ORs 2.56 and 2.63, respectively) and serious medical outcomes (ORs 2.54 and 4.90, respectively) compared with ibuprofen.
The rate of suicide-related OTC analgesic cases is increasing. Acetaminophen and acetylsalicylic acid cases are associated with greater morbidity and mortality. Prevention efforts should include implementing unit-dose packaging requirements and restrictions on package sizes and purchase quantities for acetaminophen and acetylsalicylic acid products to reduce access to large quantities of these analgesics.
调查 2000 年至 2018 年期间向美国（美国）中毒控制中心报告的年龄≥6 岁与自杀相关的非处方（OTC）止痛药暴露情况。
对国家毒物数据系统的回顾性数据分析。
从 2000 年至 2018 年，美国中毒控制中心记录了 549807 例与 OTC 止痛药相关的自杀案例，其中 327781 例（59.6%）住院，1745 人死亡（0.3%）。大多数案例涉及单一物质（67.5%），发生在女性（72.7%）和 6-19 岁人群（49.7%）中。总体而言，暴露率从 2000 年至 2018 年显著增加了 33.5%，主要是由于 6-19 岁女性的暴露率不断增加。从 2000 年至 2018 年，对乙酰氨基酚和布洛芬的暴露率增加，而乙酰水杨酸的暴露率下降。此外，所有类型的 OTC 止痛药导致严重医疗后果或医疗保健机构入院的比例均有所增加。对乙酰氨基酚和乙酰水杨酸分别占病例的 48.0%和 18.5%，分别占死亡的 64.5%和 32.6%。与布洛芬相比，对乙酰氨基酚和乙酰水杨酸都更有可能需要住院治疗（比值比分别为 2.56 和 2.63）和发生严重医疗后果（比值比分别为 2.54 和 4.90）。
与自杀相关的 OTC 止痛药的比例在增加。对乙酰氨基酚和乙酰水杨酸相关的病例发病率和死亡率更高。预防工作应包括实施单位剂量包装要求，并限制对乙酰氨基酚和乙酰水杨酸产品的包装尺寸和购买数量，以减少大量获取这些止痛药的机会。
