title: Ease of access is a principal factor in the frequency of paracetamol overdose.
abstract: BACKGROUND
  In Ireland, 30% of non-fatal overdoses involve paracetamol.
  
  
  OBJECTIVE
  To determine how and where patients obtained paracetamol, to assess awareness of toxicity and examine the relationship between dose and suicidal intent.
  
  
  METHODS
  A prospective study of patients admitted following a paracetamol overdose recording their reasons for using paracetamol, their knowledge of its toxicity and their suicidal intent scale (SIS).
  
  
  RESULTS
  Of 100 patients, 66% obtained paracetamol in non-pharmacy outlets, 82% cited ease of availability as the reason, 55% were aware of its toxicity, 31% of liver damage and 68% did not read the warning on packets. The mean number of tablets taken was 51.3 for males and 37.2 for females (p < 0.01). Males presented later than females for medical attention (12.5 versus seven hours [p < 0.02]) and more males than females took alcohol (p < 0.03). The mean SIS score was 14.71 for males and 12.38 for females. There was a significant correlation between the SIS and the amount of paracetamol consumed (r = 0.28; p < 0.01).
  
  
  CONCLUSIONS
  The majority obtained paracetamol in local shops or at home. Knowledge of toxicity and the need for early antidote was poor. There was a significant relationship between suicidal intent and number of tablets consumed. Limiting availability could reduce number of overdoses.
authors.affiliation: Liver Unit, St Vincent's University Hospital, Dublin, Ireland. m.orourke@st-vincents.ie
authors.forename: M
authors.initials: M
authors.lastname: O'Rourke
authors.forename: M R
authors.initials: MR
authors.lastname: Garland
authors.forename: P A
authors.initials: PA
authors.lastname: McCormick
mesh_terms: D000082:Acetaminophen / Q000506:poisoning*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000506:poisoning*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013406:Suicide, Attempted
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen
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