title: Choice of poison for intentional self-poisoning in rural Sri Lanka.
abstract: BACKGROUND
  Although intentional self-poisoning is a major public health problem in rural parts of the Asia-Pacific region, relatively little is known of its epidemiology. We aimed to determine why Sri Lankan self-poisoning patients choose particular poisons, and whether acts of self-harm with highly dangerous poisons were associated with more premeditation and effort.
  
  
  METHODS
  We interviewed 268 self-poisoning patients presenting to two district general hospitals in rural Sri Lanka.
  
  
  RESULTS
  Eighty-five percent of patients cited easy availability as the basis for their choice of poison. There was little premeditation: more than 50% ingested the poison less than 30 minutes after deciding to self-harm. Patients had little knowledge about treatment options or lethality of the poison chosen. We found no difference in reasons for choice of poison between people ingesting different poisons, despite marked differences in toxicity, and between people who died and those who survived.
  
  
  CONCLUSIONS
  Poisons were chosen on the basis of availability, often at short notice. There was no evidence that people using highly toxic poisons made a more serious or premeditated attempt. Restrictions on availability of highly toxic poisons in rural communities must be considered in strategies to reduce the number of intentional self-poisoning deaths in the Asia Pacific region.
authors.affiliation: South Asian Clinical Toxicology Research Collaboration, Center for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, England. eddlestonm@eureka.lk
authors.forename: Michael
authors.initials: M
authors.lastname: Eddleston
authors.forename: Ayanthi
authors.initials: A
authors.lastname: Karunaratne
authors.forename: Manjula
authors.initials: M
authors.lastname: Weerakoon
authors.forename: Subashini
authors.initials: S
authors.lastname: Kumarasinghe
authors.forename: Manjula
authors.initials: M
authors.lastname: Rajapakshe
authors.forename: M H Rezvi
authors.initials: MH
authors.lastname: Sheriff
authors.forename: Nick A
authors.initials: NA
authors.lastname: Buckley
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000293:Adolescent; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D002755:Choice Behavior; D005260:Female; D006801:Humans; D008297:Male; D011041:Poisoning / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D000931:Antidotes