title: Care versus convenience: Examining paracetamol overdose in New Zealand and harm reduction strategies through sale and supply.
abstract: OBJECTIVE
  To examine statistics on paracetamol overdose in New Zealand and investigate options to reduce paracetamol overdose rates, through supply reduction strategies.
  
  
  METHODS
  Data was gathered from the Ministry of Health's National Minimum Dataset and Wellington Hospital Emergency Department attendances. Twenty articles on supply reduction strategies were sourced through article database searches. A survey on paracetamol availability from online pharmacies within New Zealand was conducted by searching for New Zealand online pharmacies through Google.
  
  
  RESULTS
  A five-year audit of data (2007-2012) from the Wellington Hospital Emergency Department revealed that paracetamol was the most common medication used for overdose (23%). National data on aminophenol derivatives accounted for 22.4% of poisonings in New Zealand's public hospitals. An online search found that 25 out of 27 online pharmacies sold packets containing 50 grams of paracetamol. However, the literature supported restricting packets to the minimum threshold for an acute exposure (10 g).
  
  
  CONCLUSIONS
  Paracetamol poisoning is the most common form of drug overdose in many developed countries. Tightening restrictions on the quantity of paracetamol sold per packet, in all outlets in New Zealand, may be an effective strategy to reduce overdose rates. This includes online pharmacies where large quantities of paracetamol per packet are available for sale.
authors.forename: Nadia
authors.initials: N
authors.lastname: Freeman
authors.affiliation: Emergency Medicine, Capital & Coast District Health Board, Private Bag 7902, Wellington, New Zealand. paul.quigley@ccdhb.org.nz.
authors.forename: Paul
authors.initials: P
authors.lastname: Quigley
mesh_terms: D000082:Acetaminophen / Q000191:economics / Q000506:poisoning* / Q000600:supply & distribution; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000191:economics / Q000506:poisoning* / Q000600:supply & distribution; D062787:Drug Overdose / Q000453:epidemiology / Q000517:prevention & control*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D040261:Harm Reduction; D006801:Humans; D040541:Marketing; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D060946:Pharmaceutical Services, Online / Q000191:economics; D055815:Young Adult
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen