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Health

Paracetamol poisoning on the rise, TGA considers limiting how much people can buy

It's usually found in supermarkets and convenience stores and most of us would have some at home.

But right now the medicines regulator, the Therapeutics Goods Administration (TGA), is considering whether to put some restrictions on how paracetamol is accessed, because of concerns about its use in self-harm.

The commonly used drug – while safe when used correctly – is behind half of all self-poisoning attempts in young Australians and causes up to 50 deaths each year, as well as injuries.

A worrying trend of the past decade is increasing rates of intentional self-poisoning with paracetamol.

The TGA has been consulting with the community on potential changes to how it's sold and who it's sold to.

'Alarming rise in poisonings'

Earlier in the year the TGA released a report which made several recommendations, including limiting how many paracetamol tablets or capsules are sold in each pack and how many packs can be bought.

The review was ordered by Liberal MP David Coleman when he was the assistant minister for mental health and suicide prevention.

"I was very concerned about the alarming rise in paracetamol poisoning, particularly for girls and young women," he told the ABC's AM program.

"We'd seen increases over a decade of more than 200 per cent."

He would like to see all seven recommendations of the report implemented in full.

"These recommendations will significantly reduce paracetamol poisonings and they will save lives," he said.

The TGA has been asking for public feedback and will use it to decide whether to alter the Poisons Standard — which determines how paracetamol can be accessed.

Dramatic reduction in harm linked to reduced availability

Between 2019-2020, there were more than 8,700 paracetamol poisonings.

Most hospital admissions were due to intentional poisoning and young people between 10-24 years accounted for almost half.

Paracetamol poisoning can lead to liver damage and the need for a transplant, and even death. 

"Evidence from the UK showed a dramatic reduction in the need for liver transplants and deaths from paracetamol overdose when they restricted the amount of paracetamol that was available in packets," said Gold Coast GP Professor Mark Morgan, also with the Royal Australian College of GPs.

"Overall restricting access to paracetamol would reduce deaths and harms from overdose. We don't know to what extent, but evidence from overseas shows it could be as high as a 50 per cent reduction."

But Professor Morgan added it is a balancing act and there is a need for most people to be able to access short amounts of paracetamol easily for short-term health issues like headaches and flu-like illnesses.

He said the most important recommendation suggested is to make modified release paracetamol prescription only. It's harder to treat poisoning from this type of drug.

"Although deaths from paracetamol are quite rare, it's absolutely devastating when it happens," Professor Morgan said.

"It's a really significant cause of intentional self-harm and it's devastating because people are not aware of the liver damage being done and the need for hospital care immediately after an overdose."

Retailers support restricting quantity but not age

Retailers support restricting pack sizes and how many people can buy.

But in its submission to the TGA, the Australian Retailers Association does not support the recommendation to restrict sales to over 18s, arguing it'd be costly to set up a system to verify ages of customers.

It said the other measures recommended are strong enough.

Mr Coleman wants retailers to reconsider.

"There may be some minor inconvenience to retailers but frankly that is a very minor consideration relative to the very important issue of saving the lives of children," he said.

"We've seen in Denmark a very significant reduction in paracetamol poisonings by children when the product sale was restricted, when children couldn't purchase it without a prescription.

"That is a key recommendation of this report, it should be implemented in full."

Calls for more mental health support for young people

The TGA is also recommending improving safety information and expanding support for people after their self-poisoning attempts.

Often the paracetamol used in overdoses was already in the home. It's hoped measures like reducing the amount in packs will limit stockpiles in the home.

The rising incidences of intentional self-poisoning in older children and adolescents have been seen all over the world in the past decade.

"We've seen disturbing increases in mental health conditions over the past decade, particularly for girls and young women," Mr Coleman said.

"There are various views on the factors that have contributed to that. I think it's clear the rise of social media has contributed to that.

"If we're wanting to address self-poisonings by young people, if we're wanting to reduce that, which of course we should as a society, we need to implement these recommendations because they will save lives."

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