Hawton et al., from the Centre for Suicide Research, at Oxford, studied statistics on paracetamol and aspirin overdosage from before the 1998 Department of Health legislation and afterwards.
The 1998 legislation had placed restrictions on the maximum number of tablets allowed in a pack, and the maximum number of tablets allowed in an over the counter sale.
Professor Hawton's research, conducted in a number of centres throughout the UK, showed the following:
- The annual number of deaths from paracetamol overdoses decreased by 21% and the number of deaths from aspirin overdoses by 48%.
- Liver transplant rates after paracetamol overdose decreased by 66%.
- The rate of non-fatal self-poisoning with standard paracetamol decreased by 15%.
- The average number of tablets taken in all paracetamol overdoses decreased by 7% and the number of serious overdoses, that is those involving more than 32 tablets, decreased by 17%.
- Large aspirin overdoses (over 32 tablets) decreased by 34%.
The group concluded that the 1998 legislation restricting pack sizes had substantial beneficial effects on self-poisoning (overdose) using these pain relievers.
The legislation was intended to reduce impulse overdoses which are usually made using whatever is to hand in the home. This it appears to have done.
The legislators acknowledged that those seriously intent on suicide would probably not be deterred. Indeed, experience shows that there is little that is effective in preventing a serious attempt at suicide.
The 1998 legislation caused considerable inconvenience to the public in general and to those suffering from chronic pain in particular and, by making pain relievers available only in small packs, increased costs to the public. However, the PIC now believes that the restrictions strike a reasonable balance between availability of pain relievers to the public and reduction of self harm.
Update: In November 2004 Professor Hawton and his group published a further update on the effects of the 1998 legislation. This "before and after" study showed a long term sustained reduction in suicide deaths from paracetamol and aspirin overdoses and a significant decrease in the number of tablets taken in non-fatal overdoses. See BMJ abstract "UK legislation on analgesic packs: before and after study of long term effect on poisonings" in the "Specialised Subjects of Interest: Useful Abstracts" section on this website.
Keith Hawton et al. - Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study, BMJ (May 19, 2001) 322: 1203-1207.
Keith Hawton et al. - UK legislation on analgesic packs: before and after study of long term effect on poisonings, BMJ (November 6, 2004) 329: 1076-1080.