Paracetamol restrictions considered after Dunedin student's death

A month ago, drug-buying agency Pharmac wrote to the country’s pharmacists instructing them to...
Photo: ODT files.
Medsafe's medicines classification committee will today consider coronial recommendations about the sale of paracetamol made after the inquest into the death of a Dunedin student.

Alannah Lee Spankie (20) died from acute liver failure in June 2017, after the University of Otago science student took a large amount of paracetamol.

Coroner David Robinson last month found that Ms Spankie had not intended to take her own life, and recommended tighter sales restrictions be placed on drugs which can currently be bought without controls at supermarkets.

The committee received 18 submissions on Mr Robinson’s recommendations before today’s meeting, being held in Wellington.

The National Poisons Centre, based at the University of Otago, said in advice provided to the committee that paracetamol was the most common single substance involved in cases of intentional self-poisoning, and the substance it received the most inquiries about.

In the last five months of 2016 there were four cases involving people who took 30g or more of the drug, centre records showed.

In 2020, up until October 12, there were 54 such cases.

"Contacts to the centre are a reflection of exposures occurring in the New Zealand community," centre director Adam Pomerleau said.

"This data suggests that paracetamol exposures requiring medical assessment, and massive paracetamol overdoses, are likely occurring with increasing frequency over time."

Dr Pomerleau cautioned that the centre recorded only information given by individuals so the actual extent of the problem was uncertain, as was whether the availability of paracetamol was a factor.

"However, a reasonable hypothesis would be that limiting availability could limit opportunities for impulsive intentional self-poisonings."

The Pharmacy Guild said that it supported some restrictions on paracetamol sales, particularly from general retailers, but did not agree with all of the coroner’s proposed quantities.

"We are concerned that general sale retail outlets do not have the expertise to provide the level of advice and support required to ensure sufficient public safety for a medicine such as paracetamol when sold as a general sale medicine," guild membership and professional services manager Nicole Rickman said.

"Therefore, limiting the pack size to 16 x 500mg paracetamol tablets per transaction when sold by retail outlets will not effectively address the issues of unintentional overdose and harm reduction."

Paracetamol was the most commonly used pain relief medicine in New Zealand and was usually safe if taken at the recommended doses, she said.

"We are comfortable when paracetamol is sold through the pharmacy channel it is safe and controlled."

Drug company Johnson and Johnson said there was no current or historical evidence of widespread inappropriate use of paracetamol containing cold and flu products.

The firm called for paracetamol’s classification and sale regulation to remain the same, but supported better information for consumers on how to use paracetamol safely.

Glaxo Smith Kline also supported the status quo for paracetamol’s classification, but agreed a two-packet purchase limit outside of pharmacies would help, as would a government-backed public information campaign.

mike.houlahan@odt.co.nz

 

Comments

Where will the nanny state stop at? Read/follow the directions/warnings on the package. Nearly every item we buy can be harmful if used/consumed the wrong way. We seem to forget the tragedy involved another item-alcohol- so we restrict that as well? When will we take responsibility for our own actions?

I disagree. The attitude towards paracetamol in this country is dangerous. Of course people are responsible for their own actions but people will always assume that something that is freely available everywhere can't be that bad. Also, I have never seen warnings on paracetamol packages actually saying "you risk permanent liver damage and death if you take more than the recommended dosage". I think especially parents would be a lot more careful then and not always give their kids paracetamol when they just have a little elevated temperature. Paracetamol is handed out in school like lollies. My daughter told me that most kids in intermediate and high school regularly go to the office to get some if they don't feel 100%. If the office staff won't give them any more they just send a friend. When I had a fractured rib the hospital staff gave me an amount of paracetamol and ibuprofen that could probably kill a horse when all I needed was some bed rest and taking it slow for a while. It' insane! I am not saying people should suffer in pain but we have to learn that pain is a warning sign from our body and not everything can be fixed with pain killers.

Government focus should be widened to look at the factors that create the societal behavioural patterns around assumption that something must be ingested every time people desire a state change. As a culture we have been barraged by advertising for years telling us we need alcohol to relax, sleeping pills to make us sleep, and pain killers to make us feel happy. Most every kid knows the brand of beer you need to drink to become an All Black. And we even have adverts teaching us what pharmaceuticals we should ask our doctors to prescribe for us.

What would happen in society if Jilinda focused her massive advertising machinery on educating society that you can party without alcohol (and drugs if a coalition is being formed). What if serious advertising taught us that most aliments that make us reach for pain killers can be better solved by eating adequate fresh fruit and vegetables, drinking adequate water, and getting enough sleep?

Perhaps restrictions on paracetamol sales are focusing on the symptoms instead of the problem. More bureaucracy around access to headache pills will most likely just create more headaches!

Unfortunately, many doctors rapidly prescribe paracetamol for almost everything, rather than looking for the underlying cause of the issue at hand, so that's not helping anyone, except the doctors' bank account...

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