Dunedin student's paracetamol overdose: Medsafe to consider recommendations on paracetamol sales

Alannah Spankie did not take the paracetamol with the intention of taking her own life, an inquest found.

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 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.

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The committee received 18 submissions on 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.

Medsafe is going to consider coronial recommendations about the sale of paracetamol following the death of a Dunedin student in 2017. Photo / File

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.