Overdoses show risks of widely sold painkiller

Consuming large amounts of paracetamol at once can cause life-threatening liver failure. Photo / Glenn Jeffrey

Auckland City Hospital sees on average six adults a week who have poisoned themselves with New Zealand's most widely used painkiller.

A specialist in the adults emergency department, Dr Bernard Foley, said a few of the patients accidentally took too many doses of paracetamol for a headache, but in most cases people had deliberately harmed themselves.

An Auckland mother is calling for greater restrictions on supermarket sales of medicines after her daughter's overdoses.

Raewyn said her teenager Alice (not their real names) had twice overdosed on painkillers. The first time she obtained them from the home medicine cupboard; the second time she took paracetamol she had bought at a supermarket.

"Before then, she was the nerdiest, straightest kid - teacher's pet, never did anything wrong. My husband and I were splitting up. She was at [secondary school] and struggling to fit in. Quite a few of the girls were cutting themselves and she was doing that."

Alice was treated both times at Starship children's hospital and recovered. She received counselling and is now at university and doing well.

Raewyn now wants supermarket sales of all drugs banned, or at least new tobacco-style requirements that stocks be put behind the counter and sold only to adults who can prove their age. The risks of the drugs justifies this, she says.

Consuming large amounts of paracetamol at once can cause life-threatening liver failure.

Dr Foley said one or two paracetamol overdose patients a week at his hospital were in a serious enough condition for intravenous therapy with the antidote glutathione, which was very successful if started soon enough.

On average one patient every two years was referred for consideration of a liver transplant after failure to respond to the therapy. In the past 10 years, one had received a transplant and four were considered unsuitable for medical reasons.

Paracetamol was a very useful drug and safe if used according to the label, he said. The benefits to the community of having small packs available at supermarkets outweighed the risks.

In the United States, the Food and Drug Administration is yet to review advisory panel recommendations to reduce the single maximum dose of paracetamol - known there as acetaminophen - from 1000mg to 650mg. New Zealand's Ministry of Health indicated changes to the rules for supermarket sales were unlikely.

* People needing help can call Lifeline, 0800 543 354