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Suicide‐related over‐the‐counter analgesic exposures reported to United States poison control centers, 2000‐2018
Author(s) -
Hopkins Alexandra G.,
Spiller Henry A.,
Kistamgari Sandhya,
Zhu Motao,
Michaels Nichole L.,
Funk Alexandra R.,
Smith Gary A.
Publication year - 2020
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4997
Subject(s) - medicine , acetaminophen , ibuprofen , over the counter , analgesic , poison control center , pharmacoepidemiology , odds ratio , emergency medicine , poison control , injury prevention , occupational safety and health , anesthesia , pharmacology , medical prescription , pathology
Purpose To investigate suicide‐related over‐the‐counter (OTC) analgesic medication exposures among individuals ≥6 years old reported to United States (US) poison control centers. Methods Data from the National Poison Data System for the years 2000‐2018 were retrospectively analyzed. Results From 2000 to 2018, US poison control centers recorded 549 807 suicide‐related cases involving OTC analgesics, including 327 781 cases (59.6%) admitted to the hospital and 1745 deaths (0.3%). Most cases involved a single substance (67.5%) and occurred among females (72.7%) and individuals 6‐19 years old (49.7%). Overall, the rate of exposures increased significantly by 33.5% from 2000 to 2018, primarily driven by the increasing exposure rate among 6‐ to 19‐year‐old females. From 2000 to 2018, exposure rates for acetaminophen and ibuprofen increased, while that for acetylsalicylic acid decreased. Additionally, the proportion of cases resulting in a serious medical outcome or healthcare facility admission increased for all types of OTC analgesics. Acetaminophen and acetylsalicylic acid accounted for 48.0% and 18.5% of cases, respectively, and 64.5% and 32.6% of deaths, respectively. Both acetaminophen and acetylsalicylic acid had greater odds of healthcare facility admission (ORs 2.56 and 2.63, respectively) and serious medical outcomes (ORs 2.54 and 4.90, respectively) compared with ibuprofen. Conclusions The rate of suicide‐related OTC analgesic cases is increasing. Acetaminophen and acetylsalicylic acid cases are associated with greater morbidity and mortality. Prevention efforts should include implementing unit‐dose packaging requirements and restrictions on package sizes and purchase quantities for acetaminophen and acetylsalicylic acid products to reduce access to large quantities of these analgesics.