@article {Gunnell175, author = {D Gunnell and K Hawton and V Murray and R Garnier and C Bismuth and J Fagg and S Simkin}, title = {Use of paracetamol for suicide and non-fatal poisoning in the UK and France: are restrictions on availability justified?}, volume = {51}, number = {2}, pages = {175--179}, year = {1997}, doi = {10.1136/jech.51.2.175}, publisher = {BMJ Publishing Group Ltd}, abstract = {OBJECTIVE: To investigate the relationship between the availability of paracetamol and its use for overdose and suicide. DESIGN: Analysis of routinely collected information on time trends for paracetamol suicides, non-fatal overdoses, and sales. SETTING: England and Wales and France. RESULTS: There were strong correlations between trends in paracetamol sales in the UK and trends in non-fatal paracetamol overdose in Oxford between 1976 and 1993 (Spearman{\textquoteright}s r = 0.86; 95\% confidence interval (CI) 0.54, 0.96) and between paracetamol sales and non-fatal overdoses in France between 1974 and 1990 (r = 0.99; 95\% CI 0.97, 1.00). Sales figures were also correlated with paracetamol related suicides in both England and Wales, 1983-91 (r = 0.72; 95\% CI 0.11, 0.94) and France, 1974-90 (r = 0.79; 95\% CI 0.50, 0.92). Similarly strong relationships were observed between trends in non-fatal overdoses and suicide by paracetamol poisoning in England and Wales (r = 0.85; 95\% CI 0.61, 0.95) and France (r = 0.79; 95\% CI 0.50, 0.92). It is estimated that approximately 32,000 overdoses involving paracetamol occur annually in England and Wales. Fatality rates from paracetamol overdose were four times as high in England and Wales (0.4\%, 95\% CI 0.38, 0.46) as in France (0.1\%, 95\% CI 0.06, 0.17). CONCLUSION: Trends towards greater availability of paracetamol are paralleled by increases in its use for both non-fatal overdose and suicide. Paracetamol related morbidity and mortality seem to be less frequent in France where the quantity of paracetamol in a single purchase is limited. Although not conclusive, these data add to a body of evidence which suggests that restrictions in the quantity of paracetamol available as a single purchase in the UK may reduce suicide and liver failure related to paracetamol.}, issn = {0143-005X}, URL = {https://jech.bmj.com/content/51/2/175}, eprint = {https://jech.bmj.com/content/51/2/175.full.pdf}, journal = {Journal of Epidemiology \& Community Health} }