The more obvious probability is that other mainstays such as aspros and ibuprofen have been variously tarred themselves with paracetamol identified as the safer go to. Hence its use is up.
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It seems that young people are more likely to misread or misunderstand label info, or forget it later, or be unlikely to read this info at all. Many are unable to understand the safe number of doses per day.
This is more likely among less literate populations.
âMisunderstanding and Potential Unintended Misuse of Acetaminophen among Adolescents and Young Adultsâ by Shone (J Health Commun. 2011)
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An interesting idea. So is paracetamol use up overall, or has the use not changed much but misuse has? There are studies showing misuse has risen but I canât find any figures on per capita consumption over time. Any takers?
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You can find lots of market research most being on pages soliciting market research purchases with teaser information. The few with enough details to get an idea indicate it is growing more than 4% year on year. The reasons seem to be avoided with the exception that prices have done down so demand has gone up. Separately there are pages showing various comparisons of aspros, ibuprofen, and paracetamol that all have side effects, but paracetamol has fewer, especially on the stomach.
Are those pages convincing or succinct? I think not so no links from me, here.
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https://www.tga.gov.au/sites/default/files/2022-09/paracetamol_report_final.pdf Go to pp 57-69, and see esp p63 and p69. Interestingly, overall consumption per head of population hasnât changed much.
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Absolutely ineffective. I would even go so far as to say paracetamol has never been particularly effective in its normal tablet presentation, let alone slow release. I canât take aspirin anymore, so panadol is the only thing left to me. I take the soluble panadol and it works. It also works so well I donât need to take it often enough to stuff my liver.
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Panadol is paracetamol.
PANADOL Tablets contain 500 mg of paracetamol as the active ingredient. PANADOL Mini Caps contain 500 mg paracetamol as the active ingredient.
Other than coatings that might make one version easier to take or quicker to absorb (according to marketing or better from clinical trials) the difference between branding is their advertising and price. Some versions (eg with particular coatings or soluble or liquids) might be better for any given individual as @SueW mentions.
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As you say no particularly noticeable consumption trend over time, for the period of data collection (2017-21) at least.
So of the three possible reasons mentioned so far for the increase in poisoning; increases in consumption, carelessness or use for self-harm, the report suggests the third.
Page 69 sums it up:
2.7 Summary and conclusions on Australian data on paracetamol poisoning
There are increasing rates of paracetamol poisoning in the last decade. Predominantly this increase is in intentional self-poisoning in children and adolescents, and females in particular. This increase may have further accelerated during COVID years (but only the PIC data is available in the last two years). This is in the setting of a large increase in all self-poisonings in children/adolescents, which roughly doubled over the decade up to 2018. Paracetamol is taken in around 50% of these events and this proportion has not substantially changed in the last decade. The majority of paracetamol self-poisonings in all age groups are impulsive but with suicidal intent. It is common for these individuals to have repeated episodes of self-harm. Depression, anxiety, PTSD, borderline personality disorder and ADHD were the top 5 psychiatric diagnoses recorded in all age groups.
{The copy/paste has mucked up the paragraphing but you get the drift}
I have my doubts that reducing the pack size from 20 to 16 will have any effect on young women attempting self-harm.
Perhaps we need more effort spent on the health of those seeking self-harm regardless of preferred mechanism and less on regulation of pills that happen to be getting used more at the moment.
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âŠas well as ways to reduce internet, societal, and personal bullying that leads some people to a point of despair.
Classical advice such as turn the other cheek, donât listen, and so on is so old school and ineffective in these days were it can be fuelled by 24x7 pile-ons.
Some targets are more equipped to handle that than others. Some are, at least for a while. Addressing the issue as a focus on the targetâs health without a holistic view of what is going on, why, and how to start reducing or mitigating it seems like an equivalent of throwing money at a problem without reference to the problem.
+1
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As can be read on p4, âOur literature review noted that reduction in pack
size has been found to reduce deaths from poisonings by about a third, although effects may
be less for non-lethal outcomes. One study restricted the sale of paracetamol to people over
18 years and found a 17% reduction in self-poisoning for those under 18 years (but no change
in the other age cohorts).â
So, awareness programs, medical regulation, and mental intervention are probably all needed. There will not be a point at which poisonings will cease entirely. Itâs a horrible way to suffer and die.
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Blood plasma levels for solid presentations of paracetamol do not always reach levels sufficient to cause pain relief, esp if taken with food. Assuming that older people with chronic pain are more likely to take slow-release formulations, then perhaps this is where they make errors by reaching for added doses. In the report I linked, there was the suggestion of making slow-release an S4 medicine.
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I know. I should have called it one or the other. ex-nurse here and not so old Iâve forgotten :-P~~~~
Indeed. Better access to CBT and DBT would be a good start. O course no matter what is available, the individual has to want to change their behaviour and then it depends on whether the reward for change is greater than the reward for not changing. Sadly, its often the latter.
The change from bottles of paracetamol to blister packs slowed things down for a while :-/
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Forgive me if this has already been answered but how many people died in Australia due to paracetamol overdose in, say, calendar year 2022?
If three people died in 2021 and two people died in 2022 then thatâs a one-third reduction. Or it could be three thousand down to two thousand? Without some absolute numbers it is difficult to assess what policy responses might be justified. Not that the government cares what we think of their justification anyway. 
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The quoted paper is an aggregation of 15 international studies not the death rate in Oz.
You would have to dive deep into it (or maybe the individual studies) to find out the answer to your question, or the more important one (to me) of what is meant by âreduction in pack sizeâ.
The outcome of the review in Oz is quoted above. One area of reduction is the supermarket pack size. This is the easiest source for most people and the new ruling is the pack size will drop from 10g to 8g. The number of packs you can buy is not mentioned, I have bought 4 at a time without anybody blinking.
The lethal dose is variously quoted at around 150mg/kg of body weight. So if our thought experiment for impulsive self harm is a distressed young woman of 60kg that is 9g. Some references say the lethal dose is 10g, 12g, some as much as 24g. Apparently individual susceptibility is variable, as is body weight.
So if there are two of the old packs lying around the house she is fairly sure to have enough to be very ill if not dead. But the same applies to new pack size. This does not seem a significant change to me.
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Honestly, if the Australian government canât tell me that up front then they shouldnât be changing anything at all.
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You seem to be confusing logic with politics. The likely decision making process was, if we make the change we will be seen as doing something to fix a problem and some of our donors will benefit, so we will make that change.
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Maybe that can but do not want to? You could try a FOI?
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Just because I havenât found it doesnât mean it isnât there. Have you done any searching anywhere?
Hereâs an idea; google the string âhow many people died of paracetamol overdose in australiaâ. At the top of the list is this from the TGA:
Recent data shows that each year in Australia, paracetamol overdose leads to around nine people per million hospitalised with liver injury and two deaths per million â or about 50 Australian lives lost .
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I donât think that focusing on deaths alone is the only point. In the expert report (p142) there were ~42000 hospital admissions of paracetamol poisoning and ~18000 calls to Poisons Info Centre.
I have no problem with reducing pack sizes down to the recommended 12-16 tabs. 16 tabs = 8g or 2 days at MRD of 4g/day. If anyone needs more than 2 continual days supplies of paracetamol then perhaps they should seek further medical advice.
And itâs not as if price at present is a problem; I buy generic at Woolies at a price of 80c per 20 pack! If someone really wants to stock up, they simply can go in and out of the store a few times. A suicidal person is unlikely to do that because they act on impulse with whatever is lying around.
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